Are you walking this morning???

Don't forget to turn back your clock TONIGHT!

Happy Halloween!!

What are the symptoms of pancreatic cancer?

Because the pancreas lies deep in the abdomen, a doctor performing an examination on a patient would not be able to feel a pancreatic tumor. Pancreatic cancer has few early warning signs, and as a result, pancreatic cancer rarely is discovered early. Many times the diagnosis is not made until the cancer has spread to other areas of the body.  When early symptoms do occur, they are often vague and nonspecific and can be confused with symptoms caused by medical conditions other than pancreatic cancer.

 Possible early symptoms that should be evaluated by your physician are:

*  The symptoms of pancreatic cancer are easily explained by the location of the pancreas in relation to other organs in the body.  A tumor located in the head of pancreas may cause jaundice to occur. The signs of jaundice are yellow skin and eyes, dark urine, and light clay-colored stool. Jaundice occurs when a substance called bilirubin builds up in the blood. This build-up causes a person to become noticeably yellow, or jaundiced and itchy.

*  As pancreatic cancer grows and spreads, pain can develop in the upper abdomen and may also spread to the back. The pain may become worse after eating or lying down. Advanced cancers or cancers in the body of the pancreas are most likely to cause pain.

*  Indigestion, lack of appetite, nausea, and weight loss can occur when a pancreatic tumor presses against the stomach and small intestine.  These symptoms may be due to the ability of pancreatic cancers to produce certain proteins that dramatically change the body’s normal physiology.

*  Islet-cell cancer, which is the uncommon form of pancreatic cancer, can cause the pancreas to make too much insulin, which results in low blood sugar levels. When this happens, the individual may feel weak or dizzy. Chills, muscle spasms, and diarrhea are frequent symptoms of islet-cell cancers as well. The symptoms that develop depend on the specific hormones that are being overproduced.


*  Other symptoms that can occur with pancreatic cancer result from the spread of the cancer to other parts of the body, a process called metastases. Under these circumstances, the symptoms will depend on which organs have been affected by the cancer.

http://www.lustgarten.org/get-informed/what-are-the-symptoms-of-pancreatic-cancer-page

You can make a difference!

Hereditary Pancreatic Cancer

What is Hereditary (Familial) Pancreatic Cancer?

Today, oncology investigators and clinicians agree that at least 10% of all pancreatic cancers are inherited. This means that pancreatic cancer has a tendency to run in certain families, and scientists want to know why. The risk of developing pancreatic cancer increases 2-fold for a person who has one first-degree relative (mother, father, brother, sister) with the disease. Having multiple affected members increases risk even more. The term Familial Pancreatic Cancer (FPC) is for families with 2 or more family members with pancreatic adenocarcinoma (the most common form of pancreatic cancer).

What are Familial Registries and Why are They Important?

Gathering information from families with a history of pancreatic cancer offers an opportunity to study the cause of cancer of the pancreas. This information is helping to devise new ways to diagnose pancreatic cancers in earlier stages, and ultimately, to develop better treatments for the disease. These registries are research-based. While your participation in one of these registries may help investigators learn more about familial pancreatic cancer, your participation in a registry does not substitute for clinical care by your own doctors.

What are Surveillance Programs?

A number of research programs studying how best to screen for early pancreatic pre-cancer have also been created. These surveillance programs differ throughout the United States, and each program designs its own research and clinical protocols. For example, some involve periodic screening of individuals with an increased risk of pancreatic cancer using endoscopic ultrasound (EUS). Just as is true for family research registries, your participation in a surveillance program does not substitute for clinical care by your own doctors. All Surveillance Programs and Familial Registries share a common goal: To learn more about the biological cause of familial pancreatic cancer in the hopes of developing early detection strategies and better treatments for the disease.

Walk for a cure. You can make a difference!

Want to volunteer?

Volunteers are among our greatest assets. Here are some opportunities to consider:

At Our Office Headquarters

If you reside on Long Island and would like to help, we'd love to meet you!
Office hours are weekdays, 9 am – 5 pm ET.

At Our Events

Volunteers are among our greatest assets. The Lustgarten Foundation hosts Walks all over the country and volunteers are needed for the following areas: Set-up, registration, greeters/crowd control, distributing refreshments, rest stops, assisting along the route and cheering walkers across the finish line. Find a Walk in your area, and register to volunteer today!
In addition to Walks, we also host several fundraising events throughout the year. Volunteers are always need to assist with set-up, registration, and greeting guests.

The Gift of Volunteering

We encourage students, scout groups, and teachers with their classes to get involved.
Volunteers Make It Happen! Contact us today and get involved!

