Pancreatic Cancer in Louisiana: Awareness, Challenges, and Ongoing Research

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In Louisiana and throughout the United States, pancreatic cancer remains one of the most aggressive and deadly forms of cancer. The average five-year survival rate for pancreatic cancer is a mere 12 percent nationwide, and even lower at 8 percent in Louisiana, underscoring the urgent need for increased awareness and medical advancements. This dismal prognosis is partly attributed to the challenges in diagnosing pancreatic cancer in its earliest stages, combined with the tumor’s resilient development that complicates treatment efforts.

“This is one form of cancer that needs more awareness,” emphasized Dr. Omeed Moaven, a prominent surgical oncologist, assistant professor of clinical surgery at LSU Health New Orleans, and chair of the Gastrointestinal Oncology Disease Group at the LSU LCMC Health Cancer Center. “It is frequently diagnosed in late stages, with approximately half of all patients learning of their pancreatic cancer at Stage Four. Only about 15 to 20 percent of patients are diagnosed when surgical intervention is still a viable option. However, the aggressive and systemic nature of this disease often leads to recurrence, even in the hands of the most skilled surgeons.”

Dr. Moaven elaborated that another significant challenge is that existing chemotherapy treatments often prove ineffective against pancreatic cancer. “We are in desperate need to find more novel treatment options that can yield better outcomes,” he stated. In spite of the daunting hurdles, dedicated teams of doctors and researchers at the LSU LCMC Health Cancer Center are fervently working on innovative treatments for pancreatic cancer, particularly through clinical trials and pioneering immunotherapy approaches. Moreover, the Moaven Lab is conducting a translational research program aimed at discovering new methodologies to enhance how pancreatic cancer patients respond to immunotherapy.

Here, Dr. Moaven provides deeper insights into pancreatic cancer in Louisiana, including its risk factors and details on how patients can get involved in ongoing research initiatives.

What makes pancreatic cancer especially hard to diagnose and treat?

It’s the nature of the tumor itself. Pancreatic cancer manifests as a fibrotic tumor, which means that its cells exist within a dense scaffold of scar tissue. This unique characteristic creates a prohibitive environment for the treatments currently at our disposal, forming a physical barrier that hinders drug delivery to the tumor site. This dense tissue also suppresses the patient’s immune system to the extent that it hampers the body’s natural defenses against the disease.

Additionally, many symptoms of pancreatic cancer are non-specific and can easily be confused with other ailments. The most common symptoms reported—including weakness, weight loss, and abdominal pain—are relatively broad. This vagueness, particularly in older adults who are most commonly diagnosed with this cancer, can lead to delays in recognizing the seriousness of the situation. Consequently, these tumors are often identified at more advanced stages. I strongly encourage individuals, especially older adults, to take any concerning symptoms seriously and to seek prompt medical attention when something doesn’t feel right.

What are the most common risk factors for pancreatic cancer?

Pancreatic cancer differs from some other tumors in that it does not have a broad range of well-established risk factors; however, research has identified several key contributors to its development. Age is a significant determinant; the likelihood of diagnosis increases with advancing age. Smoking is another modifiable environmental risk factor, and studies show that smokers have a disproportionate risk of developing pancreatic cancer. Emerging research suggests that obesity, sedentary lifestyles, and high alcohol consumption may also elevate risk, though the extent of these associations is still under investigation.

There is intriguing data pointing to a possible correlation between new-onset diabetes and pancreatic cancer. This area is ripe for research, as it remains unclear whether pancreatic cancer triggers diabetes or vice versa. Understanding this relationship is vital for early detection efforts. While substantial research initiatives focus on identifying new methods for early detection of pancreatic cancer, as of now, no standard tool has been proven effective for this purpose.

What is the typical treatment protocol for pancreatic cancer?

The initial step when a patient presents with potential pancreatic cancer is a comprehensive evaluation that includes imaging studies, laboratory work, and a biopsy of the affected mass. Upon confirming the diagnosis, the critical question becomes determining the stage of the disease and evaluating whether it has metastasized beyond the pancreas. This staging is crucial in dictating subsequent treatment strategies. Alarmingly, about 50 percent of pancreatic cancer patients receive their diagnoses at metastatic stages, leaving chemotherapy as their sole treatment option. Conversely, if the disease has not spread, a multidisciplinary team comprising surgeons, oncologists, and other healthcare professionals will convene to decide on the best course of action. They consider factors such as cancer advancement and potential involvement of major blood vessels when discussing surgical options. In general, chemotherapy is recommended for all patients, as surgical removal—when feasible—offers the best chance for improved outcomes. Radiation may be considered, but it is not suitable for everyone.

