Pancreatic Cancer: Know the Facts

More than 60,000 people will be diagnosed with pancreatic cancer in the United States this year. Because it often doesn’t cause symptoms until it has progressed into later stages, the deadly condition can be very difficult to treat.

“Pancreatic cancer is hard to diagnose early because there’s no standard screening test for it,” says gastrointestinal oncologist and Associate Director of Clinical Research Maged Khalil, MD, with LVH Hematology Oncology (part of Lehigh Valley Topper Cancer Institute). “Most people experience symptoms before ever being checked for it.”

By the time Dr. Khalil sees most of his patients, they are already experiencing symptoms, including:

• Abdominal or back pain
• Blood clots
• Dark urine
• Fatigue
• Jaundice
• Light-colored stools
• Loss of appetite
• Nausea and vomiting
• Unexplained weight loss

However, even if Dr. Khalil and his team identify it early, pancreatic cancer is still problematic.

“Stage for stage, pancreatic cancer is associated with lower survival rates than many other cancers,” he says.

This is because pancreatic cancer is resistant to many standard therapies, partially because the tumors are often surrounded by connective tissue (making it difficult for treatments to reach the cancer).

Dr. Khalil sees pancreatic cancer in more men than women and usually in older patients, between the ages of 65 and 80. About 30 percent of his patients are smokers, and 5 percent have a history of pancreatitis, an inflammation of the pancreas, which can be caused by stones or heavy alcohol intake.

In addition, approximately 10 percent of all pancreatic cancers are caused by an inherited gene alteration, like BRCA1 or BRCA2.

“Diets high in fat and processed meat, obesity, a history of diabetes and exposure to industrial carcinogens also may increase your risk,” Dr. Khalil says.

While advanced pancreatic cancer is considered incurable, there are more treatment and care options available today than ever before at Lehigh Valley Topper Cancer Institute:

Expanded chemotherapy treatments

Within the last two decades, chemotherapy options for pancreatic cancer have expanded from a single drug to multiple that offer patients longer life expectancy and a better quality of life.

A multidisciplinary clinic (MDC)

Lehigh Valley Topper Cancer Institute offers cancer patients consultations with multiple cancer specialists through multidisciplinary clinics (MDC). For pancreatic cancer patients, the gastrointestinal cancer MDC brings together specialists from surgical oncology, radiation oncology, hematology oncology, nursing, radiology, pathology clinical trials, nutrition and social services. This collaborative, interdisciplinary group explains the patient’s diagnosis and offers recommendations for treatment. As part of the MDC meeting, the patient and his or her loved ones are encouraged to ask questions. A nurse navigator also attends the MDC and coordinates care for the patient afterward.

Access to clinical trials

Innovative pancreatic cancer research is taking place every day, including trials for new chemotherapy agents, targeted therapies and immunotherapies. At the Cancer Institute, the region’s only clinical trial for an immunotherapeutic pancreatic cancer vaccine is currently taking place. The randomized trial is evaluating a drug that “teaches” the immune system to fight pancreatic cancer recurrence by targeting specific genetic mutations that cause cancer cells to grow.

Patients at the Cancer Institute can participate in clinical trials through the National Cancer Institute Community Oncology Research Program, as well as clinical trials available at Memorial Sloan Kettering through the Memorial Sloan Kettering Cancer Alliance. We also offer pharmaceutical and investigator-initiated trials and can determine which clinical trial may be appropriate.

“We perform molecular testing on our patients’ tumors, which allows us to look for genetic mutations that we can target with specific medications,” Dr. Khalil says. “This helps us recommend the most appropriate clinical trials for each of our eligible patients. This is the future of cancer care, and it’s already here at our Cancer Institute.”