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Leaders in the Detection and Treatment of Pancreatic Cancer

Pancreatic cancer is a devastating disease that is often detected too late for effective treatment. Hoag Family Cancer Institute is changing that. As a leader in the early detection and innovative treatment of pancreatic cancer, Hoag offers programs unlike any other hospital in Orange County to turn the tables on pancreatic cancer.

Pancreatic Cyst Surveillance Program

Thanks to advances in imaging technology, specialists are getting better at finding pancreatic cysts. If those cysts turn out to be cancerous, oncology providers have a better chance of effectively treating them.

But many of these cysts are not dangerous, just stress-inducing for the patients who find out that they have them. To differentiate between harmless, or benign cysts, pre-malignant cysts and cancerous cysts, Hoag has developed a Pancreatic Cyst Surveillance Program, which reviews the risk of these lesions.

Only Hoag has a multidisciplinary team that actively monitors a patient’s pancreatic cyst using evidence-based management algorithms, coupled with advanced imaging and molecular testing.

“We recognize the patient’s concerns and search for the best care through clinical research, tumor board presentations and physician expertise,” said Phoenix Nguyen, M.D., director of Hoag Advanced Endoscopy. “The surveillance program gives physicians and their patients an avenue to monitor and act on pancreatic lesions, if needed.”

“Hoag is unique not just in Orange County, but in most of the country to have a very high volume pancreatic cyst surveillance program that is monitored through intense multidisciplinary participation,” said Robert Selby, M.D., program director of Hoag’s Pancreas and Hepatobiliary Cancer Program. “The program possesses a level of technical and technological sophistication that is necessary to identify early malignancy at a near-microscopic level.”

Anita Erickson Pancreatic Cancer Early Detection Program

Hoag is also the first hospital in Southern California and one of only a few in the nation to offer a program for people who are at high risk of developing pancreatic cancer. Hoag’s Anita Erickson Pancreatic Cancer Early Detection Program aims to detect early-stage pancreatic cancer through labs, imaging and diagnostic testing, as well as genetic counseling. People who have a family history of pancreatic cancer or are carriers of high risk germline mutations can reach out to Hoag to learn more.

“Typically, pancreatic cancer is identified at a late stage, where medical intervention is very limited,” said Valentina Dalili-Shoaie, M.D., director of the Anita Erickson Pancreatic Cancer Early Detection Program. “But if we can proactively monitor higher risk patients and detect cancer at an early stage, we can successfully treat the tumor and increase survival rates.”

First in Orange County Clinical Trials

Hoag is the only hospital in Orange County to offer a Phase 1 clinical trial testing natural killer (NK) cell therapy for pancreatic tumors. NK cells are the “first responders” that help the immune system recognize and kill cancer. An immunotherapy, NK is proving to be less toxic or have less side effects than the standard CAR-T cell therapies.

“Hoag is on the forefront of clinical research innovation with the adoption of NK cell therapy in the treatment of pancreatic cancer,” said Tara Seery, M.D., medical oncologist specializing in gastrointestinal cancers. “We have seen patients from all over the United States and beyond accessing this trial. Hoag is pleased to offer these advanced therapies for our pancreatic cancer patients.”

“We have multiple clinical trials aimed to help patients with advanced pancreatic cancer,” said Diana Hanna, M.D., medical oncologist specializing in gastrointestinal cancers. “These trials utilize novel immune therapy or targeted treatments tailored against a cancer’s unique genetic profile, as well as nutritional interventions (e.g. trying to enhance the efficacy of chemotherapy with the ketogenic diet). Depending on the trial, these innovative therapies may be administered orally, intravenously, or injected directly into the tumor.”

Advanced Surgical Options

Pancreatic cancer surgery takes the utmost skill and experience. Hoag’s team of fellowship-trained pancreatic surgeons offer multiple surgical options for pancreatic cancer, including laparoscopic and robotic approaches to pancreatic resection.

“Hoag’s hepatobiliary surgeons are uniquely equipped to deal with the complexities of pancreatic surgery,” said Dr. Selby, M.D. “Our team has extensive experience in organ preservation and removal, and with the associated blood vessel reconstructions that are needed for this higher level of surgery. Working in close collaboration with our multidisciplinary team allows us access to advanced imaging and endoscopic platforms to support an integrated approach to pancreatic care.”

ViewRay MRIdian® Linear Accelerator

The ViewRay MRIdian® linear accelerator is the most advanced radiation treatment available in the U.S. Through the generosity of community donors Dean and Gerda Koontz, Hoag was one of the first hospitals in the state to acquire the MRIdian, and is the only hospital in Orange County to offer this effective treatment option for pancreatic cancer.

“The ViewRay MRIdian allows clinicians to more precisely treat tumors of the abdomen, like the pancreas,” said Peter Chen, M.D., Hoag radiation oncologist. “The MRI imaging provides high quality soft tissue definition, providing a clear treatment area, allowing us to avoid healthy tissue and minimize side effects of treatment. This new technology is a complete game changer for radiation of pancreatic cancer.”

The pancreas can be difficult to treat, as it moves when one breathes, and it’s surrounded by bowel, which is sensitive to radiation. The ViewRay MRIdian allows us to visualize the internal anatomy with full MR clarity, and to adapt our radiation plan to the conditions of the day. We can also account for motion with breathing by watching tumors in real time with continuous MR. This new technology delivers radiation with the utmost precision to treat pancreatic cancer safely and more effectively.

A Multidisciplinary Approach

Hoag’s multidisciplinary team of experts, including medical oncologists who specialize in gastrointestinal cancers, gastrointestinal surgeons, advanced endoscopists, geneticists, radiation oncologists, pathologists, radiologists, a dedicated clinical nurse navigator, oncology dietitians and genetic counselors, work seamlessly to coordinate care for patients and their families, including meeting in tumor board regularly to review patient cases and identify the best treatment path.

For more information, call 888-467-8590.