Contacts:

Walks:Ann Walsh
516.803.2419
AWalsh@cablevision.com

Special Events:Suzanne Igneri
Special Events Coordinator
516.803.2339
signeri@cablevision.com

Distinguished Scholar Award

The Distinguished Scholars program is a new Lustgarten Foundation initiative that will identify and fund the best minds in research today to engage in pancreatic cancer research.  The grantees are selected by The Lustgarten Foundation’s Scientific Advisory Board based on their historical accomplishments of breakthrough research.  As a Lustgarten Foundation Distinguished Scholar, each grantee is required to:

1. devote at least 75% of their total time to research.
2. dedicate a major portion of their research efforts to pancreatic cancer, and commit a significant effort as Principal Investigator of the Pancreatic Cancer Research Project (PCRP).
3. direct and dedicate a portion of their laboratory to the project with a reasonable number of lab personnel dedicating 100% effort to the PCRP.

Continuation of annual funding is contingent upon the achievement of predefined research milestones and approval of scientific progress reports. 
More information about the 2014 Lustgarten Foundation Distinguished Scholars is included below.

Ronald M. Evans, Ph. D.

Dr. Ronald M. Evans is a Howard Hughes Investigator, March of Dimes Chair in Developmental and Molecular Biology, and a Professor and Director of the Gene Expression Laboratory at the Salk Institute.  Dr. Evans has received numerous awards for his research, most notably the Albert Lasker Award for Basic Medical Research in 2004 and the Wolf Prize in Medicine in 2012.  Dr. Evans is an authority on hormones and how they communicate signals in the body.  Several of the hormone signals Dr. Evans discovered are primary targets in the treatment of breast cancer, prostate cancer, pancreatic cancer and leukemia, as well as osteoporosis and asthma.  Most recently he has been studying the use of Vitamin D in the treatment of pancreatic cancer in the laboratory.  As a Lustgarten Foundation Distinguished Scholar, he will expand these studies to conduct clinical trials in pancreatic cancer patients using Vitamin D therapies.

Douglas Fearon, M.D.

An internationally known expert in the field of immunology, Dr. Doug Fearon will assume a new joint position on July 1 at Cold Spring Harbor Laboratory and Weill Cornell Medical College.  Dr. Fearon  focused his studies initially on rheumatoid arthritis and is now applying that knowledge to cancer. Recently, he discovered a new drug that harnesses the immune system to break down the protective stromal barrier surrounding pancreatic cancer tumors and enables cancer-attacking T cells to penetrate it.  One of his first goals as a Lustgarten Foundation Distinguished Scholar will be to conduct clinical trials to test this new drug combination in pancreatic cancer patients. Previously, Dr. Fearon was a Sheila Joan Smith Professor of Immunology in the Department of Medicine at the Cancer Research UK Cambridge Institute.

David Tuveson, M.D., Ph.D.

Dr. David Tuveson, who heads the dedicated laboratory for pancreatic cancer research at Cold Spring Harbor Laboratory, discovered that drug delivery to the tumor can be enhanced by degrading hyaluronan, a major component of the dense matrix surrounding the pancreatic tumor. Currently, there is a clinical trial underway to test if pre-treating patients with PEGPH20, the modified enzyme that degrades hyaluronan, will increase the amount of active drug delivered to the tumor cells. Additionally, he has adapted a culturing technology called “organoids” as a model for studying pancreatic cancer, which allows cells of a patient’s tumor to be grown outside of the body and in a tissue culture dish. The goal is to use a patient’s personal organoid to study its unique genetic makeup and biology, which will allow basic researchers and clinicians to test the effectiveness of different drugs on the organoid before testing them on the patient in the clinic.

Bert Vogelstein, M.D.

Dr. Bert Vogelstein is a Howard Hughes Investigator, Clayton Professor of Oncology and Pathology, and director of the Ludwig Center for Cancer Genetics and Therapeutics at the Sidney Kimmel Comprehensive Cancer Center of the Johns Hopkins University School of Medicine.  He has led the way in the use of genetics technology to better understand genes and their mutations in order to treat and detect a variety of aggressive cancers.  He was first funded by The Lustgarten Foundation in 2007 to sequence the genome for pancreatic cancer, and his findings were published in the prestigious journal Science, which designated the project as among the top three 2008 "Breakthroughs of the Year." Since then, he has applied his vast expertise of genetics to early detection techniques for pancreatic cancer, which has led to the development of an early detection blood test in the laboratory that is now being tested in clinical trials with patients. The Lustgarten Foundation Distinguished Scholar grant will enable Dr. Vogelstein to continue his critical work in developing the first early detection test for pancreatic cancer.

https://www.lustgarten.org/get-research-informationdistinguishedscholaraward

Meet us at Sloan's Lake!

Early Detection Initiative

Lustgarten Foundation-Funded Research Study Holds 

Potential to Detect Pancreatic Cancer at Earliest Stages

The Johns Hopkins Kimmel Cancer Center announced results from a new research study that holds the potential to detect pancreatic cancer at an early stage by determining harmless pancreatic cysts from precancerous ones. Published in the July 20 edition of the prestigious Science Transnational Medicine, the research study was primarily funded by The Lustgarten Foundation and represents the first study from projects that were created through The Lustgarten Foundation’s Pancreatic Cancer Research Consortium.

