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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.

Also Read Symptoms of Pancreatic Cancer.

“Typically, people with pancreas cancer exhibit very vague symptoms,” Dr. Korn said, “and the only way to get a sense of what’s causing them is to have a radiologic exam.” His advice: don’t wait more than two weeks to see your primary care provider after you experience any of these symptoms and ask your provider if diagnostic imaging might be appropriate to look at the pancreas for any early signs of disease, especially if you have any family history of this type of cancer.

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.”

Medical imaging has played a major role in assessing the success of a treatment, he said. Imaging can confirm that a tumor is shrinking. And it can confirm that a new treatment shows enormous promise. “We use both structure and function to understand the biology of a tumor and to determine whether it’s responding to treatment,” he said. Dr. Korn has been a leading researcher or principal investigator in about 120 clinical trials over the years that have resulted in new protocols for treatment of cancer.

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.”

Funding Critical

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.

The Seena Magowitz Foundation provides the motivation, the resources and the conduit to get the message out about the importance of early detection,” Dr. Korn said. “In fact, in the past 15 years, the Foundation has impacted survival among pancreas cancer patients tremendously.” And unlike other fund-raising organizations that may want to dictate how funds will be distributed, he pointed out, the Seena Magowitz Foundation “essentially says to a researcher, ‘if you’ve got a good idea, we’re willing to fund it.’ Roger (Magowitz, the founder of the Foundation) and Tony (Subia, who works with Magowitz to further the cause of funding pancreatic cancer research) put their support behind work that researchers believe will really make a difference in the fight against pancreas cancer.”

Related Reading

What Causes Pancreatic Cancer?
Signs and Symptoms of Pancreatic Cancer
Pancreatic Cancer Risk Factors
Reducing The Risk of Getting Pancreatic Cancer
What Are The Stages of Pancreatic Cancer?
Imaging EndPoints

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