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Advanced Imaging Technologies
When a patient with pancreatic cancer comes to Memorial Sloan-Kettering, the extent of disease is carefully determined through advanced computed tomographic (CT) scanning and laparoscopy, a minimally invasive procedure. This careful evaluation allows for precise determination of the extent of the disease, facilitating appropriate, individualized therapy and avoiding unnecessarily extensive surgery. Patients are then treated with surgery, chemotherapy, radiation therapy, or immunotherapy, alone or in combination.
Planning surgical treatment or selecting other therapies for pancreatic tumors depends on high-quality diagnostic imaging of the tumors. Memorial Sloan-Kettering has a team of radiologists who specialize in pancreatic cancer. Diagnosing pancreatic cancer can be difficult since this part of the body is complex and includes several organs and major blood vessels. Computed tomography, magnetic resonance imaging (MRI), ultrasound, and nuclear medicine scans are the main noninvasive methods. Diagnostic imaging techniques have become more sophisticated, capable of revealing more details such as the exact size, density, and nature of a newly diagnosed tumor and response to treatment. In some cases, diagnosis is performed invasively, by removing a small amount of tissue for a biopsy, or by inspecting parts of the interior of the abdomen using a scope.
New Approaches to Therapy
Memorial Sloan-Kettering has several new programs, including the use of radiation therapy with or without chemotherapeutic agents such as gemcitabine, a potent radiation therapy sensitizer, to treat pancreatic cancer that cannot be removed surgically in order to improve the patient's quality of life and relieve pain.
Innovative research efforts are currently under way involving improvements in surgical techniques, advances in radiation therapy and combinations of radiation therapy with drug therapy, and the use of novel chemotherapeutic agents. Newer treatment options, available in clinical trials, include biologic therapy for advanced and recurrent disease.
Clinical researchers in the Gastrointestinal Oncology Service are evaluating pancreatic cancer vaccines as a way to prevent recurrence of the disease. One approach focuses on the common mutations of the K-ras protein that occur in 85 percent of pancreatic cancers. Treatments and combinations of treatments are being investigated for patients whose cancer has spread locally and to distant sites of the body, including chemotherapeutic drugs (e.g, gemcitabine, irinotecan, paclitaxel, flavopiridol, and exatecan), and combinations of chemotherapy and radiation therapy.