Led by Dr. Bert Vogelstein, a Pancreatic Cancer Research Consortium member and scientific advisor of The Lustgarten Foundation, the research is a cooperative effort between Johns Hopkins and Memorial Sloan Kettering Cancer Center, in collaboration with Indiana University. Johns Hopkins and Memorial Sloan Kettering both serve on the Foundation’s Consortium. Created in 2010, the Consortium is a collaboration involving six world-renowned medical institutions to advance the most promising research initiatives aimed at ultimately finding a cure for pancreatic cancer.
A significant percentage of pancreatic cancers begin as pancreatic cysts, fluid filled growths in the pancreas.  This study has uncovered a specific combination of gene mutations that can distinguish cancerous cysts from some non-cancerous cysts by obtaining small volumes of liquid obtained from patients by needle biopsy.  This is a critical step toward early detection that holds the potential for testing cysts that have been discovered through imaging technologies, like an MRI, using endoscopy techniques (similar to a colonoscopy).  Dangerous cysts would be removed immediately, before they became a malignant cancer, and benign cysts could safely be left alone without the risks of unnecessary surgery.
For more information, please see the full press release from Johns Hopkins.

Wake up early on Sunday for a good cause!

Donate your car!

The Lustgarten Foundation is please to accept all types of vehicle donations including autos, trucks, sport utilities, motorcycles, motor homes, boats, farm equipment and construction equipment.

Our program is managed by Auto-Donation.com, a respected national vehicle donation program, allowing us to accept and process vehicle donations in all 50 states.

Donating is simple and your vehicle does not need to be in running condition. Auto-Donation.com will make arrangements to have your vehicle picked-up and brought to auction for sale. The Lustgarten Foundation will receive the highest possible returns for you donation once your vehicle is sold - on average nearly 80 percent. After the sale, Auto-Donation.com will provide you with a receipt for your tax-deductibile donation.

Thank you for your support! Your donation will help fund urgently needed pancreatic cancer research.

http://www.lustgarten.org/DonateYourVehicle

Are you walking?

Artificial Pancreas Offers New Hope For Diabetics

AURORA, Colo. (CBS4)– Researchers are getting closer to perfecting an artificial pancreas which may offer new hope for Coloradans living with diabetes. The device takes the guesswork out of managing thedisease.

“Because my mom and dad knew the signs,” said 18-year-old Dominic Villano, a type 1 diabetic who was diagnosed at age six.

The disease runs in the family, Dominic’s father, Dean, is also a diabetic and also was diagnosed at age six.

Dominic checks his blood seven times a day and takes insulin shots. It hasn’t stopped him from playing sports but his disease is always on his mind.

“Is my blood sugar high or low, am I going to get low during a football game or something like that is probably the worst part,” said Dominic.

Dominic Villano tests his blood (credit: CBS)

Diabetes treatment has come a long way since Dominic’s father was diagnosed with diabetes.

Dr. Peter Chase with the Barbara Davis Center for Childhood Diabetes at the University of Colorado Anschutz Medical Campus in Aurora has cared for both Dominic and Dean.

At the center, researchers have been testing an artificial pancreas system to help diabetics automatically control their blood glucose levels.

“It doesn’t do away entirely with blood sugar checking but most people go down in the number they do per day,” said Chase.

“No shots would be a huge deal,” said Dominic.

It could be a game changer for those living with diabetes.

The Children’s Diabetes Foundation supports the Barbara Davis Center. The 29th Denver Carousel Ball Fundraiser is scheduled for Oct. 2 where John and Paige Elway will be honored

http://denver.cbslocal.com/2015/09/16/artificial-pancreas-offers-new-hope-for-diabetics/

AngioDynamics' NanoKnife prolonged pancreatic cancer patients' survival: study

A paper published in the September issue of Annals of Surgery found that Irreversible Electroporation performed on 200 patients with locally advanced pancreatic cancer had prolonged their survival. The procedure used Latham-based AngioDynamics’ NanoKnife technology. The study was partially funded by a grant from AngioDynamics.

The study’s goal was to “evaluate the effectiveness of IRE as a consolidative therapy in combination with chemotherapy and/or chemoradiation therapy in the management of LAPC.”

The NanoKnife removes soft tissue with a series of high-voltage, low-energy electrical pulses. It is approved by the U.S. Food and Drug Administration for use in the removal of soft tissue but not as a therapy or treatment for any specific disease or condition, the company said.

AngioDynamics is headquartered in Latham, with local manufacturing operations in Queensbury.

An abstract of the article is available here.

http://blog.timesunion.com/business/angiodynamics-nanoknife-prolonged-pancreatic-cancer-patients-survival-study-finds/68335/

Tumor cells associated with pancreatic cancer work with each other to increase tumor spread

Tumor cells associated with pancreatic cancer often behave like communities by working with each other to increase tumor spread and growth to different organs. Groups of these cancer cells are better than single cancer cells in driving tumor spread, according to new research from the Perelman School of Medicine at the University of Pennsylvania published in Cancer Discovery online in advance of the print issue.

