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According to the American Cancer Society® roughly 43,000 people are diagnosed with pancreatic cancer in the U.S. each year. However, fewer than one in five of these cancers are caught early enough to be surgically removed. Kevin Watkins, MD, Chief, Upper Gastrointestinal and General Oncologic Surgery Group, is a pioneering surgeon who was the first in the world to use a novel technique to treat pancreatic cancer. Dr. Watkins talks about pancreatic cancer risk factors and the latest treatments now available at Stony Brook University Medical Center.

What is pancreatic cancer?

Made up of abnormal cells or tumors, most pancreatic cancers begin in the ducts that carry pancreatic juices — the enzymes that aid digestion. Even when diagnosed in its early stages, pancreatic cancer remains a
difficult disease to cure. Signs and symptoms may not appear until the cancer is quite advanced. Signs to watch for include upper abdominal pain that may radiate to your back, yellowing of your skin and the whites of your eyes (jaundice), loss of appetite, weight loss, depression, unexpected onset of diabetes and blood clots.

What are the causes and risk factors for pancreatic cancer?

No one really knows what causes pancreatic cancer, but factors that
may increase your risk include:

  • Age: increasing age, especially over age 60
  • Gender: men have slightly higher rates than women
  • Race: African-Americans typically have higher rates
  • Weight: being overweight or obese
  • Other medical conditions: including chronic inflammation of the pancreas (pancreatitis) or diabetes
  • Family/personal history:  a family history of genetic syndromes such  as BRCA2 gene mutation, Peutz-Jeghers syndrome, Lynch syndrome, and familial atypical molemalignant melanoma. Also a personal or family history of pancreatic cancer.

Have survival rates improved for pancreatic cancer?

According to the American Cancer Society, for all stages of pancreatic cancer combined, the one-year relative survival rate is 20 percent, and the five-year rate is four percent. Survival rates are low because fewer than 10 percent of patients’ tumors are confined to the pancreas at the time of the diagnosis; in most cases, the malignancy has already progressed to the point where surgical removal is impossible. Although survival rates are low compared with other cancers,
they have slowly increased over the years, mostly due to — like with so many other forms of cancer — new tests that can help identify cancer earlier. Improved treatments also play a role.

What are these improved treatments?

We offer a breakthrough procedure called irreversible electroporation (IRE), which was pioneered by us in December 2009. In fact, we were the first in the world to use this technique for pancreatic cancer and to date have treated the most patients worldwide. IRE is a surgical technique that kills the cancer by using electrical fields to generate pores in the tumor cells. The NanoKnife®, a computerized system used for the procedure, uses brief and controlled electrical pulses to open microscopic pores in a targeted area. By increasing the number, strength and duration of the electrical pulses, pores in the cells remain open permanently, causing microscopic damage. The cells then die, and the body rids itself of these dead cells. The main benefit of IRE is that it gives us the potential to offer treatment to some patients who previously had no options. For those patients who are candidates, the procedure may result in a major improvement in quality of life and extended time beyond the anticipated few months associated with the advanced level of disease.

What other breakthroughs does Stony Brook offer?

Stony Brook surgeons also successfully performed the region’s first robotic pancreaticoduodenectomy for treating pancreatic cancer in 2009. Commonly referred to as the Whipple procedure, this minimally invasive procedure, which is one of the most difficult abdominal surgeries to perform, is considered the pinnacle of achievement in the field.

For more information on pancreatic cancer treatment, email Jennifer.Novotny@sbumed.org or call (631) 444-8086.

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