Pancreatic cancer has one of the poorest survival rates in the world due to the aggressive nature of the disease. Diagnosis typically occurs at a late stage, and individuals with the disease have debilitating symptoms that deteriorate rapidly with limited treatment options. Research into the pathogenesis of the disease and potential therapies which could improve both survival and the quality of life of individuals with the disease are therefore of paramount importance.

This thesis examines the geospatial trends of pancreatic cancer in England, the
glycaemic control of individuals with pancreatic cancer, and potential therapies such as exercise and prehabilitation. The incidence, mortality and survival of pancreatic cancer in England between 2013 and 2019 were mapped, and further analyses explored some of the potential risk factors associated. Continuous glucose monitors were utilised to compare the glycaemic control of individuals with pancreatic cancer and matched healthy individuals. The relationship between exercise and glycaemic control was investigated in a group of healthy participants and the facilitators and barriers to implementing a prehabilitation intervention for all individuals with pancreatic cancer was evaluated.

This thesis highlights hotspots in England where resources could be directed, and
interventions could target to reduce inequalities in incidence, mortality, and survival. It demonstrates that individuals with pancreatic cancer experience poor glycaemic control when compared to healthy participants which could be an area for intervention. It also highlights the key facilitators and barriers for both healthcare professionals implementing and for individuals with pancreatic cancer participating in prehabilitation which could be used as a framework for future prehabilitation programmes.