2023 SKCC Pancreatic Cancer Symposium
On Saturday, November 11, 2023, the Pancreatic Cancer Cure Foundation (PCCF) attended the Sidney Kimmel Cancer Center (SKCC), Pancreatic Cancer Symposium at Jefferson Health. The Symposium brings together patients, survivors, caregivers, benefactors, students, clinicians, and researchers. It was a day of celebration and recognition – an opportunity to acknowledge the courage, resilience, and strength of those living with pancreatic cancer.
PCCF at Jefferson Symposium. Photo Courtesy of Jefferson Health.
This annual symposium has become somewhat of a spiritual retreat for us. It reignites our passion to raise funds for research and patient support. Over the years, it has become a familiar gathering where we connect with survivors who return each year, witnessing their journeys from the early stages of their battle to a decade or more into their survivorship. It’s become a bit of a reunion in a sense. We’ve gotten to know so many wonderful human beings and look forward to seeing new and familiar faces every year. The hardest part is waiting a whole other year to be reunited.
Last year, we learned of many new and exciting advances in molecular and genomic research on pancreatic cancer. This year, the Jain research team updated us on their discovery, which could lead to designing targeted therapy for BARD1 mutations. In addition to research updates, we delved deeper into the patient experience—from the emotional journey to post-treatment care. The emphasis was on ensuring that, now that individuals are healthy and cancer-free, efforts are directed towards improving their quality of life as much as possible. This includes access to patient support programs and social workers, receiving the newly recommended prophylactic antibiotic to reduce the risk of infection and re-hospitalization or delay in chemotherapy, and monitoring GI tract health and nutrient absorption.
Below is a quick summary of the event presentations.
Read or download the Pancreatic Cancer Program 2023 Update.
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“At the heart of everything we do is you: our community. We are
working to create a brighter future for our pancreatic cancer patients
and their loved ones, one discovery at a time.”
– Charles J. Yeo, MD, FACS, Samuel D. Gross Professor and Chair of Surgery
Presentation Highlights
Jefferson Pancreas Tumor Registry (JPTR): 2022-2023 Update
Eika Barriera-Justiniano, CRNP, and Nicole Pocetti, CRNP
The Jefferson Pancreas Tumor Registry gives patients and family members the opportunity to provide data on familial and environmental aspects of pancreatic cancer on a voluntary basis. JPTR was established to further study the frequency of pancreatic cancer in families with a history of the disease and to identify environmental and occupational risk factors to which patients may have been exposed. Jefferson Health physicians are also using the results of genetic testing obtained through the Registry to determine the most effective targeted therapies. (Source: Jefferson Health Website)
Risk Factors Associated with Pancreas & Related Cancers
- Advancing age (>60 – 65 years)
- Cigarette smoking (25 – 35%)
Second-hand tobacco smoke exposure (in childhood) - Inherited gene mutations and family history of pancreatic cancer (10%)
- Diabetes (longstanding and new-onset diabetes)
Chronic pancreatitis - High fat/cholesterol diet
Obesity (BMI > 30)
Nitrosamines in food (preservatives) - Occupational & environmental exposure to carcinogens (12%)
- Heavy alcohol use (>60 gms/day or ~ 6 drinks per day)
- Unknown causes of pancreatic cancer (30%)
Conclusions
- Rare opportunity to glimpse real-life experience of pancreatic, other cancers, and pre-cancerous tumor survivors
- Overall, survivors report good-to-excellent quality of life
- Very active – 85 patients walking and 19 other activities
- Uncovered long-term complications
- Lingering symptoms such as fatigue, weight loss, and gastrointestinal problems are common and may be under-appreciated as persistent problems.
- The 2024 Survivor Survey will look into the long-term side effects of surgery
- Weight loss
- Vitamin D Deficiency
- Osteoporosis
- Anemia Iron-Deficiency
- Anemia B12/ Folate Deficiency
- Delayed wound healing
- Skin changes/Hair loss
- New or worsening diabetes
Learn More or Join the Jefferson Pancreas Tumor Registry
Watch the Presentation from Eika and Nicole
Patient Support and Programming at SKCC
Greg Garber, MSW, LCSW and Katie Lundy, MSW, LSW
In the presentation from Patient Support and Programming, Katie Lundy talks about the emotional impact of cancer and the range of feelings patients go through. She shares her experience and observations of patients’ journeys
“Patients and families who allow themselves a balanced emotional response to their illness do better psychologically than those who are overly optimistic or pessimistic”
She also shares tips for reducing stress:
- Learn your limits, set appropriate boundaries
- Seek out help from those you know and trust
- Politely decline assistance from those who can’t add positively to the situation
- Prioritize tasks, know what is a priority and what can wait
- Break down tasks into smaller steps
- Concentrate your efforts on things you can control
- Don’t lose sight of basic care needs: nutrition, hydration, sleep/rest, exercise
- Spend time outside when you can
Katie Lundy also describes the three pillars of oncology social work
- Social/Emotional
- Financial
- Practical Concerns
Jefferson Patient Support services are available to patients who are newly diagnosed, undergoing treatment, or in survivorship, including caregivers and families too.
