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Jason Merrill
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ST. LOUIS – News of Aretha Franklin’s pancreatic cancer diagnosis took many by surprise. Overall, the news sheds light on a disease that while one of the deadliest cancers, has remarkable improved mortality rates over the past few years.

“Results for treating pancreatic cancer are improving yearly,” says Steven Strasberg, MD, pancreatic cancer surgeon at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine. “At one time the number of patients getting pancreatic cancer was roughly equal to the number of people who were dying of it, but in the last few years we’ve seen a remarkable improvement in results.”

The reason is advancement in surgery and targeted therapies. The pancreas is a long organ that stretches across the upper abdomen from right to left, and if cancer is confined to the pancreas and hasn’t spread, surgery is the best option. If it has spread to other organs, the first option is chemotherapy.

For years, the Whipple procedure is most identified with pancreatic cancer. The surgery targets cancers in the head of the pancreas. “It’s a big procedure,” says Dr. Strasberg. “The cancer is removed in its entirety along with the duodenum and bile duct.”

Mortality for the procedure has gone from 15 percent twenty-five years ago to about one percent today if done at a high volume center like the Siteman Cancer Center, where approximately around 110 are performed annually.

“It’s highly specialized and it’s best to have it done at an institution that does a lot of them,” he says.

In addition, Dr. Strasberg and his colleagues have developed a new surgical procedure that’s showing great promise. Called radical antegrade modular pancreatosplenectomy (RAMPs), a surgery specifically done to deal with cancer in the body and tail of pancreas. “Survival rates are quite satisfactory and are similar to rates reported for the Whipple procedure,” says Dr. Strasberg.

Dr. Strasberg notes there are two types of pancreatic cancers, one that appears in a part that of the pancreas that creates hormones (which has a much better outlook) and another that appears in the part that creates enzymes (which is more dangerous).

Pancreatic cancer is considered deadly because by the time it is diagnosed, it’s too late. Symptoms of the disease are:

-loss of weight.
-jaundice.
-new onset of diabetes over the age of 50.
-digestive upset.
-change in number of bowel movements a day.

“When it comes to chemotherapy, we’re learning more and more about how to target therapy against cancer,” says Dr. Strasberg. “Up until fairly recently, we were using drugs that target actively growing cells and while it worked it didn’t target the specific cancer.

“Now with targeted therapies, we’re able to shrink the tumor with less collateral damage,” says Dr. Strasberg. “The future of treating pancreatic cancer is bright.”

For more information about pancreatic cancer, visit the Siteman Cancer Center at www.siteman.wustl.edu or call 800-600-3606.