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Vaccine offers promise as post-surgery treatment for pancreatic cancer patients
Date:12/11/2012

WINSTON-SALEM, N.C., Dec. 11, 2012 /PRNewswire-USNewswire/ -- When Teresa Thorn started getting nausea last February, she thought it was an ulcer, something she'd had years earlier.

As the days went on, though, the nausea remained and Thorn's color started changing, something her co-workers noticed. Finally one Sunday, she and her mother, Naomi Ivester, went to the Emergency Department at Wake Forest Baptist Medical Center, where a battery of tests began.

Her longtime physician at Wake Forest Baptist, Mary Lyles, M.D., eventually broke the news: Thorn, 53, had pancreatic cancer.

Although pancreatic cancer has the nation's highest cancer mortality rate, with just 6 percent of patients surviving five years after diagnosis, the outlook improves dramatically when the disease is diagnosed early and surgery can remove the cancerous tumor. As Thorn soon learned from Perry Shen, M.D., her cancer was operable, giving her a chance for cure.

Thorn was sent home to Rural Hall to prepare for the surgery, which would ultimately remove 30 percent of her pancreas as well as 9 inches of her small intestine and her gallbladder.

"The whole time I was home it was like I was in somebody else's life," Thorn said. "I did not believe it; all I thought about was dying. Then I met Dr. Shen. He's just very caring. He explains things to where everybody can understand – procedures and what my odds were.''

Shen, professor of general surgery and program director of surgical sciences-oncology at Wake Forest Baptist, leads weekly conferences at the Medical Center during which a multidisciplinary team of experts discusses cancer cases. Around a conference table and with a computer screen to study diagnostic images, these oncologists, radiologists and surgeons devise the best strategies for their individual patients based on current medical evidence and research.

For those with pancreatic cancer, strategies can include the latest techniques in surgery, such as the robotic type in which Shen specializes. Wake Forest Baptist is one of just a few centers around the country using robotic surgery to remove pancreatic tumors.

The benefit of robotic surgery is that it allows surgeons more dexterity in the abdomen even as the operation remains a minimally invasive procedure. As a result, Shen said, patients get out of the hospital sooner, and the faster recovery time allows them to more quickly start the chemotherapy they need to try to kill remaining cancer cells once the tumor is removed.

Shen, who has been at Wake Forest Baptist since 2000, has pursued not only the latest surgical techniques, but also clinical trials of drugs and therapies not yet on the market.

One of those trials could prove fruitful to Thorn.

The goal of multiple therapies is to eradicate cancer. Surgery removes the actual tumor while chemotherapy is aimed at destroying any cancer cells left in the body. Wake Forest Baptist is among several medical centers nationwide participating in a new clinical trial. And so, every two weeks along with her chemotherapy, Thorn receives a dose of medicine considered "immunotherapy."

Shen said the vaccine being given to Thorn is designed to make any pancreatic cancer cells "seem like a foreign body, not part of the patient's own body."

If the medicine works properly, Shen said, "the body will consider any pancreatic cancer cells not its own tissue type and cause a rejection of those cancer cells.''

Because pancreatic cancer cells are aggressive and frequently return after surgery and even chemo, the vaccine holds promise as another tool to increase a patient's odds of survival.

Although the surgery was difficult ("Mom said when Dr. Shen came out after nine hours he looked like he had been through a war,'' Thorn noted) and she continues to have bouts of nausea after eating, Thorn is positive about how things have turned out. She has lost weight, has her color back and returned to her customer-service position at HanesBrands Inc. in early October.

"I really feel good," she said. "I haven't felt this good in a couple of years,''

Lyles said her longtime patient's recent lab results, such as hemoglobin level, are "totally normal'' for an adult woman.

"I think Perry Shen's idea that this was a lady whose body could respond to this treatment was right on,'' Lyles said.

Shen said patients such as Thorn make his job worthwhile because they point to the value of attacking difficult cases with a multidisciplinary team.

"That really allows us to give these patients the most appropriate treatment plan up front,'' he said. "I like trying to determine the best combination of therapeutic interventions and then personalize it for that specific patient. It is quite gratifying when a patient undergoes successful intervention.''

When asked about the difficulties of his specialty field, dealing with devastating illnesses such as pancreatic cancer, his answer brings to mind a Tom Hanks line from the baseball movie "A League of Their Own."

"I enjoy the challenge,'' Shen said. "If it was easy, everyone would be doing it.''

Thorn, meanwhile, said she can't wait to get back to doing things that she couldn't for most of 2012, including planting flowers, painting and spending time with her mother as well as her son and daughter-in-law.

Being a recipient of the latest treatments has helped shape her own decisions.

"I am an organ donor,'' Thorn said. "I believe anything that can help our future, we need to do it.''

Cancer survival ratesHere are the five-year overall survival rates of the three most common cancers in this county and pancreatic cancer:Type of cancer New annual cases in U.S. 

5-year survival rateProstate 

240,740

Nearly 100%Breast 

229,060

90%Lung 

226,160

16%Pancreas 

43,920

6%Source: American Cancer Society
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SOURCE Wake Forest Baptist HealthWire
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