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Pancreatic Cancer
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The pancreas
The pancreas is a gland found behind the stomach. It measures about 9-10" long and is shaped somewhat like a tadpole, with the head (on the patient's right side) larger than the tail. The pancreas extends across the abdomen (behind the stomach and in front of the spine).
Pancreatic cancer is a disease in which cancerous cells form from the 2 kinds of cells in the pancreas. The ductal cells give rise to adenocarcinoma (the most common and the most dangerous of the pancreatic cancers), while the islet cells (those that produce insulin and other hormones) can produce pancreatic endocrine neoplasms.
Although Genevieve Sliker tells other cancer patients to be patient, she doesn't waste time herself.
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Treatment Team
The Pancreatic Cancer Team includes, among others you might see:
Gastroenterologists
Stephen J. Heller, MD
Jeffrey L. Tokar, MD
Melissa Thompson Griffin, PA-C
Medical Oncologists
Barbara Burtness, MD
Jonathan D. Cheng, MD
Steven J. Cohen, MD
Crystal S. Denlinger, MD
Efrat Dotan, MD
Paul F. Engstrom, MD
Pathology
Harry S. Cooper, MD
Radiation Oncologist
Joshua Meyer, MD
Surgical Oncologists
Yun Shin Chun, MD
John Michael Daly, MD, FACS
Nestor F. Esnaola, MD, MPH, MBA, FACS
John P. Hoffman, MD, FACS
Andreas Karachristos, MD
Elin Sigurdson, MD, PhD, FACS
James C. Watson, MD, FACS
Donna Edmondson, MSN, CRNP, OCN
These 2-cell systems have separate normal functions:
- The acini produce enzymes that are secreted into the pancreatic ducts. These enzymes are essential for digestion (food breakdown).
- The islet cells produce hormones, such as insulin and glucagon, that help control blood sugar levels. Both of these hormones help the body use and store the energy it gets from food.
Treatment for Cancer of the Pancreas
Patients with pancreatic cancer at Fox Chase Cancer Center are often treated by a team that includes surgical, medical and radiation oncologists, as well as gastroenterologists.
Pancreatic Cancer Surgery
Patients who are told their disease is unresectable elsewhere often seek treatment at Fox Chase. Sometimes a combination of radiation therapy and chemotherapy can be given prior to surgery in an effort to render surgical removal of the tumor possible.
John P. Hoffman, MD, FACS, Yun Shin Chun, MD, John Michael Daly, MD, FACS, Nestor F. Esnaola, MD, MPH, MBA, FACS, Andreas Karachristos, MD, and James C. Watson, MD, FACS are experts in complex pancreatic surgeries. They have successfully treated patients, including Bill Demesquita, who have very rare tumors, such as an osteoclast-like giant cell carcinoma (less than 50 reported cases in the world).
Their experience, with surgical volumes that rank in the top quarter in the country, results in the best possible outcomes. Each is constantly working to develop new approaches to effectively treat this cancer by offering minimally-invasive (laparoscopic) surgery where appropriate and continuing to optimize the use of other cancer therapies with surgery.
Systemic Therapy and Radiation Oncology
Fox Chase medical oncologists are leaders in the development of systemic therapy for pancreatic cancer using novel agents, vaccines and antibodies. This gives our patients unique access to exciting new treatment options before they become commercially available. Patients with advanced disease especially may benefit from access to new drugs. Radiation therapy and chemotherapy are also used to manage the disease. Three-dimensional conformal radiation therapy is used to spare normal tissue from the effects of radiation therapy.
Our expert team of medical oncologists includes Barbara Burtness, MD, Jonathan D. Cheng, MD, Steven J. Cohen, MD, Crystal S. Denlinger, MD, and Paul F. Engstrom, MD.
Dr. Jeffrey Tokar talks about interventional endoscopy
Tumors of the pancreas, bile ducts and ampulla (the common area where the bile duct and pancreas duct join each other and drain juices into the intestine) can cause yellowing of the eyes and skin (jaundice) if they block the flow of bile from the liver. The majority of these patients can be treated non-surgically, using endoscopic techniques. Gastroenterologist Jeffrey L. Tokar, MD, performs a procedure called endoscopic retrograde cholangiopancreatography (ERCP). During this procedure, plastic or metal stents can be placed in the bile ducts to restore bile flow and resolve jaundice. In certain situations, Dr. Tokar can remove tumors of the ampulla, eliminating the need for a more radical and invasive surgical procedure.
Improving Outcomes for Patients with Pancreatic Cancer
Fox Chase physicians are currently developing treatments combining radiation, new types of chemotherapy, and surgery to improve patient outcome. In addition, novel treatments directed at genetic targets are being developed by Fox Chase clinical scientists.
In addition, Fox Chase researchers are studying the proteomics (structure and function of proteins) of pancreatic cysts. Some of these cysts have the potential to develop into cancer. This research may help identify better diagnostic tests that will help doctors assess the malignant (cancerous) potential of an individual patient's pancreatic cyst, and help determine which patients would benefit from surgical resection for their pancreatic cyst.
