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Pancreatic cancer is the fourth leading cause of cancer-related deaths in the US, with more than 48,000 new cases diagnosed each year. Because pancreas cancers and precancerous lesions are among the most challenging tumors to diagnose and effectively treat, Capital Health now offers the most advanced screening and treatment options as part of its Center for Digestive Health and Cancer Center, both located at Capital Health Medical Center – Hopewell.
GI Surgery That’s a Cut Above the Norm
A pancreaticoduodenectomy (commonly referred to as a Whipple operation) is a surgical procedure performed to treat cancers of the pancreas. The operation is complex, technically demanding, and not something typically offered in a community hospital setting.
Now, thanks to the recent arrival of Dr. Cataldo Doria, medical director of the Capital Health Cancer Center and surgeon who specializes in hepato-bilio-pancreatic diseases (benign conditions and cancers related to the liver, pancreas, and bile duct), procedures like the Whipple are being performed routinely at Capital Health.
“Deciding on the appropriate surgical treatment for cancer of the pancreas is largely based on the location of the tumor. Tumors located in the head and neck of the pancreas require removal of the head of the pancreas as well as portions of the duodenum, bile duct, gallbladder and lymph nodes. For tumors located in the body and tail of the pancreas, a distal pancreatectomy is performed leaving the head intact,” said Dr. Doria, who has performed hundreds of Whipple procedures over his career.
The Whipple procedure requires the surgeon to disconnect and reconnect the pancreas and nearby digestive organs in order to complete the surgery, which is why the procedure requires only the most skilled surgeon. In some cases, a minimally invasive approach can be used in order to reduce incision size, decrease pain and shorten recovery time.
“In the past, operations to treat pancreatic cancer meant that patients could expect big incisions and long recovery times. Today, we can aggressively treat cancers and other lesions of the pancreas using minimally invasive techniques proven to reduce recovery time while providing equivalent outcomes to traditional open surgery,” said Dr. Doria.
Minimally Invasive Screening Options, Accurate Results
Led by Dr. Jason Rogart, director of Interventional Gastroenterology & Therapeutic Endoscopy at Capital Health, Capital Health’s Pancreas Screening Program aims to identify early precancerous lesions before they turn into cancer. While screening the general population for pancreatic cancer is not recommended, there are high risk groups of people who should consider screening, such as those with a family history of the disease.
“In addition to family history concerns, adults older than age 45 are at greater risk, as are those who are overweight or have diabetes,” said Dr. Rogart. “Men and African Americans are also diagnosed more frequently, and controllable risk factors like smoking and heavy alcohol use can increase the risk very significantly.”
Providers at the Capital Health Center for Digestive Health and Cancer Center have years of specialized training and subspecialty fellowships in the field of pancreatic cancer and can recommend a plan and tests based on an individual’s personal risk factors and a comprehensive review of their medical history.
Options may include:
- Endoscopic ultrasound (EUS): Examines the organs of the digestive tract and the surrounding tissue. EUS is the most accurate test for identifying and diagnosing pancreatic cancer and pre-cancerous cysts, often finding tumors that can be missed by CT scan or MRI. During the procedure, a sample of suspicious tissue or a cyst may be obtained via fine needle aspiration (FNA) as an alternative to exploratory surgery or other invasive testing.
- Magnetic resonance imaging (MRI) and Magnetic resonance cholangiopancreatography (MRCP): Tests that produce detailed images of the pancreas, liver, gallbladder, bile ducts, and pancreatic duct without x-rays.
- Computed Tomography (CT) scans: Sometimes called a “cat” scan, this imaging test uses special x-ray equipment to obtain images from different angles around the body. The Spiral CT scanner at Capital Health Medical Center – Hopewell provides extended coverage of the body, produces images with much greater detail, and allows for a faster and more accurate assessment of the pancreas and other organs.
For those concerned about their family’s history of pancreatic cancer, Capital Health’s Cancer Genetics Risk Assessment Program helps individuals and families understand the genetics of cancer and how it may affect them. A visit with Capital Health’s genetic counseling team includes:
- An explanation of how cancer develops and how it is inherited
- A thorough review of the patient’s family history
- An assessment of the patient’s risk to develop cancer
- An estimation of the likelihood that there is a detectable cancer gene in the patient’s family
- A discussion of the risks, benefits, and limitations of genetic testing
- A discussion of the genetic testing options
- Recommendations for cancer screening
- A comprehensive summary letter
Appointments for Capital Health Cancer Genetics Risk Assessment Program can be scheduled by calling 609-537-7043, 8 a.m. – 4 p.m., Monday through Friday.