New treatment offers hope for pancreatic cancer patients 

New hope may be on the horizon for one of the most aggressive and deadly cancers - pancreatic cancer. This promising proclaim comes recently from the Mayo Clinic in Rochester, Minnesota which has been studying new methods of treating the third leading cause of cancer-related deaths in the U.S.  Considering that pancreatic cancer – which has the highest mortality rate of all cancers with 74% of all patients who die within the first year of diagnosis - is one of the few cancers for which survival has not improved substantially for nearly 40 years.  For 2019, the American Cancer Society estimates that 56,770 people will be diagnosed with pancreatic cancer in the U.S. with more than 45,000 who will die of the disease.

What makes pancreatic cancer so deadly is that it tends to spread quickly and is usually not found until it is advanced. Because the pancreas is hidden dep within the abdomen, it makes it difficult to see in imaging tests.  In addition, symptoms are often vague ranging from lower back pain, weight loss, or an upset stomach.

The Mayo Clinic is taking a different approach in treating pancreatic cancer – performing surgery on the disease that often is considered to be inoperable. What researchers have found is that if patients are treated appropriately and doctors are able to predict their long-term outcome, then surgery is worth the risk.

Up to one-third of patients diagnosed with pancreatic cancer are discovered at stage 3. Many of those patients will be told their tumors are not able to be surgically removed. Historically, doctors have given pancreatic cancer patients chemotherapy or radiation hoping it would cause the tumor to shrink from the artery or vein its ensnared. In this scenario, surgery is not usually considered an option. This is where the approach at the Mayo Clinic is taking a new direction in treatment. 

What has been done at the Mayo Clinic is to give patients with pancreatic cancer extended, personalized chemotherapy until levels of a tumor marker in the blood called CA 19-9 fall to a normal range. Then if a PET scan shows the tumor is destroyed, the doctors move forward with radiation and surgery. What has been found among 194 patients, who have been treated in this way, is that 89 percent lived longer than the expected 12 to 18 months.  This new approach of treating pancreatic cancer has extended the average survival to five years after diagnosis.

It should be noted that this approach of using surgery to remove pancreatic cancer does not work for all patients diagnosed with stage 3 cancer. If a patient receives chemotherapy but their tumor does not shrink or respond or if other patients are too sick to tolerate the therapy, then they would not be considered good candidates.  Also, the approach that the Mayo Clinic is taking is only for patients who have stage 3 pancreatic cancer. If the cancer is more advanced, this approach is not used. As Dr. Mark Truty of the Mayo Clinic stated, “It’s all about timing. Putting things together, knowing when to stop chemotherapy and moving on to the next step.