As part of Memorial Sloan-Kettering's CancerSmart community lecture series, more than 150 members of the public gathered in the Rockefeller Research Laboratories Auditorium on May 1 to hear two Memorial Sloan-Kettering Cancer Center oncologists discuss diagnosis, current treatments, and new therapies for pancreatic and esophageal cancers.
Medical oncologist Eileen M. O'Reilly explained that pancreatic cancer is one of the most difficult types of cancer to detect and treat. However, for a subset of patients who have tumors that can be removed, surgery carries a low risk when performed by experienced surgeons. At Memorial Sloan-Kettering, surgery is usually followed by treatment with a drug called gemcitabine, a protocol that has been shown to increase overall survival. At Memorial Sloan-Kettering, for patients with operable disease, clinical trials are assessing the role of preoperative chemotherapy. For more-advanced disease, trials are assessing new drugs and new agents that make cancer cells more sensitive to radiation.
Radiation oncologist Karyn A. Goodman discussed esophageal cancer and the increased use of ultrasound, CT scans, and PET scans to help doctors more accurately diagnose and determine the stage of cancer. She observed that although no single optimal treatment has emerged for esophageal cancer, the current standard of care is either surgery or radiation combined with chemotherapy. At Memorial Sloan-Kettering, all three treatments are combined: A sequence of initial chemotherapy is followed by chemotherapy and radiation, and then surgery. One small, recent study suggested preoperative chemotherapy and radiation can significantly increase survival time. Memorial Sloan-Kettering physicians are using PET scans to determine how well patients respond to preoperative treatment based on how they respond to the initial round of chemotherapy alone. Patients whose tumors do not respond to the initial chemotherapy can then receive alternative chemotherapy regimens during radiation therapy that may be more active against their cancer.
