Help of Pancreatic Cancer surgeons make tiebreak decisions

Australian researchers have identified two ' biomarkers ' who seem to have the ability to predict patient survival after surgery for pancreatic cancer before the operation takes place. It is the first predictive instrument of its kind for this most deadly of cancer.

The biomarkers are the proteins S100A2 and S100A4. Absence of both proteins leads to average postoperative survival of almost 3 years. Presence of both proteins results in the survival of less than a year.

We now know that although cancer look the same under the microscope, their genetic makeup can be vastly different, making them susceptible to different therapies. Biomarkers to ensure that the appropriate treatment is given to the right patient without delay and unnecessary side effects avoided by not using ineffective therapies.

The American Society of Clinical Oncology (ASCO) stresses the finding in its current newsletter (ASCO Post)-worldwide disseminated to a wide audience of cancer professionals.

Professor Andrew Biankin, Dr. David Chang and members of the pancreatic cancer research team of Sydney's Garvan Institute of Medical Research their research presented at the 2011 ASCO Gastrointestinal Cancers Symposium, 20-22 January held in San Francisco. They connected the expression of the biomarkers, together with the tumour size, survival in a cohort of 372 patients who had undergone thoracic surgery.

Biankin and Chang are both pancreatic cancer surgeons who regularly advise patients not undergoing surgery, a challenging task especially if borderline patient suitability for surgery.

The Whipple's procedure is a major operation involving the removal of half of the pancreas, which is packed around large blood vessels. Approximately 3-5% of patients die from the complications of the surgery, and another 20% die within 6 months after early cancer recurrence pattern. Operation also covers at least 3 months recovery time. So the stakes are high and decide who will and who will not benefit from advance is important.

"We know that the operation very well about 20% of the people for parts, and of course we can predict that they want to be in danger," said Biankin.

"At this moment, we make decisions about when to work on the basis of very indirect measures, such as CT scans, which are not really sensitive enough."

"This information will enable us to be more aggressive, even if a tumor is large, if it is a benign biology-i.e., when neither biomarker is present. Conversely, if both biomarkers were present, you probably would not work. "

"We need something to help us if we're making a tiebreaker decision. Something to help us decide whether surgery worth the risk. "

"Ultimately, each patient must decide" is this operation will benefit me? "and if not, why put yourself through the operation? "

Source:
Garvan Institute of medical research