Other Types of GI Cancers

Pancreatic Cancer

For decades, patients with pancreatic cancer have faced a poor prognosis, oftentimes because pancreatic cancer has few symptoms that appear until after the cancer has spread. However, in recent years, pancreatic research has increased and survival rates have improved.

There is a 1 in 64 lifetime chance of developing pancreatic cancer. It is more common in obese people with a history of diabetes mellitus and among smokers. Alcohol use is implicated if there are other risk factors, along with genetics. Once pancreatic cancer has advanced, symptoms include anorexia, weight loss, nausea, vomiting, and pain under the ribs that radiates to the back.

Diagnosis:

• Computed Tomography (CT)— CT is a series of X-ray images taken from different angles around your body that uses computer processing to create cross-sectional images (slices) of the bones, blood vessels, and soft tissues inside your body.
• Endoscopic Retrograde Cholangiopancreatography (ERCP)— This is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It uses X-ray and an endoscope — a long, flexible, lighted tube. The scope goes through your mouth and throat, down the esophagus, stomach, and the first part of the small intestine. Then a tube is passed through the scope, and your doctor injects a dye that shows up on the X-ray.
• Endoscopic Ultrasound (EUS)— This uses high-frequency sound waves to evaluate the gastrointestinal tract and lungs by inserting a tube down the esophagus and the stomach, into the small bowel, or into the brachial tubes for the lungs.
• Magnetic Resonance Imaging (MRI)— An MRI is an imaging technique that uses a magnetic field and computer-generated radio waves to create detailed images of the organs and tissues in your body. It is made of magnets that cause the magnetic field to realign with the water molecules in your body and produce radio waves to produce faint signals that create 3-D cross-sectional images like slices of bread.
• Positron Emission Tomography (PET)— A PET uses a radioactive drug (tracer) to show rapidly metabolizing cells in your body, like cancer cells that grow and divide more rapidly than normal cells. On a PET scan, these areas show up as bright spots. This scan can sometimes detect disease before it shows up on other tests.
• Transcutaneous Ultrasonography (TUS)— This imaging is similar to endoscopic imaging, except that the probe is placed on the outside of the body.
• Biopsy— We collect tissue samples that can be checked for abnormal cells in a pancreatic mass.

Treatment:

Genetic analysis of pancreatic cancer is routinely performed at Mount Sinai Medical Center to look for abnormal genes and novel treatment approaches. At Mount Sinai, our multidisciplinary GI cancer team approaches pancreatic cancer with an aggressive stance, often utilizing a combination of therapies to improve survival of our patients. For patients who are candidates for surgery, often chemotherapy is given prior to surgery to help treat the cancer and try to shrink it. Following chemotherapy, aggressive surgical resection is offered to appropriate patients. It has frequently been shown that experience of the surgical team is important to obtain the best outcomes for our patients. Our advanced team of surgeons are leaders in state-of-the-art surgical techniques that ensure aggressive tumor and lymph node removal. Frequently, laparoscopic and robotic approaches to pancreatic cancer resection are available at our pancreas center. In addition, Mount Sinai’s oncologists sometimes use immunotherapy for patients whose pancreatic cancer has certain genetic or biologic features.