Pancreatic Cancer Exhibits Very Vague Symptoms. Diagnostic Images Are Appropriate To Look For Evidence of Pancreatic Cancer.
Written By Debra Gelbart
March 20, 2018
Ron Korn, M.D., Ph.D., a world-renowned radiologist specializing in cancer imaging, wants you to pay attention to any symptoms you might be experiencing that could indicate the presence of pancreatic cancer. “Early detection can be a critical factor in long-term survival,” said Dr. Korn, who is also the Medical Director of Oncology at HonorHealth in Scottsdale. Imaging modalities constantly undergoing refinement are the key to that early detection.
Symptoms of pancreatic cancer in its earliest stages may include low energy, nausea, vomiting, abnormal stools, pain or discomfort in the upper abdomen that may extend to your back, loss of appetite, sudden, unexplained weight loss, jaundice, blood clots or diabetes in the absence of risk factors such as being overweight or having a family history.
We tend to think of pancreatic cancer as rarer than other cancers such as breast, prostate, lung and colon cancers. But by the year 2025, Dr. Korn points out, pancreatic cancer could become one of the nation’s top cancer killers. In fact, as of the date of this article (2018), pancreatic cancer has surpassed breast cancer to become the 3rd leading cause of cancer deaths in the USA.
The Importance of Medical Imaging
A physician will probably order an ultrasound and/or a computed tomography (CT) scan first if there is any concern about pancreas abnormalities, Dr. Korn explained. “A CT scan in particular gives us a really important look at the patient’s anatomy to see if anything structurally is going on that could explain their symptoms.” If the CT scan findings are concerning for a mass, then an endoscopic ultrasound may be ordered next. A biopsy may be taken at that time and could lead to a confirmed diagnosis of pancreas cancer.
To determine if the cancer has spread, a CT of the chest, abdomen and pelvis is then performed to look for the spread of disease. What’s known as a positron emissions tomography (PET) scan may be ordered next.
“An FDG (radioactive glucose) PET scan is an essential part of the diagnosis toolbox,” Dr. Korn said. In about 20 percent of patients, “we find more cancer than the CT scan can show because pancreas cancer metastasis takes up radioactive glucose (called FDG) more than normal cells. This gives us a very exquisite look at any potential areas of disease. And, these PET scans are helpful to look for improvement in the radioactive glucose (FDG) uptake in cancer cells. If that’s evident on a PET scan, our research—which has been supported through the generosity of the Seena Magowitz Foundation—has shown this usually is a very good sign that the treatment is working. You’re more likely to have a better outcome from your treatment than if the PET scan does not change.”
In 2012, Dr. Daniel Von Hoff of the HonorHealth Research Institute developed the Gemcitabine-Abraxane combination therapy for pancreatic cancer. During the early development of this new therapy, Dr. Korn was “very excited” when he looked at a patient’s PET scan and noticed that “dozens of tumors had disappeared shortly after the patient got started on the investigational combination drug therapy regimen.” Until that time, he had never seen such a dramatic response to treatment. Dr. Korn added, “PET has proven to be critical with new drug therapies and is used to show the Food and Drug Administration that a new therapy regimen is working” and can help accelerate FDA approval of new drug therapies. “Imaging plays a huge part in treatment regimens and improving the outcomes of patients with pancreas cancer,” Dr. Korn said.
Next Generation of Imaging For Pancreatic Cancer
The earliest possible detection of pancreas cancer is the projected “next-generation” advancement in pancreatic cancer management, Dr. Korn said, and researchers and clinicians like him are hopeful that this will become routine in the next five years. Researchers will look at textural changes in the pancreas seen with CT and PET scans, combined with artificial intelligence and advanced magnetic resonance imaging (MRI) analysis as a way to identify very early changes in the pancreas that could indicate cancer, Dr. Korn said. “Basically, we’re hoping to develop the equivalent of a mammogram to detect early pancreatic cancer.”
The work to produce the method for early detection of pancreatic cancer requires funding, Dr. Korn emphasized, and that’s why he is grateful for the Seena Magowitz Foundation.
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