For most people, a diagnosis of pancreatic cancer carries a dire prognosis. That’s because the malignancies usually aren’t found until effective treatment is no longer possible.
Doctors in North Florida, however, are trying to improve the odds by developing a non-invasive technique to detect evidence of pancreatic cancer in an abdominal neighbor of the pancreas, the duodenum.
Writing in the journal Gastrointestinal Endoscopy, researchers at Mayo Clinic Jacksonville say changes in duodenal tissue are evidence of cancer in the adjacent pancreas. Cancers can create what scientists have dubbed a “field effect,” altering blood flow in surrounding tissue in order to get more of the oxygen- and nutrient-rich blood they need to survive and grow.
The diagnostic technique gastroenterologist Michael Wallace and his Mayo Jacksonville colleagues are developing involves passing a sensor through a flexible endoscope in the duodenum, the C-shape section of small intestine that leads away from the stomach.
The sensor measures blood vessel diameter and the ratio of oxygen-poor to oxygen-rich hemoglobin in red blood cells in duodenal tissue. The sensor employs a relatively new spectrographic imaging technique called four-dimensional elastic light-scattering fingerprinting, or 4D-ELF.
The Mayo study was based on data from 29 test subjects, 14 known to have pancreatic cancer, and 15 without pancreatic cancer undergoing upper GI tract endoscopy for other reasons.
In a recorded presentation, Wallace said the study found “significantly higher” oxygen-poor hemoglobin ratios and blood vessel diameters in the duodenal mucosa tissue of pancreatic cancer patients, compared to the subjects without cancer.
The Mayo researchers say the endoscopic examination can detect the disease in 92 of 100 people with pancreatic cancer examined and would correctly find no signs of the disease in 86 of 100 people who don’t have cancerous pancreases. “Although this is a small pilot study, the outcome is very promising,” Wallace said.
In an attempt to confirm these early results, the Mayo researchers are conducting a larger study at centers in the United States and Europe. The technique’s ability to detect cancer in the esophagus and colon is also being studied. If the preliminary study results are confirmed, doctors could have an easier way to detect pancreatic cancer while it is still treatable. At present, pancreatic tissue biopsies are considered the best way to diagnose pancreatic cancer.
Because pancreatic cancer causes few if any early warning signs or symptoms, the biopsy usually isn’t performed until after the tumor is too advanced to treat.
“We need new ways to detect pancreatic cancer effectively, and simply, as early as possible,” Wallace said.
Even with early detection, the Mayo Clinic website notes, pancreatic cancer is a challenge to treat because it is so aggressive.
The study was funded by the National Institutes of Health and National Cancer Institute and the Mayo Clinic Foundation for Medical Education and Research.