Ben Stanger, MD, PhD, a professor in the division of Gastroenterology, and first author Ravi Maddipati , MD, an instructor in the division of Gastroenterology, say that these results may prove useful in designing better targeted therapies to stop tumor progression and provide an improved non-invasive method for detecting early disease states in this highly lethal cancer. Stanger is also a professor in the department of Cell and Developmental Biology and the Abramson Family Cancer Research Institute.

Cancer genome studies have shown that within most tumors there exists many different types of cells, which often harbor unique genetic alterations that lead to differences in their physiological properties. Previous studies using tumor cells lines suggested that these different tumor cell types may interact with each other to produce a more aggressive type of cancer. However, the mechanisms by which tumor cells interact to enhance the spread of cancer remained unclear.

From other earlier studies, the Penn team also knew that cells from a primary tumor do better replicating and surviving in a group rather than if they are grown on their own. From this, the researchers asked if the spread of cancer is primarily derived from one cell or a cell cluster derived from the interactions between different cancer cell types. Stanger and Maddipati tested the hunch that clusters of cells of different genetic makeup were better at establishing secondary tumors and found that a significant fraction of metastases involve seeding by more than one type of tumor cell during the natural course of pancreatic tumor progression.

To understand this spread, the Penn researchers developed a mouse model that uses multiple fluorescent proteins to tag and track different pancreatic cancer cells as they enter the bloodstream and spread to distant organs. In this mouse model, mutations in Kras and p53 genes resulted in the formation of individual tumor cell populations that were labeled with different colors. Similar to humans, the mice developed tumors at secondary sites including the liver, lung, peritoneum, and diaphragm. They observed that these metastases were often made of cells from at least two different colors of tumor cell populations. To understand how these multi-colored lesions originated they examined blood from these mice and found that tumor cells in circulation frequently occurred as clusters comprised of different colored cancer cells.

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What's more, they also found that once these multi-colored clusters arrived at the secondary sites, the exact characteristics of subsequent growth was heavily dependent on the organ in which they now resided. During cell expansion in the peritoneum and diaphragm the lesions remained multi-colored, whereas in the lung and liver only a single color population was able to grow out. This suggested that specific factors in each organ may also influence the evolution of metastases.

"These results provide an unprecedented window into the cellular dynamics of tumor evolution and suggest that interactions between subpopulations of tumor cell types contribute to metastatic progression from initial tumors," Stanger said. "The finding that metastases are frequently polyclonal and that subsequent cellular behavior is site-dependent also gives us insight into the origins and evolution of clonal diversity in metastatic disease."

"If cells do cooperate during metastasis, what is the molecular basis for their communication, and can we hit that?," Stanger asked. The work also reinforces the importance of finding tumor cell clusters in the blood as a mechanism of detecting cancer metastasis earlier.

http://www.news-medical.net/news/20150813/Tumor-cells-associated-with-pancreatic-cancer-work-with-each-other-to-increase-tumor-spread.aspx

Source:

Penn Medicine

After 30 years, Tauer still ready to battle cancer

See the full article at http://www.bizjournals.com/memphis/blog/2015/08/after-30-years-tauer-still-ready-to-battle-cancer.html

Beating Pancreatic Cancer

Posted on Aug 12, 2015

Ronald Chamberlain, M.D., surgeon-in-chief and chairman of the Department of Surgery at Saint Barnabas Medical Center, doesn't sugar-coat what happened to Elizabeth Sprague of Maplewood: "She is that 'one in a million' who survives pancreatic cancer," he says.

This cancer is particularly deadly because there are no screening tests to find it early. By the time any symptoms show up, it has almost always spread to the lymph nodes and other areas of the gastrointestinal tract. The actual survival rate of patients with node-positive pancreatic cancer is about 5 percent, Dr. Chamberlain says. So while "one in a million" is a bit hyperbolic, five in 100 are still odds no one would bet on.

Yet the odds are improving, thanks to advances in surgical, chemotherapy and radiation treatments. And the future holds even more promise, with genetic testing that will be able to help oncologists target specific tumors with the treatments most likely to be successful.

Sprague, who was diagnosed in November 2007, didn't have those options yet. The retired airline employee, who will admit to being "over 39," and her husband, David, a retired engineer, have three grown children and eight grandchildren. While she was undergoing endoscopic testing for gastroesophageal reflux disease (GERD) and for noncancerous colon polyps, her physician noticed a small tumor on her pancreas. "He said, 'Do me a favor, please have another imaging test,'" Sprague says. "That one found cancer."

Her reaction, she admits, was a bit odd. "I went home and cleaned my closets," she recalls with a laugh. "That's how I dealt with it."

In truth, Sprague tackles most things with clear-headedness and humor. "I knew it was serious, but I didn't dwell on it," she says. "That wouldn't make it go away. I told my children that this was not a morbid situation; we just had to take care of it."

