Henry Ford Hospital has been approved to begin a new study on the use of gene therapy in the treatment of pancreatic cancer.  Patients who are interested in participating should contact the department at (313) 916-8984

Vic Velanovich.  Case–control comparison of laparoscopic versus open distal pancreatectomy.  Journal of Gastrointestinal Surgery, Vol.  10, pp. 95-98, 2006
This study compared a minimally invasive surgical approach to removal of the body and/or tail of the pancreas compared to the standard approach through a larger incision.  It found that the procedure can be done safely, with shorter hospital stay and faster return to normal function by doing it through minimally-invasive techniques when compared to regular surgery.  It appears to be most appropriate for smaller tumors and cysts but may be more difficult in larger cancers.

David A. Tessler, Andrew Catanzaro, Vic Velanovich, Suzanne Havstad, Sachin Goel.  Predictors of cancer in patients with suspected pancreas malignancy without a tissue diagnosis.  American Journal of Surgery, Vol. 191, pp. 191-197, 2006
This study demonstrated that about three-fourths of patients with symptoms of pancreatic cancer and a abnormalities in their pancreas will have a cancer.  Patients with a weight loss of more than 20 pounds, jaundice as determined by a blood test (bilirubin level) and a high tumor marker on a blood test (CA 19-9), will almost always have a cancer.  These patients should be offered surgical removal of the affected area of the pancreas and usually will do well with an operation.

Shahin Sheibani-Rad, Vic Velanovich.  The effects of depression on the survival pancreatic adenocarcinoma.  Pancreas, Vol. 32, pp. 58-61, 2006
Patients with pancreatic cancer have a higher incidence of depression compared to patients with other cancers.  However, it appears that depression is not associated with how advanced the cancer is nor with the ability to complete all the treatments recommended for this cancer.  In addition, depression does not seem to affect survival of pancreatic cancer.  Nevertheless, physicians and patients should be aware that depression can be a major problem for pancreatic cancer patients and should be treated to improve quality of life.

Stephen J. Warnick, Vic Velanovich.  Correlation of patient derived utility values and quality of life after pancreaticoduodenectomy for pancreatic cancer.  Journal of the American College of Surgeons, Vol. 202, pp. 906-911, 2006
Surgical removal of the pancreas for pancreatic cancer is a major operation. It usually takes some time for patients to completely recover from the operation.  This study demonstrated that after one year from the operation, patients report quality of life similar to patients with “minor medical problems.”  In addition, after one year, they felt closer to “perfect health” and where not willing to trade-off longevity for “perfect health.”  These results imply that pancreatic cancer patients who remain disease-free can return to a good level of quality of life.

Timothy Liao, Vic Velanovich.  Asymptomatic pancreatic cysts:  A decision analysis approach to observation versus resection.  Presented at the 2006 Annual Meeting of the Society for Surgical Oncology.
Pancreatic cysts are becoming of more common diagnosis.  As many cysts are not cancerous and some can be cancerous or precancerous, the decision to surgically remove these cysts or watch them is becoming a more frequent and difficult decision. This study evaluated the frequency of malignant vs. benign cysts as well as the potential outcomes of observing these cysts compared to operating upon them.  This study demonstrated that the decision should take into account the probability that the cyst is cancerous, the probability of surviving the operation, and the expected survival benefit of removing a cancerous cyst. 

Vinod Narra, Vic Velanovich.  The extent of resection of intraductal mucinous papillary neoplasm of the pancreas.  Presented that the 2006 Annual Meeting of the Pancreas Club.
The diagnosis of intraductal mucinous papillary neoplasms is becoming more common.  These tumors are either cancerous or precancerous. Therefore, all required surgical removal.  Because these tumors can involve part or all of the pancreatic ducts, at times it can be unclear whether part or all of the pancreas should be removed.  What this study demonstrated is that if all of the tumor can be removed completely, then removal of only part of the pancreas is most appropriate.  The only time when the entire pancreas needs to be removed is when all or nearly all of the pancreatic duct is involved.

Bellal Joseph, Ilan Rubinfeld, Joseph Musial, Chadi Faraj, Vic Velanovich.  Relationship between hospital volume and system support in pancreatic resection.  Presented at the 2006 Annual Meeting of the American College of Surgeons.
Although it is well know that operative deaths in patients undergoing removal of the pancreas for cancer is related to the number of these types of operations done at the hospital, what is unclear is why?  What this study showed is the higher the number of pancreas operations performed, the more likely it is for the hospital to have meet the requirements for intensive care unit staffing, safe practice score, a Healthgrade 5-star rating for complex gastrointestinal procedures and operations, the presence of a general surgery residency, the presence of a gastrointestinal fellowship and the presence of an interventional radiology service.  This implies that not only should patients seek high volume hospitals for pancreas surgery, but also those hospitals that have the other support necessary to successfully care to the pancreatic surgery patient.