Pancreatic cancer is one of the leading causes of cancer deaths and is often viewed by doctors and patients alike as a veritable death sentence. But it doesn't have to be.
In April 2010, Steve Lockwood was diagnosed with Stage IV pancreatic cancer. Steve met with a local oncologist, as well as experts at UCLA and City of Hope. All spoke of conventional treatments and advised Steve to get his affairs in order. Then Steve met Dr. Nagourney. Steve is alive and well today, six years later. .
Cancers arising in the pancreas may not exhibit any noticeable symptoms in the early stage. Because of this, pancreatic cancer is typically diagnosed at a late stage making treatment difficult and prognosis poor.
Surgery is the most effective way to manage pancreatic cancers if the disease remains confined to the pancreas (Stage I). If the disease has progressed, then radiation or combinations of radiation plus chemotherapy are typically employed.
Unfortunately, pancreatic cancers are often advanced when first diagnosed and the only option left is chemotherapy. Despite years of study, there are no curative therapies for metastatic pancreatic cancer. Nonetheless, some patients have dramatic and durable benefit from chemotherapy.
We find that advanced metastatic pancreatic patients fall into several broad categories:
- The truly drug sensitive patients who will respond to numerous treatments and can benefit from the least toxic drug combinations
- A small minority of patients who are sensitive to "targeted agents" like Erlotinib (Tarceva)
- A large group of patients have distinct sensitivity to one of the three standard drug regimens used in this disease: Platinum-based (GemOx, Cisplatin & Gemcitabine), Taxane-based (GTX, Abraxane/Gemcitabine), or Irinotecan-based (FOLFIRINOX, FOLFIRI)
- A final group of patients are resistant to standard chemotherapeutics and should be considered for experimental therapies as early as possible.
Today, patients are selected for treatment based on physician experience, ease of administration or the cost of the chemotherapy combinations. Think what would happen if each patient received the therapy that was best suited to their unique tumor makeup.
This is why we perform functional profiling on your tumor to determine which drug or drug combination will most likely kill YOUR specific cancer.
One such patient had a dramatic response to the combination of Cisplatin plus Gemcitabine, leading to an 11-year survival with Stage IV pancreatic cancer. His story was the subject of a report in Scientific American in July 1998.
The liver is not typically a primary tumor site, especially in the United States. More often, cancer in this organ has originated elsewhere and metastasized. But, in adult primary liver cancer there are three subtypes.
The majority – about 90 percent – are hepatocellular carcinoma, which can either begin as a single tumor that increases in size or as a collection of tumors (multifocal). Hepatocellular carcinoma is particularly common in patients with underlying liver disease associated with hepatitis and cirrhosis.
Cancer of the bile duct, known as cholangiocarcinomas, occur in less than 10 percent of all cases. The cancer starts within the tubes that course through the liver carrying bile fluids and can then spread throughout the liver and to distant sites. These tumors also arise in the gallbladder itself.
The last type is even more rare, starting in the blood vessels within the liver. It can either be classified as angiosarcomas or hemangiosarcomas. These types of cancers are sometimes associated with exposures to hepatotoxins and typically grow rapidly.
Common Treatments for Liver Cancer
Surgery is usually the first form of treatment. Other liver cancer treatment options are also used in conjunction with surgery: Including thermal ablation, radiation, transplantation, alcohol injection and chemoembolization.
Partly because the liver is so active in its role as a detoxifying organ, it is characteristically resistant to many forms of "cytotoxic" chemotherapy. As a result, many active forms of therapy have little effect on this disease. Nonetheless, doxorubicin, cisplatin, Mitomycin-C, 5-FU, FUDR, gemcitabine and some of the newer targeted therapies like sorafenib and bevacizumab have shown favorable results in select patients.
What To Do Next?
Call us at (800) 542-4357 or click here to email us for additional information on how Dr. Nagourney and Rational Therapeutics can help you identify the most effective treatment based on your unique tumor makeup.