Pancreatic cancer expert: ‘Specialization is the secret sauce of MD Anderson’

Because I treat patients in MD Anderson’s Gastrointestinal Cancer Center and I have a special interest in pancreatic cancer, I often get asked by other doctors, “How can you focus on just one disease?”

But working with one particular type of cancer day in and day out is what allows us to understand it better and notice patterns beyond what books can illustrate. It’s also what makes us unique. So I believe that specialization is the “secret sauce” of MD Anderson.

Advances in research mean more personalized treatment

When I first joined MD Anderson 16 years ago, a pancreatic cancer diagnosis was considered a death sentence. But research has made several advances since then.   

For one thing, we can stage pancreatic cancer more accurately now, which helps us determine which patients would benefit the most from surgery, as well as the best timing of that surgery: before or after chemotherapy and/or radiation therapy.

We also have a number of clinical trials to help us determine if certain new treatment options and sequencing regimens are effective. And we continue to work on identifying predictive markers that can help us determine the appropriateness and timing of surgery.

Why it’s important to start conversations early

It’s not easy to cure pancreatic cancer with surgery only, though, so it’s very important to start conversations early with patients about possible treatments.  

Sometimes, patients are in a tremendous rush to hurry up and “get rid of the cancer,” but acting in haste can do more harm than good. So, even if someone comes to us for a second opinion, we’re going to go all out to determine the best path first, before pushing forward.

What the future holds for pancreatic cancer treatment

There are still many mysteries around pancreatic cancer, but MD Anderson physicians are re-evaluating different treatment strategies, such as double- and even triple-drug chemotherapy combinations.

Mutational profiling and germline testing can sometimes open up clinical trial opportunities for our patients. There are also several combination immunotherapy clinical trials going on. And there’s ongoing research into “unusual responders,” or patients who do really well on a particular treatment unexpectedly.

Currently, pancreatic cancer patients are living longer with the disease. A small percentage of those show no evidence of disease five years after diagnosis. So there are a lot of good reasons for hope. And we remain optimistic.

Gauri Varadhachary, M.D., specializes in treating pancreatic cancer.

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