Pancreatic Cancer

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Fox Chase physicians take a team approach to treating cancer. Learn about the team for hepatobiliary and pancreatic cancers. (9 min.)

map: the pancreas,

The pancreas

The pancreas is a gland found behind the stomach. It measures about 9-10" long and is shaped somewhat like a tadpole, with the head (on the patient's right side) larger than the tail. The pancreas extends across the abdomen (behind the stomach and in front of the spine).

Pancreatic cancer is a disease in which cancerous cells form from the 2 kinds of cells in the pancreas. The ductal cells give rise to adenocarcinoma (the most common and the most dangerous of the pancreatic cancers), while the islet cells (those that produce insulin and other hormones) can produce pancreatic endocrine neoplasms.

Genevieve Sliker

Although Genevieve Sliker tells other cancer patients to be patient, she doesn't waste time herself.

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Treatment Team

The Pancreatic Cancer Team includes, among others you might see:

Stephen J. Heller, MD
Jeffrey L. Tokar, MD

Hematology Oncology
Igor Astsaturov, MD, PhD
Jonathan D. Cheng, MD
Steven J. Cohen, MD
Crystal S. Denlinger, MD
Efrat Dotan, MD
Paul F. Engstrom, MD
Anthony J. Olszanski, MD, RPh

Harry S. Cooper, MD

Radiation Oncology
Joshua Meyer, MD

Surgical Oncology
John Michael Daly, MD, FACS
Nestor F. Esnaola, MD, MPH, MBA, FACS
John P. Hoffman, MD, FACS
Andreas Karachristos, MD
Sanjay S. Reddy, MD
Elin Sigurdson, MD, PhD, FACS

Advanced Practice Clinician
Donna Edmondson, MSN, CRNP, OCN

These 2-cell systems have separate normal functions:

  1. The acini produce enzymes that are secreted into the pancreatic ducts. These enzymes are essential for digestion (food breakdown).
  2. The islet cells produce hormones, such as insulin and glucagon, that help control blood sugar levels. Both of these hormones help the body use and store the energy it gets from food.

Treatment for Cancer of the Pancreas

Patients with pancreatic cancer at Fox Chase Cancer Center are often treated by a team that includes surgical, medical and radiation oncologists, as well as gastroenterologists.

Patients who are told their disease is unresectable elsewhere often seek treatment at Fox Chase. Sometimes a combination of radiation therapy and chemotherapy can be given prior to surgery in an effort to render surgical removal of the tumor possible.

Pancreatic Cancer Surgery

John P. Hoffman, MD, FACS, John Michael Daly, MD, FACS, Nestor F. Esnaola, MD, MPH, MBA, FACS, and Andreas Karachristos, MD, are experienced in complex pancreatic surgeries.

Their experience, with surgical volumes that rank in the top quarter in the country, results in the best possible outcomes. Each is constantly working to develop new approaches to effectively treat this cancer by offering minimally-invasive (laparoscopic) surgery where appropriate and continuing to optimize the use of other cancer therapies with surgery.

They have successfully treated patients who have very rare tumors, including Bill Demesquita, who had an osteoclast-like giant cell carcinoma (less than 50 reported cases in the world).

Systemic Therapy and Radiation Oncology

Fox Chase medical oncologists are leaders in the development of systemic therapy for pancreatic cancer using novel agents, vaccines and antibodies. This gives our patients unique access to exciting new treatment options before they become commercially available. Patients with advanced disease especially may benefit from access to new drugs. Radiation therapy and chemotherapy are also used to manage the disease. Three-dimensional conformal radiation therapy is used to spare normal tissue from the effects of radiation therapy.

Our experienced team of medical oncologists includes Jonathan D. Cheng, MD, Steven J. Cohen, MD, Crystal S. Denlinger, MD, and Paul F. Engstrom, MD.

Tumors of the pancreas, bile ducts and ampulla (the common area where the bile duct and pancreas duct join each other and drain juices into the intestine) can cause yellowing of the eyes and skin (jaundice) if they block the flow of bile from the liver. The majority of these patients can be treated non-surgically, using endoscopic techniques. Gastroenterologists Jeffrey L. Tokar, MD, and Stephen Heller, MD, perform a procedure called endoscopic retrograde cholangiopancreatography (ERCP). During this procedure, plastic or metal stents can be placed in the bile ducts to restore bile flow and resolve jaundice. In certain situations, They can remove tumors of the ampulla, eliminating the need for a more radical and invasive surgical procedure.

Improving Outcomes for Patients with Pancreatic Cancer

Fox Chase physicians are currently developing treatments combining radiation, new types of chemotherapy, and surgery to improve patient outcome. In addition, novel treatments directed at genetic targets are being developed by Fox Chase clinical scientists.

In addition, Fox Chase researchers are studying the proteomics (structure and function of proteins) of pancreatic cysts. Some of these cysts have the potential to develop into cancer. This research may help identify better diagnostic tests that will help doctors assess the malignant (cancerous) potential of an individual patient's pancreatic cyst, and help determine which patients would benefit from surgical resection for their pancreatic cyst.


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