CONTACT
Cancer Support and Welcome Center
914 Chestnut Street, Philadelphia PA 19107
215-955-1800
Watch the Presentation from Greg and Katie
Targeting BARD1 in Pancreatic Ductal Adenocarcinoma: Expanding BRCAness”
Aditi Jain, PhD
- DNA Damage Repair Alterations Are Prevalent in Cancer
- BRCA1 and BARD1 genes are the repair kit in normal healthy cells
- When superpowers are lost or missing, mutations occur in cells and cause cancer
- How to engineer pancreatic cells so they become sensitive to minimally toxic agents by exploiting these superpowers
- BRCA defect is present in 5-10% of pancreatic cancers
- Vulnerable to PARP inhibitor and platinum therapy
- Make BARD1 cells more like BRCA cells
- Cells with BARD1 grow rapidly
- No BARD1 cells, grow slowly, less invasion
- BARD1 plays a significant role in migration and invasion/metastasis
- When mice were injected with tumors without BARD1, tumors had very slow growth
- Less amount of PARP inhibitor drug needed when BARD1 was eliminated
- Conclusion
- Design targeted therapy for BARD1
- Identify cancer-causing mutations of BARD1 in PDAC
- Identify what genes/proteins/signaling pathways are involved in BARD1
- Study tumor cell immune reaction to BARD1 loss
- This promising research could extend the period of therapy for patients
Watch the Presentation from Dr. Aditi Jain
Therapeutic Endoscopy: Leaping Forward
David Kastenberg, MD
Chief, Gastroenterology and Hepatology
A lot of exciting things happening in advanced endoscopy.
- Third space Endoscopy
- POEM
- Minimally invasive and very effective for disorders like achalasia of the esophagus
- Endoscopic submucosal resection (ESD)
- Can treat precancerous and cancerous lesions
- Can spare patients from surgery and avoid resecting the GI tract for early lesions
- POEM
- Endoscopic Anastomoses using Lumen opposing metal stents (LAMS)
- High rate of success
- Often, a good alternative to surgery
Watch the Presentation from Dr. David Kastenberg
Antibiotics in Pancreatic Cancer
Harish Lavu, MD, FACS
Whipple operation is the safest is has ever been in history due to many advances in surgical technique and perioperative care, and yet…
- 47% of patients will still suffer some complications.
- Surgical site infection is the most common complication
- Can lead to deconditioning, prolonged hospital stays
- Sepsis and C. Diff Colitis
- Most common cause of hospital readmission
- Can limit or delay chemotherapy
- Reduce quality of life
- Affect cancer outcomes
- Whipple surgery is a surgery on the GI tract
- Study shows switching patients from Cefoxitin (standard care) to Piperacillin Tazobactam resulted in 40% reduction in overall infections
- Changed protocol to every patient now receives “Pip-tazo”
- It turns out the 2 most common bacteria in the bile are both cefoxitin-resistant
- 3.5x more likely to get an infection if you had enterbacter or enterococcus (42% of patients)
- If you receive the newer drug pip-tazo you are 50% lower chance of getting an infection
- Pip-tazo can also reduce pancreatic fistulas in whipple patients compared to Cefoxitin
“What an amazing day; my favorite day of the year. It’s just wonderful to see my big extended family here.”
– Harish Lavu, MD, FACS
Watch the Presentation from Dr. Harish Lavu
What About My Gut …?
James A. Posey, III, MD
Post pancreaticoduodenectomy improved GI tract and bowel health
- Optimal absorption of fats, proteins, carbs
- Is pancreatic enzyme enough?
- Food likely inadequately prepared for absorption, forcing overeating to gain weight
- How should we measure the effectiveness
- Stool for fat pre/post
- Impact of chronic nutrient loss
- Fat-soluble vitamin deficiency
- Osteoporosis
- Is pancreatic enzyme enough?
Watch the Presentation from Dr. James Posey
A Patient’s Story
Shawn Johnson
“My message of hope for fellow pancreas cancer survivors is never doubt; don’t give up. The future can always be bright when you remain positive, when you have a spiritual guide, when you settle in to understanding your body and knowing that if you remain positive–that it’s the best medicine you can ever have.”
– Shawn Johnson, Survivor
Watch the Survivor Testimony from Shawn Johnson
If you didn’t get a chance to attend or would like to watch the replay, hit play below or view it on Vimeo: https://vimeo.com/884977269
We’re already looking forward to next year’s event! Here are photos from 2023:
