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Increasing The Odds Against Pancreatic Cancer

Many people believe there are no long-term survivors from pancreatic cancer — but thankfully, that’s not true. Ask Richard Luze, associate vice chancellor for development programs at Washington University, who is cancer-free six years after his diagnosis. He received aggressive therapy from Washington University specialist at the Siteman Cancer cneter and Barnes-Jewish Hospital. “I was treated at one of the top places in the Untied States for pancreatic cancer, and some of the best doctors in the country were part of my medical team,” Luze says. “They were outstanding, and the care I received was wonderful.”

Since pancreatic cancer is so often deadly, it needs to be managed by experts who specialize in treating the disease. Siteman has one of the highest-volume pancreatic cancer programs in the United States. The three Washington Unviersity surgeons in the program perform close to 200 pancreatic operations each year.

Pioneering New Procedures for Better Survival

Among the operations are some 125 Whipple procedures, a complex operation that includes removing the head of the pancreas — if the cancer has arisen in that area — along with the gallbladder, the common bile duct, most of the duodenum and part of the stomach. Washington Unviersity surgeon Steven Strasberg, MD, has played an instrumental role in refining the procedure in recent years. He and his colleagues pioneered a modification to the technique that involves sewing the pancreatic duct to the bowel during surgery, which drastically reduces the risk of life-threatening leakages from 15 percent to less than 2 percent.

Surgical mortality and morbidity rates from the Whipple procedure are extremely low at Stieman, where surgeons have lengthy experience in performing it. Mortality rates are less than two percent. For pancreatic cancers that arise in the body and tail of the pancreas, these Washington University surgeons have also developed a highly effective removal procedure called RAMPS (radical antegrade modular pancreatosplenectomy) with encouraging survival rates.

Making Progress Through Research

We feel strongly that every patient with pancreatic cancer should be in a clinical trail to test novel methods of diagnosis and treatment,” says surgeon David Linehan, MD. “Without this kind of study, we can’t make much progress against this disease.

Linehan and other members of Siteman’s pancreatic cancer team are also scientists who engage in basic and clinical research that can translate into new treatments. In a newly published study, they showed that an aggressive and creative combination of treatment methods –the Whipple procedure, chemotherapy, immunotherapy and radiation therapy — resulted in an extraordinary three-year overall survival rate of 41 percent. Richard Luze was the third patient entered in this study, soon after it began.

Other studies also show promise for the future. One is investigating genetic biomarkers that can improve early detection and predict whose cancer will recur. Only 7 percent of patients with pancreatic cancer are diagnosed at an early stage, which is why the cancer is so deadly. Another study is looking at novel drugs for pancreatic cancer treatment.

Long-Term Survivors Give Hope

Right now, pancreatic cancer is too often lethal. But Washington University physicians are contributing to a brighter future with new treatment regimens and surgical innovations. “Historically, the diagnosis of pancreatic cancer was tantamount to a death sentence,” Linehan says. “But through aggressive treatments and cutting-edge research, we now have several long-term survivors who are a source of hope and inspiration.”

That includes long-term survivors like Luze. “The Whipple procedure is the granddad of all abdominal surgeries, a very massive operation, and you want to go to a place where they have done a lot of them and know how to treat patients afterward,” he says. “You want the very best doctors, giving the best medical treatment.

Article from Innovate (Summer Edition of 2008)

By: Candace O’Connor

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