Michael Choti, MD
Although the goal is to cure patients with pancreatic cancer through surgery, many patients who present with this disease are ineligible for resection at the time of diagnosis, making imaging and early detection imperative, said Michael A. Choti, MD.
, Choti highlighted ongoing developments in the field of pancreatic cancer.
OncLive: What is the role of surgery in the pancreatic cancer paradigm? Has it shifted at all in recent years?
: There are many changes happening in the treatment of patients with pancreatic cancer. The most common form, pancreatic adenocarcinoma, is still a very difficult disease and very life-threatening; few of these patients can be cured. As a surgical oncologist, the goal for most of us is to determine if we can cure the disease through surgery. Unfortunately, most patients who present with pancreatic adenocarcinoma are not operable at the time of diagnosis. These patients can either have metastatic disease or have locally advanced disease, precluding the ability to resect it.
What is new in the landscape of patients with operable disease is the multimodality therapy. We are seeing more effective forms of systemic chemotherapy for patients with pancreatic cancer. We are aggressively bringing the regimens in that were being used for patients with advanced disease. Rather than giving chemotherapy postoperatively, we are seeing a strong trend toward neoadjuvant chemotherapy. This is mostly for patients with what we call borderline operability. More often than not, we are recommending systemic chemotherapy prior to surgery.
What are the biggest advances being made in the field?
We are learning more about the area of hereditary or familial high-risk pancreatic cancer. There is a lot of ongoing research trying to [find ways to] screen patients with high-risk disease. Clearly, early diagnosis and prevention are very important, but we are learning that there is a lot of room for improvement in our ability to detect pancreatic cancer.
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