She was referred to Dr. Chamberlain. "I immediately felt comfortable with him," she says. "He calmly explained what he would do, and I said OK, let's go." He scheduled surgery for Jan. 3, 2008, because she wanted to wait until after the holidays.

Pancreatic cancer requires a difficult operation called the Whipple procedure. "It's very complex and involves removing parts of five different organs—the pancreas, small intestine, bile duct, gallbladder and stomach," Dr. Chamberlain says. Then the remaining pieces must be reconnected into a functioning system. "The operation used to take 20 hours, but now we can do it in about four," he says.

Dr. Chamberlain did not offer a prognosis, Sprague says. "But he did say to my husband, 'If I am out in 45 minutes, it isn't good. The longer I am in there, the better the situation," she says. "He didn't come out for quite a while, so that was promising."

Sprague spent about two weeks in the hospital. Recovery was not bad, she says. "I have a scar that is now disappearing, but I don't wear a bikini anyway, so it doesn't matter if it completely disappears." She has fond words for the staff at the hospital. "The attitude of the people I encountered in the cancer ward was extremely nice—not morbid, very pleasant and caring," she says. "They had someone come in and play the harp, and the first time I thought, 'Oh no, that's the music they play when you go to Never-Never Land!" she says with a chuckle. "But I found it very relaxing."

Chemotherapy and radiation followed, but Sprague suffered no side effects, thanks to improvements in the therapies. And now, "I feel great," Sprague says. "I am a very lucky person." Someone in her position today is luckier still, says Dr. Chamberlain. "Medicine is in the middle of a revolution, from disease specific care to patient-specific care," he explains. Until now everyone has been treated essentially the same way. "Now they are treated differently, based on genetic aspects of their particular tumor. Today I would send a tumor like hers for bio genomic profiling," he says. "That can tell us what drugs it might respond to and what drugs it might not." For example, African- Americans tend to respond poorly to a certain drug because they typically possess an enzyme, which Caucasians don't have, that breaks the drug down. "Other genes may reveal a certain growth factor, which would make a particular drug a great choice," he says. These changes are helping to push pancreatic cancer survival rates into the 15 to 30 percent range.

"That is by no stretch a home run, but it is a substantial improvement," says the doctor. Only a reliable screening test similar to colonoscopy or mammography will bring those numbers up to the levels now seen in other cancers, but that is still year's away, he cautions.

Until then, Sprague is helping others newly diagnosed with pancreatic cancer to prepare for the daunting road ahead. "She brings a tremendous ability to look at it in a positive light and has talked to or met with 30 to 40 different patients about the Whipple surgery," Dr. Chamberlain says. "She steps in and explains that it's not the 1960s anymore. It's 2013, and medicine is advancing."

http://www.barnabashealth.org/Press-Center/Saint-Barnabas-Medical-Center-News/2015/Beating-Pancreatic-Cancer.aspx

UK Study

Birmingham Study Day by Jeni Jones.

Posted by: Information and support 12 August 2015

- See more at: http://www.pancreaticcancer.org.uk/our-blog/2015/august/birmingham-study-day-by-jeni-jones/#sthash.mmdhxbJ8.dpuf

Tuesday 7th July saw the Pancreatic Cancer UK Hepatobiliary and Pancreatic study day for Health Professionals take place at the University Hospitals of Birmingham Postgraduate Centre.

Mr.Keith Roberts explained to attendees what they could expect from the day and this was followed by an excellent presentation by his colleague, Professor Darius Mirza, who spoke about vein resection during pancreatic surgery. He emphasised the fact that studies have demonstrated a survival benefit for vein resection over palliative surgery. Keith Roberts then took to the stand for a second time on the prediction of pancreatic fistula following pancreatoduodenectomy. He commented that the rate across most HPB units was 20-25%, and that drain fluid amylase was the key to diagnosis.

We then had a very stimulating presentation by Mr Ravi Marudanayagam, Hepatobiliary and Pancreatic Surgeon at QEHB discussing the ESPAC 5 clinical trial in the surgical group of patients.  This is an excellently designed feasibility trial, with 4 arms, comparing immediate surgery (within 2 weeks of randomisation), with neoadjuvant chemo/chemo radiotherapy. Chemotherapy regimes used will be Gemcitabine/Capecitabine or Folfirinox, and in the chemorad arm, the chemotherapy is the choice of the clinician. The outcomes of this study will be very much anticipated.

Professor Sohei Satoi, from Osaka, Japan gave us two insightful presentations about his practice in Japan. The first was about surgery after down staging chemotherapy using the drug S-1. After 6 months of initial treatment with this drug, 15 out of 509 patients went on to have surgery for their previously unresectable pancreatic cancer.

His second presentation was on S-1, which is now considered as the new standard treatment for resected pancreatic cancer  patients in Japan, and it is well tolerated. It appears though, that toxicity from this drug will be greater in the Caucasian population, whereas, it is significantly less in the Japanese.

