Pancreatic cancer is one of the deadliest types of cancer for both men and women in the United States, and its prevalence is expected to continue to rise. But doctors and scientists at Atlantic Health System are changing patient outcomes with clinical trials and a new high-risk surveillance program.
“The pancreas is a sensitive endocrine and exocrine organ involved in all metabolic processes. It makes perfect sense to target cancer metabolism with agents that can modify the response to current standard treatments in combination with other therapies,” says Angela Alistar, MD, a medical oncologist with Atlantic Health System.
The Pancreas and Pancreatic Cancer: A Brief Overview
The pancreas is a small, pear-shaped organ located in the upper left side of the abdomen, behind the stomach. It is responsible for producing digestive enzymes to help break down food (an exocrine function) and metabolism hormones such as insulin to process sugar (an endocrine function).
There are two types of pancreatic cancer: pancreatic exocrine cancer (begins in the cells that line the ducts of the pancreas) and pancreatic endocrine cancer (begins in the neuroendocrine cells of the pancreas.) Exocrine cancer is more common.
Signs and Symptoms of Pancreatic Cancer
Pancreatic cancer is often called a silent killer. Sometimes, late-onset diabetes mellitus (DM) or unexplained depression can be a warning sign of developing pancreatic cancer. However, pancreatic cancer doesn’t usually cause symptoms until the disease is advanced or has (metastasized (spread).
How is Pancreatic Cancer Detected?
Unlike other cancers, there are no standard screening tests for pancreatic cancer. And while certain antigens in the blood are elevated in people with pancreatic cancer, blood tests don’t allow for early disease detection because the levels don’t rise until the cancer is advanced.
Most often, pancreatic cancer is detected when late-stage symptoms like unintentional weight loss, jaundice (yellowing of skin and whites of eyes) and stomach pain that spreads to your side or back develop, or an imaging study (such as an MRI or CT scan) is done for other medical reasons. Genetic testing and imaging can be done if you have a family history of pancreatic cancer, although most pancreatic cancer is not inherited.
Current Treatment Options for Pancreatic Cancer
While you may not be able to prevent pancreatic cancer, you can lower your risk by maintaining a healthy weight, eating a diet low in fat, stopping smoking and limiting high-risk behaviors.
Surgery, chemotherapy and radiation therapy are the standard treatment options, depending on your overall health, the stage of the disease and characteristics of the tumor. While these treatments may delay the spread of the disease, there is no cure for pancreatic cancer.
New Detection Programs at Atlantic Health System
Early detection is crucial for improving patient outcomes, as it increases the chance of catching the disease when it’s more treatable. As Dr. Alistar explains, there are currently at least two new promising screening platforms being evaluated for detecting pancreatic cancer.
“These new platforms are not yet considered standard of care,” says Dr. Alistar. “However, it is likely that soon we will have a screening test for patients who have a high risk of developing pancreatic cancer.”
Building on that, Dr Alistar has developed a high-risk pancreatic cancer program for patients who either have a genetic disposition for developing pancreatic cancer or a family history of the disease. Through this program, interventions are introduced and new strategies for early detection are incorporated.
To further expand the quest for early detection, patients with pancreatic cancer can now participate in biorepository studies at Atlantic Health. Biorepository studies collect and analyze biospecimens for future research. A pancreatic cyst program is also available to Atlantic Health patients.
What’s Next in Pancreatic Cancer Care at Atlantic Health?
Oncology trials are the gold standard for finding new therapies, and Atlantic Health is leading the way with important clinical trials to find the most effective treatment options for pancreatic cancer.
According to Dr. Alistar, pancreatic cancer treatment will likely require a multi-faceted approach and a combination of several mechanisms of action. Under her leadership, treatment modalities such as targeting the KRAS pathway, or immune system, are being actively investigated at Morristown Medical Center. There, patients can participate in first-in-human, phase 1 and phase 2 clinical trials, which are offered and discussed from diagnosis throughout their medical journey.
“The only way to make progress in pancreatic cancer treatment is to participate in clinical trials,” Dr. Alistar says. “It’s also where you’ll find the best treatments.”
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