What type of pancreatic cancer research is happening at LSU LCMC Health Cancer Center?

The Moaven Lab is at the forefront of developing innovative treatment strategies that leverage the patient’s immune system. While immunotherapy has transformative potential for other cancer types, it has not yet produced satisfactory results in pancreatic cancer treatment. Our primary focus is on modifying the tumor environment to enhance its responsiveness to immunotherapy and achieve better patient outcomes.

In our lab, we have created oncolytic viruses engineered to target the tumor directly, aiming to dismantle the surrounding scar tissue while simultaneously activating the immune system. By doing so, we hope to employ a combined approach with traditional treatments to more effectively target the cancer from multiple fronts.

Furthermore, we are conducting clinical trials to identify the most effective treatment methodologies for pancreatic cancer patients who may qualify for surgical intervention. A key area of our investigation involves determining the optimal sequence of treatments—specifically, whether chemotherapy proves more effective before or after surgery.

Additionally, my colleagues and I at the LSU LCMC Health Cancer Center are committed to addressing healthcare disparities within Louisiana. Recent studies have highlighted that underserved populations in the state often lack adequate access to treatment, a situation that can have severe repercussions on patient outcomes. Enhancing access to quality care is crucial for improving the overall prognosis of pancreatic cancer patients, and we are diligently working to identify the underlying factors contributing to these inequities to develop effective solutions.

As LSU’s key clinical partner in the vision to elevate the LSU LCMC Health Cancer Center to an NCI-Designated Cancer Center, LCMC Health has allocated an initial $50 million to establish world-class cancer care and clinical research programs. The aim is to achieve NCI designation for Louisiana. For more information, please visit www.lsu.edu/healthcare-partnership/cancer-research-center.php to learn more.

**Interview with Dr. ‌Omeed Moaven on the Challenges of Pancreatic Cancer ‌and Ongoing Research Initiatives**

*Editor:* Thank‍ you for joining us, Dr. Moaven.⁤ Pancreatic cancer is famously difficult to⁣ diagnose and treat. Can you explain why?

*Dr.⁤ Moaven:* Absolutely. The difficulty largely stems from the tumor’s fibrotic nature. Pancreatic cancer tumors develop within a dense scaffold of scar ‍tissue. This creates a challenging environment for current treatments, as the scar tissue serves as a​ barrier to effective drug delivery. Additionally, this dense stroma can suppress the immune response, hindering the body’s ability to fight the cancer. Symptoms are often vague and non-specific, making early detection‌ difficult, particularly in older patients.

*Editor:* What are some of the key risk ⁢factors associated with pancreatic cancer?

*Dr. Moaven:* Age is the most ⁢significant factor; the risk increases‍ as people get older. ⁤Smoking is another⁤ major risk factor, and emerging research‍ indicates that obesity, sedentary lifestyles, and high alcohol consumption ​may also play a role. We’re also exploring the relationship between new-onset diabetes and⁢ pancreatic cancer, which may ​be critical for early detection.

*Editor:* For those diagnosed, what is ⁤the usual treatment protocol?

*Dr. Moaven:* The initial step ​involves a thorough evaluation, ‍including imaging and biopsy, to⁤ confirm the diagnosis. The stage of cancer at diagnosis is ‌vital in ⁤determining treatment options. Unfortunately,⁢ about 50% of patients are diagnosed at a metastatic stage, meaning chemotherapy is often their only​ option. For localized cases, surgical intervention offers the best chance for improvement, but we assemble a multidisciplinary team to evaluate the best course of action for each patient.

*Editor:* What‌ research initiatives are currently underway at the LSU LCMC Health Cancer Center?

*Dr.⁣ Moaven:* Our lab is focusing on developing innovative immunotherapy strategies. While this approach has shown promise in other cancers,⁢ it hasn’t worked as effectively for pancreatic cancer. We are‍ investigating ways to modify the tumor environment to enhance its responsiveness to immunotherapy. For example, we’ve engineered oncolytic viruses that specifically target pancreatic cancer cells, aiming to improve patient outcomes.

*Editor:* Thank you, Dr. Moaven,‍ for​ shedding light on this‌ critical issue. It’s inspiring to ⁣hear about the research ‌efforts aimed ‍at overcoming the challenges posed by pancreatic cancer.

*Dr. Moaven:* Thank you ‍for the opportunity to discuss this important topic. Increased awareness and continued research are ‌vital for improving diagnosis and treatment for pancreatic cancer.