As ever, diet and the use of pancreatic enzyme replace therapy (PERT) was on our agenda. Mary Phillips gave another fantastic presentation on malnutrition in pancreatic cancer, and encouraged us to be more “aggressive” in feeding patients who are malnourished – in the inoperable setting.

Professor Harald Schrem from Hannover continued this theme presenting data from a study carried out between Hannover and Birmingham, evaluating the relationship between pancreatic enzyme replacement therapy and survival after pancreatoduodenectomy.

Our keynote lecture was from Professor Dominguez-Munoz, from Spain, who gave us a very clear and concise presentation on Pancreatic Enzyme Insufficiency (PEI). There can be no doubt after listening to him that we are not assessing these patients early enough, nor are we actually assessing all of the patients – in his opinion, all pancreatic cancer  patients will suffer from PEI and will need PERT.

Our own Anna Jewell, acting Director of Operations, gave an excellent round up of the work of Pancreatic Cancer UK, and the ongoing projects which people can get involved with.

After lunch, we had a very good presentation on enhanced recovery by Mr.Rob Sutcliffe from Queen Elizabeth Hospital, Birmingham (QEHB). Dr. Yuk Ting Ma spoke on down staging chemotherapy, and spoke about this from the point of view of the “pre Folfirinox” and “post Folfirinox” era.

Dr. Shakeeb Khan spoke on the local experience of down staging chemotherapy at QEHB, and Dr.Max Almond gave an overview of total pancreatectomy over the past 25 years.

Lewis Stephens presented on survival prediction based on lymph node ratio, showing that positive lymph node involvement has a significantly negative influence on post-op survival.

Perhaps the greatest congratulations of the day should go to Margaret Datson, who spoke about her own experience of being a pancreatic cancer patient. Margaret spoke eloquently, and replayed her journey in a measured and constructive way, from her own mother’s death from pancreatic cancer in 2000, to her diagnosis in 2006. Margaret spoke highly about the care and attention she received at QEHB. A poignant moment occurred at the end of Margaret’s talk, when she went to greet her surgeon on the front row, Professor Darius Mirza, and they exchanged a hug. This more or less epitomised the theme of the day at Birmingham, a theme of gratitude all around.

All in all, a great day was had at Birmingham, and we were delighted with the attendance. It was great to forge links with folk in QEHB, one of the largest specialist centres in the UK, and to see the day evolve after so much hard work from all involved. A massive thanks to all.

Our next study day will be in Crewe on the 19th October.

- See more at: http://www.pancreaticcancer.org.uk/our-blog/2015/august/birmingham-study-day-by-jeni-jones/#sthash.mmdhxbJ8.dpuf

For the Most Lethal Cancer: Find the Best Science

When I tell people that living with pancreatic cancer has some blessings, my statement typically is met with a curious disbelief that leaves me uncomfortable for having said it. But, the blessings are oddly true. Each day feels more alive, intense and important. I take the opportunity to tell my family and friends what they mean to me in great detail and with great regularity. It creates a life of love.

Meeting brilliant, courageous scientists and doctors (including my doctors, William Isacoff and Allyson Ocean) committed to changing the course of this disease is among these blessings as well. Knowing them helps me deal with the incomprehensible truth that there are no long-term treatments, no early detection tests and no cures for this most lethal cancer.

It may be unusual to call scientists courageous but research challenges in pancreatic cancer are immense. Pancreas tumors are complex and continually mutating. The K-RAS gene found to be mutated in the majority of pancreatic cancer patients has continued to stymie researchers' efforts to block it. The stroma, the barrier surrounding the pancreatic tumor, is a resistant shield preventing therapy from reaching the tumor effectively.

Although the past 40 years have given us very few (and no long-term) treatments for pancreatic cancer, there is now new progress from a number of exceptional scientists willing to focus on these challenges.

Getting to know some of these amazing scientists has not only enhanced my life, but it has reinforced the fact that pancreatic cancer patients and families must keep informed of the best science efforts. It is the key to extending our lives.

These organizations can provide some information. The Lustgarten Foundation is the nation's largest private funder of pancreatic cancer research; 100 percent of its funding goes to research due to the support of Cablevision. The Pancreatic Cancer Action Network is another valuable source for science and patient information.

Dr. Isacoff introduced me to Dr. David Tuveson, the director of research at The Lustgarten Foundation and director of The Lustgarten Pancreatic Cancer Research Laboratory in partnership with Cold Spring Harbor Laboratory. This is a picture of Dr. Tuveson.

When my family and I went to see the lab we were so galvanized. The scientific attack on pancreatic cancer made us feel that we were seeing history happen, giving us a fortifying glimpse into a positive future.

One of the projects of the lab is the generation of organoids, a new breakthrough investigative mechanism for pancreatic cancer. What makes organoids so exciting is that they can reproduce pancreatic tissue samples giving patients many potential benefits. This is a picture of the organoid from the lab.

Here is the paper in Cell.

