UNMC discoveries hold key to longer lives after pancreatic cancer diagnosis.

No doubt about it:
This community cares. That’s part of the reason regional researchers tirelessly tackle some of the most elusive diseases, dread diagnoses and proactive procedures in the world.

Regardless of region, however, “cancer” inspires fear. “Pancreatic cancer” inspires another level of dread. But, as one of three National Cancer Institute Specialized Programs of Research Excellence in pancreatic cancer, the University of Nebraska Medical Center aims to take the dread out of the diagnosis.

“Pancreatic cancer is diagnosed so late that it runs sort of a silent course,” said Michael A. “Tony” Hollingsworth, Ph.D., Eppley Institute for Research in Cancer professor and Fred and Pamela Buffett Cancer Center associate director for basic research. “Because of that, there aren’t many surgical candidates. So, it’s difficult to get tissue to study.”

The Rapid Autopsy Pancreatic Program (RAPP) was established in 2002 as an “organ donation program,” which Hollingsworth said enables patients to fight cancer after death – giving hope to someone else.

It’s a cycle of hope happening right here in Greater Omaha.

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“We can study the cancer in depth,” he said. “We get a lot of tissue to study that allows us to look at a lot of different things.”

Tissues obtained within three hours of death hold the answers to elusive questions like, “How did this tumor spread?” “Experimental” observations in test tubes can be validated in human tissue samples.

Nature in April featured findings from RAPP repository samples. Investigators with the La Jolla, California-based Salk Institute confirmed Leukemia Inhibitory Factor (LIF) protects tumors. Understanding LIF’s relationship to tumors could inform targeted therapy. In March, Nature featured a study directed by UNMC’s own Pankaj Singh, Ph.D., which explored combination therapies to suppress the growth of KRAS gene-driven cancer cells.

“We have a number of experimental therapies and immunotherapy ideas,” Hollingsworth said. “We expect to be in clinical trials in the next couple of years.”

Researchers are wrapping their arms around paraneoplastic syndromes, effects like extreme muscle wasting that occur in body parts distant from tumor sites. Studies aim to mitigate those effects, too – some are funded, some aren’t.

“We have so many ideas,” Hollingsworth said. “But only 10 or 15% are funded by national agencies.”

Legislative Bill 669 would invest $15 million in state funds and $15 million in matching private funds to create a center of excellence in pancreatic cancer research at UNMC.

Typically, Hollingsworth noted, pancreatic cancer patients present with advanced disease that has spread. The prognosis isn’t good (up to 12 months with chemo).

“If you can diagnose earlier in disease progression and shrink the tumor in its earliest stages, some patients may live several years,” he said. “We have a novel early detection strategy.”

Screening with a blood test that casts a wide net isn’t feasible. Comparatively few individuals are at risk as a whole. Health care won’t foot that bill.

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“Something has to be deployed in the primary care setting,” Hollingsworth said.

Researchers developed a diagnostic algorithm, based off of symptoms patients commonly experience in the two to three years leading up to their diagnosis: low back pain, appetite changes, weight loss, fatigue.

“Each [symptom] has been independently treated,” he said. “Nobody is pulling things together and saying, ‘This could be a feature of pancreas cancer.’”

Type 3c diabetes (secondary to pancreatic diseases) is a risk factor. Adults with pre-diabetes or diabetes diagnosed within the past three years, should consider participating in a study designed to identify clinical and blood markers. Coordinated by Christina Hoy, DNP, the study’s goal is to create a blood test that screens for cancer in its earliest, most curable stages. The study is also open to those with chronic pancreatitis, pancreatic cysts, and at least two blood relatives with pancreas cancer.

Relevant research that leads to greater understanding and heightened discoveries: It’s all happening here at UNMC, thanks to a no-coasting attitude toward cancer.

Christina Hoy, D.N.P., studies those with a higher than average risk of developing pancreatic cancer, including those with a family history. Every six months, study participants come in to answer questions and undergo blood draws. While there is still no screening for pancreatic cancer, UNMC scientists are hoping this research could lead to a screen for clinical and blood markers of the disease someday.

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