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Unique U-M protocol brings hope to some with pancreatic cancer

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Treatment developed in lab moves to clinical care where it's improving survival among patients with this killer cancer --added 11/03/05

Ann Arbor, MI. -- It was one of Arnold Morawa's assistants who first saved his life by noticing his eyes looked yellow. Recognizing jaundice, Morawa went to his doctor and was eventually diagnosed with pancreatic cancer.

Arnold Morawa
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It was then an experimental treatment, developed in the laboratory at the University of Michigan Comprehensive Cancer Center, that gave Morawa the hope that he could beat one of the most deadly types of cancer.

More than six years later, he credits that treatment – an intensified chemotherapy drug that makes radiation treatment even more potent – with saving his life.

Pancreatic cancer will strike about 32,100 Americans in 2005, and it will kill 31,800, according to the American Cancer Society. Surgery is possible only in about one-sixth of patients, those whose tumor has not grown too large. Standard chemotherapy and radiation that work so well in other types of cancer have only small benefits against pancreatic cancer, which is why most patients are likely to die in less than a year.

Despite that dismal prognosis, new treatments such as that developed at U-M are giving patients a glimmer of hope.

“This is actually a very exciting time in the treatment of pancreatic cancer. In the past, pancreas cancer was a death sentence and even as recently as five years ago, if someone had a diagnosis of pancreas cancer that couldn't be removed, many physicians would recommend that they seek only care of their symptoms and not even undertake anti-cancer treatment,” says Theodore Lawrence, M.D., Ph.D., Isadore Lampe Professor and Chair of Radiation Oncology at the U-M Medical School.

Morawa, whose yellowing eyes tipped him off to pancreatic cancer, is now more than six years out from his treatment and remains cancer free.

In the lab photo“The first thing I thought of is ‘I don't know of anybody that's survived this,'” Morawa said, thinking back to his diagnosis. “There was a great deal of fear. But then I calmed down and Gail, my wife, and I went on the Internet and pulled up all we could. We read over 100 different papers and we saw there was a chance.”

The treatment Morawa underwent involved intense doses of the drug gemcitabine combined with radiation therapy. Gemcitabine is known as a radiosensitizer, meaning it enhances the effects of radiation treatment.

“The strategy that we've used that's unique is to intensify the therapy that will go throughout the body, while maximizing the strength of the treatment to the primary pancreatic tumor. This is done by intensifying the chemotherapy cocktail using gemcitabine and other medications, while using very targeted and sophisticated radiation techniques to limit the dose just to the tumor,” Lawrence said.

The researchers are finding that this protocol leads to survival of more than a year, compared with an average 10 months – a significant step forward for a disease that has seen little success. For as many as one in five patients, the treatment has allowed doctors to shrink the tumor to a point where it can be removed through surgery. Lawrence notes that with this new treatment some patients have even been cured of this previously incurable disease.

The U-M researchers began developing this treatment in the lab before bringing it into the clinic. And now they take what they learn in the clinic back into the lab to help refine the approach. The lab studies are looking at adding molecularly targeted therapies, drugs designed to hone in on and attack only the cancer cells, leaving normal cells unharmed.

“The recent developments, particularly using intensified chemotherapy with radiation, have now made pancreatic cancer still a serious disease, but a hopeful disease, and in fact a disease in which we can hope for a cure in patients who previously had no chance for a cure,” Lawrence said.

Symptoms of pancreatic cancer

Pancreatic cancer is often not diagnosed until the tumor has grown too large to remove or has spread to other organs. This is partly why patients face such a grim prognosis. Here are some signs of pancreatic cancer:

  • yellowing of the skin and eyes (jaundice)
  • weight loss, possibly rapid and severe
  • loss of appetite
  • nausea and diarrhea
  • light-colored bowel movements
  • dark-colored urine
  • pain in the abdomen that worsens several hours after eating
  • pain that moves to your back

Resources

U-M Comprehensive Cancer Center's Pancreatic Cancer Diagnosis and Treatment page

National Cancer Institute's Pancreatic Cancer page

American Cancer Society:
(Click on choose a cancer topic and select pancreatic cancer)

Pancreatic Cancer Action Network

Pancreatica

U-M Cancer AnswerLine™: 800-865-1125

Written by Nicole Fawcett

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Please Note:

This article is part of the Cancer Center's News Archive, and is listed here for historical purposes.

The information and links may no longer be up-to-date.

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