First, these living tumor cells can be tested over time with a wide range of medications, enabling scientists to find biomarkers and identify new combinations of drugs to treat the disease. Simply, in the future, instead of pancreatic cancer patients being tested with new medications, organoids can endure that experience.

Second, organoids can speed up research and the search for treatment options which we urgently need. As Dr. Tuveson noted, "Patients are dying. Organoids will speed up the process for creating robust clinical trials by providing a whole new set of data based on this new access to living tumor tissue."

Third, organoids create more tissue for testing. A major research constraint has been the lack of tissue. Organoids will create a supply in pancreatic cancer tissue that will assist investigators. Indeed the lab provides an "organoid training school" so that many institutions will have access to the technology and tissue.

A young scientist, Dr. Hervé Tiriac, a postdoctoral fellow at the lab, has the responsibility to ensure that more than 40 organoids under his care are growing well and are being tested. Here is a picture of Dr. Tiriac.

Hervé's deep intelligence and passion for his work are clearly evident. He told me that he found this passion for making a difference in pancreatic cancer in a round-about way. A graduate of the University of California at Davis and San Diego, he first focused on hardcore genetics and biochemistry.

While in graduate school, he met Dannielle Engle a fellow scientist, and that changed his life. Her father had died of pancreatic cancer and her professional and personal mission is to cure the disease. Hervé and Dannie, now married, are a dynamic force for progress, working together in the lab.

I learned a lot talking to Hervé about the potential of organoids to extend life spans. Along with the organoid tumor cells, he is also growing organoids with normal cells. He said, "The hope is to weed out novel therapeutics that would be too toxic. That's why we test normal cells too."

He explained that organoids could help address the differences within pancreatic cancer by breaking tumors into subclasses that would be treated by different therapeutics. "With more tissue you have more to learn." he said. "Organoids can eventually offer models of personalized medicine for patients and become an excellent way to analyze the link between genetic mutations and treatment."

Talking to Hervé made me realize that organoid research may lead to the better design of clinical trials and faster, more effective treatment.

Staying on top of what is happening in leading scientific research is a lifeline for all pancreatic cancer patients and families. We have the most lethal cancer, and yet only 2 percent of the federal funding is directed to pancreatic cancer research!

While many extraordinary scientists are now working for cures and early detection tests, more than 40,000 people this year will die of pancreatic cancer.

We must all be familiar with the science and support these scientists. And we must advocate urgently for more private and public research funding. It will save our lives.

This blog is dedicated to Jeff Schmahl, my friend on this path, who inspired so many with his wonderful life.

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Significant breakthrough in pancreatic cancer treatment

Dr. Sunil Hingorani, pictured with Dr. Vikas Goel, right, unraveled the secrets of how pancreatic tumors thwart chemotherapy and developed a way to penetrate those defenses. These breakthroughs are so significant, he is fast-tracking this new treatment to help patients with metastatic pancreatic cancer.

Pancreatic cancer is a formidable foe. It grows fast and spreads quickly, often before any symptoms appear. And because of its notorious resistance to treatment, 97 percent of patients aren't alive five years after diagnosis.

Dr. Sunil Hingorani understands all too well the pain inflicted by a pancreatic cancer diagnosis. He lost his father to the disease, leading him on a personal and professional mission to find ways to beat it. His dedication is paying off with some of the most significant contributions in the fight against pancreatic cancer—including a breakthrough discovery that could change the way it is treated.

A few years ago, Hingorani developed the first mouse model that faithfully mimics human pancreatic cancer, from its precancerous inception to its advanced stages. This powerful tool has enabled researchers to get closer to understanding pancreatic cancer’s defenses better than ever before, opening the door to more effective ways to detect and treat the disease.

Using this model, Hingorani recently made two potentially momentous discoveries. He unraveled the secrets of how pancreatic tumors thwart therapies and then developed a way to penetrate those defenses. Most cancerous tumors grow blood vessels to deliver nutrients and oxygen to them, providing an entrance for chemotherapy drugs to gain access to the tumor.

In pancreatic cancer, however, Hingorani discovered that pancreatic tumors build a tough, protective shell—similar to scar tissue—that physically keeps chemotherapy from entering the tumor. This revelation explains why treatments that eliminate other cancers are ineffective here; the cancer drugs never reach the pancreatic cancer cells.

With this knowledge, Hingorani and colleagues found a way around the protective shell: Using their mouse model, the team employed an enzyme that digests and removes the scar-like tissue around the tumor. With the tumor defenses breached, the chemotherapy can enter and attack the cancerous tissue.

The results were so successful, Hingorani worked to get clinical trials fast-tracked. Hingorani, with his unwavering dedication to patients, is now leading an international trial for patients with metastatic pancreatic cancer, using a combination of the enzyme and chemotherapy.

Already, his work is bringing new hope to patients at Seattle Cancer Care Alliance, the treatment arm of the Hutchinson Center. “We’re not just treating a disease,” he said. “We are treating a person. Patients are not statistics. We think about this disease day and night.”

