New Pancreatic Cancer Treatments at Hollings Include NanoKnife Procedure as well as Innovative Clinical Trials

Pancreatic cancer, a type of cancer that starts in the pancreas, is one of the most difficult types of cancer to detect and treat.

That's because it has few early signs and symptoms. "We don't know how to prevent pancreatic cancer, and there is no effective screening for it," says Hollings oncologist and director of the Hollings Cancer Center Division of Hematology and Oncology Craig Lockhart, M.D. Because the disease is difficult to diagnose early, it often goes undetected until it has advanced and spread to nearby organs.

"Pancreatic cancer remains one of the deadliest cancers we deal with as oncologists," says Lockhart, who is also associate director of clinical science for the cancer center. "Most patients who are diagnosed with pancreatic cancer cannot receive curative therapy because the cancer is diagnosed at such an advanced stage."

Though it's relatively rare compared to other cancers, pancreatic cancer's dismal survival rate has catapulted it to the third leading cause of cancer death in the United States. About 90% of people diagnosed with pancreatic cancer will die from it.

Signs of Pancreatic Cancer

Signs of pancreatic cancer include weight loss, jaundice, indigestion, and abdominal pain, says. Lockhart. Risk factors include tobacco use, obesity, diabetes, age, and hereditary genetic factors.

Surgery, ablation, chemotherapy, radiation, and clinical trials are all treatment options used to fight pancreatic cancer, and often a combination of treatments is most effective.

Lockhart and Hollings surgeon Katherine Morgan, M.D., share how Hollings Cancer Center is at the forefront of treatments and the search for better therapies for patients with pancreatic cancer.

Access to NanoKnife Surgery at Hollings

The nature and location of pancreatic cancer require complicated treatment by skilled experts. Hollings Cancer Center is the only center in the region offering irreversible electroporation (IRE), also known as the NanoKnife procedure, to treat pancreatic cancer. Morgan, chief of the MUSC Health Division of GI and Laparoscopic Surgery, is the surgeon who performs it.

The NanoKnife procedure uses precisely directed electric shockwaves to kill cancer cells in difficult-to-reach areas without damaging surrounding structures. Probes placed around the tumor send out pulsing shockwaves that disrupt membranes in the cancer cells, weakening them so the immune system can more easily kill them off. The approach is particularly effective in the pancreas because it allows surgeons to maneuver around surrounding large blood vessels, a vulnerable area where traditional ablation techniques often fail.

"We've added NanoKnife surgery to our armamentarium in the past six months," says Morgan. "We also continue to offer surgical resection and reconstruction to patients with pancreatic cancer, as we have for decades."

"NanoKnife can be used during surgery for pancreatic cancer to target tumor cells that are otherwise not easily entirely removable with surgery alone," explains Morgan. "It's most useful in patients with stage 2 or stage 3 pancreatic cancer. Previously we've had limited surgical treatment options for patients with stage 3 pancreatic cancer, so NanoKnife offers an important opportunity for these patients."

While the NanoKnife procedure is not a curative therapy, when used in the correct setting it can double a patient's survival time. In trials, patients with stage 3 pancreatic cancer who underwent treatment with NanoKnife surgery had a survival rate that approaches that of patients with earlier stages who are able to have conventional resection surgery, says Morgan.

"Results are better than anticipated, with patients living twice as long as expected," says Lockhart.

Pancreatic Cancer Treatments and Clinical Trials

Patients at the cancer center receive a personalized cancer treatment plan from a multidisciplinary team of pancreatic cancer experts. In addition, Hollings' Pancreatic Transdisciplinary Cancer Team brings together the expertise of different disciplines to advance the understanding of pancreatic cancer and translate that information to clinical trials.

As a result, Hollings offers innovative clinical trials for patients with pancreatic cancer as its researchers work to find more effective options to improve the odds for a population desperate for better treatments.

Clinical trials at Hollings include the Renovo CATH study, which uses a thin tube called a catheter to deliver chemotherapy drugs directly into the pancreas through a patient's arteries for a targeted approach to help shrink and stabilize the tumor.

Another upcoming trial uses a novel protein to activate the anti-cancer properties of the immune system and minimize those that are not beneficial.

Genetic testing, or immunotherapy, clinical studies are helping researchers determine if there are more novel and effective treatments patients could receive, says Lockhart, who has served as principal investigator on more than 100 clinical trials. "We will continue to offer new and developing clinical trials at Hollings Cancer Center."

For more information or to make an appointment at Hollings Cancer Center, please call 843-792-9300.