The Severity of Pancreatic Cancer with Diane M. Simeone, MD
In this episode, Diane M. Simeone, MD, director of the Pancreatic Cancer Center at NYU Langone Health, discusses the severity of pancreas cancer. She analyzes how pancreas cancer has impacted many families but is still neglected. Dr. Simeone talks with Tricia and Doro about their experience with pancreas cancer affecting their families and how having educators teach about a widely unknown cancer is important.
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Quotes:
“If we can land on Mars, we should be able to detect and remove pancreatic cancer.” -Diane M. Simeone, MD
“Fighting pancreatic cancer is like pushing a boulder uphill. But as we're getting more traction, it's getting easier.” -Diane M. Simeone, MD
“We have to increase the army of those of us that are educating patients and physicians about pancreatic cancer and what is the current standard of care.” -Diane M. Simeone, MD
Show Notes:
Diane Simeone: I'm a surgeon and a scientist, and I am the director of the Pancreatic Cancer Center at NYU Langone Health. I'm also the associate director of our translational research here at the Perlmutter Cancer Center.
Diane Simeone: Well, as a surgeon, you know, the pancreas is always a tough organ. It's kind of hidden in the back of the abdomen.
Diane Simeone: I was really struck how almost all the patients that came in, they actually weren't candidates for surgery because the disease was too advanced.
Diane Simeone: So why is pancreatic cancer so different? That's a question we've been asking for a long time.
Diane Simeone: I always say if we can land on Mars, we should be able to pick up a 3 to 4 millimeter pancreas cancer, right?
Diane Simeone: When I give a talk to a large audience and I ask people to raise their hand, if someone in their family or someone they love has died of pancreas cancer, at least a third, if not 40% of the hands in the room go up. So it's time to pay attention to what has been a neglected cancer.
Diane Simeone: So if you have two or more family members with pancreas cancer in particular on the same side, you should get genetic testing to see if you carry a gene that put you at risk for pancreas cancer and be enrolled in a screening program where your pancreas gets imaged once a year.
Diane Simeone: We need to understand who's at risk to define what that level of risk is and make sure we're proactive in getting the right people getting tested and screened.
Diane Simeone: Just today I saw somebody in clinic that was found through a family member. A family member was identified as having a mutation. And it's actually a mutation, a BRCA2 mutation that for which they should have been instructed to consider pancreas cancer screening.
Diane Simeone: We just have to increase the army of us that are out there educating not only patients, but physicians about what is the current standard of care.
Diane Simeone: If you have long standing type two diabetes, 5 or 10 years, that can double your risk of the development of pancreas cancer.
Diane Simeone: I think this is one of those cancers where you really need to go to a center that has expertise.
Diane Simeone: Most comprehensive cancer centers in the United States, there's between 50 or 60 of them, will have a organized multidisciplinary team for patients to see that have pancreas cancer.
Diane Simeone: Sometimes patients ask me, how do I find out what clinical trials I might be available for? And the best way is to go to a center of excellence. But also you can look at websites like the American Cancer Society.
Diane Simeone: Patients should not worry or feel guilty about the doctor's feelings. You know, any good doctor would be very comfortable with a patient getting a second opinion.
Diane Simeone: From a surgical perspective, it's very important to make sure if you're going to undergo surgery that you have a competent surgeon. It's okay to ask a surgeon, How many of these have you done?
Diane Simeone: I encourage patients before you get a biopsy, make sure the doctor is going to send your tumor for sequencing. Sometimes we find things that can be game changers.
Diane Simeone: So I thought, my gosh, I'm going to go through my entire career and we are not going to have moved the needle in pancreas cancer. And it's so clear to me that early detection is where we need to be.
Diane Simeone: Last year I operated on six people who developed a pancreas cancer in our screening program, and they all had small tumors, all stage one.
Diane Simeone: It is a little bit like pushing the boulder up hill, but I think as we're getting more traction, it's getting easier.
Diane Simeone: First of all, if someone needs to get testing and screening, that should be covered by insurance.
Diane Simeone: It's an incredible privilege to be able to take care of patients and help them through something that is very, very hard.
Diane Simeone: So I think we still need a much larger investment, but hopefully we'll get where we need to go and we're going to start to see that survival rate for pancreas cancer change by more than a single digit every year or two.