The Giles W. and Elise G. Mead Foundation is a longtime supporter of Dr. Sunil Hingorani’s pancreatic cancer research. In addition, a generous donation from Maryanne Tagney-Jones and David Jones challenged a community of supporters, and collectively their gifts helped make possible his potential breakthrough in treatment.

New treatment option for pancreatic cancer shows early promise

ANN ARBOR, MI - When someone is diagnosed with pancreatic cancer, surgery to remove the tumor offers the greatest potential for survival. But in the vast majority of cases, surgery is not an option, forcing patients and their doctors to look to other, less-effective treatments - often involving radiation together with chemotherapy, or chemotherapy alone. .

Even with these therapies, nearly all pancreatic cancer patients show evidence that the cancer has spread throughout the body within months of diagnosis, making it one of the most deadly and difficult cancers to treat. In 1996, the Food and Drug Administration approved a more effective chemotherapy drug called gemcitabine for use, and several leading medical centers have investigated techniques to combine this drug with radiation. But many of these studies have found the combination causes unacceptable side effects.

Now, a new University of Michigan study has now shown that the drug can be delivered safely in combination with accurately targeted radiation. In fact, the combination could actually be more beneficial than currently available therapy, without an increased risk of severe side effects.

In a paper published today in the Journal of Clinical Oncology, a team of pancreatic cancer specialists at the U-M Comprehensive Cancer Center reports that gemcitabine can be delivered at the recommended standard dose together with carefully aimed radiation without substantial side effects. This clinical study results from years of laboratory research at the U-M to understand the mechanism of interaction between gemcitabine and radiation, and technical advances in the delivery of radiation.

Previous research on this combination has focused on broadly targeted radiation therapy techniques with the addition of relatively low doses of gemcitabine. Although promising, the combination proved to result in unacceptable nausea, vomiting, and excessive weight loss.

The study reported today shows that the U-M technique, co-developed by Cornelius McGinn, M.D., assistant professor of radiation oncology and Mark Zalupski, M.D., clinical associate professor in medical oncology at the U-M Health System, produced relatively modest side effects and allowed the chemotherapy to be kept at a standard dose, rather than a reduced dose.

"Since pancreatic cancer spreads very easily, it is important to attack it throughout the body with effective chemotherapy. But treatment must also target the tumor in the pancreas itself, and that's where focused radiation comes in," McGinn says. "By investigating the appropriate radiation dose using a conformal radiation technique that spares non-cancerous tissue, we have effectively targeted the primary cancer while still delivering systemic therapy for potential spread, something no other study has attempted."

Encouraged by the initial results, the team of researchers will embark on a new trial later this year, testing the approach at the U-M and other medical centers throughout the country. The development of a specific clinic for patients with pancreatic cancer within the U-M Comprehensive Cancer Center is being considered as well, as a means to provide coordinated multidisciplinary care for this special patient population and develop further research efforts.

Pancreatic cancer is the fourth leading cancer killer, claiming almost 30,000 lives every year in the United States. Even more alarming is the fact that by the time pancreatic cancer is diagnosed, it is usually too late for surgical removal, with the average life expectancy being only six to nine months.

But the findings of the study conducted at the U-M Health System offer a glimmer of hope that survival time could be extended while patients enjoy a better quality of life.

The study looked at 37 patients with locally advanced pancreatic cancer, including many with evidence that the cancer had already spread. Over the course of three weeks, gemcitabine was given once a week during a course of radiation therapy delivered every weekday. The radiation was administered by conformal therapy directed at the primary tumor, without targeting any other areas at risk. After a week break, a second three week course of gemcitabine alone was given. Additional chemotherapy was then given to many patients, but not as part of the trial.

During the trial, seven different radiation dose levels were investigated in as many groups of patients. Some patients who received the highest doses of radiation did experience toxic side effects. As a result, the next trial will use a slightly lower radiation dose that was well tolerated.

McGinn says the overall results were promising. On average, patients lost less than 1 percent of their pretreatment body weight. In fact, more than 40 percent of patients were actually able to gain weight during the course of therapy. This is significant achievement when compared to results of previous studies of gemcitabine and radiation, in which patients often experienced substantial nausea, vomiting and weight loss occasionally resulting in hospitalization. The time required for daily radiation (three weeks) was appealing as well, when compared with more conventional course of radiation which requires five to six weeks.

Survival time for patients ranged from five months to longer than two years. Median survival was just over 11 months. Compared to the expected survival time for this group of patients, this result is encouraging. However, McGinn cautions that this doesn't represent a cure and noted that the trial was not designed to investigate outcome as a primary endpoint. It is possible, he says, that this approach represents new strategy which could be built upon for additional gains.

"Pancreatic cancer is a terribly tragic disease. We believe we have made a small step towards giving patients a chance at a longer and better life," he says. "The reality is we're still trying to learn more about pancreatic cancer and ways to treat it, without jeopardizing quality of life."

For more information on cancer care at the U-M contact the UMHS Cancer AnswerLine™ at 1-800-865-1125.