Pancreatic cancer is a very aggressive form of cancer; that may be why many think it is a death warrant.
“Many patients who could benefit from surgery are not being offered it. We need to change that,” said Gerard Aranha, MD, professor, Surgical Oncology, Loyola University Chicago Stritch School of Medicine (Stritch).
Survival rates for pancreatic cancer are improving, particularly at academic medical centers that perform a large number of pancreaticoduodenectomies, the medical term for what is often called the Whipple procedure. For this operation, patients should seek out a center that performs more than 10 procedures a year with mortality rates less than 3 percent. Loyola University Medical Center performs 40 to 50 of these extremely complex and extensive surgeries a year with a mortality rate of 1.4 percent.
In 2004, Dr. Aranha performed the Whipple procedure to treat Marilyn Ziaja’s pancreatic cancer. Like nearly all patients at Loyola that undergo the operation, Marilyn also had chemotherapy and radiation treatments to increase her chance of long-term survival.
Treatment decisions for any type of gastrointestinal (GI) cancer are made by Loyola’s multidisciplinary team of surgeons, medical and radiation oncologists, radiologists, pathologists, genetic counselors, nurses, social workers and dietitians. They meet every Thursday to discuss GI cancer patients and develop individualized treatments plans for each one of them.
“We try to optimize the sequencing of events to include all components of cancer treatment namely surgery, chemotherapy and radiation to improve patient outcomes,” said Sam G. Pappas, MD, associate Professor, Surgical Oncology, Stritch.
Loyola’s GI oncology team has been advancing the treatment for foregut malignancies (cancers found in esophagus, stomach, duodenum, liver, gallbladder, pancreas or spleen) with minimally invasive and robotic surgery approaches. Loyola is one of the few cancer centers in the Midwest to offer such procedures.
The team also offers the latest advancements in radiation therapy, such as intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT).
“We use IMRT and IGRT to treat GI cancers more precisely,” said William Small, Jr., MD, professor and chair, Department of Radiation Oncology, Stritch. “They help us direct and control the therapeutic radiation so that we can kill the tumor and preserve healthy tissue. We also use brachytherapy, which involves implanting tiny radiation-containing capsules into the tumor site. It is another effective, targeted way to destroy cancer cells while reducing side effects.”
GI oncology specialists emphasize the importance of early detection of pancreatic tumors, before the aggressive cancer spreads and eliminates the opportunity for surgery. Family history of pancreatic cancer, and abdominal pain that continues despite taking antacids should be discussed with a physician. It’s important to maintain a proper weight and a healthy lifestyle. Smoking and excessive alcohol use significantly increase the risk of pancreatic cancer.
The Loyola GI oncology team is researching experimental therapies for GI tumors including an innovative mobile device designed to deliver radiation to a tumor during surgery, and a vaccine for pancreatic cancer patients. The team’s hope is that the vaccine would cause the person’s immune system to produce antibodies that would attack tumor cells, causing the tumors to shrink and not come back.
Marilyn Ziaja is extremely grateful for the care she received nine years ago at Loyola. Since then, the GI oncology team has been working toward improving outcomes for all GI cancer patients through knowledge sharing using the latest techniques and research.