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Pancreatic cancer fight gets a boost - New Test Holds Out Hope

Mumbai: Dirty Dancing star Patrick Swayze knows all about pancreatic cancer. He was diagnosed with the “dismal cancer’’ a year ago and, while fighting it “moment to moment’’, he realised that he might not be around for “more than a couple of years’’.
Late detection and lack of medical advances make pancreatic cancer one of the most aggressive forms of the disease, say doctors. But on Tuesday, Mumbai gastro-intestinal specialist Dr Amit Maydeo held out a new tool to boost the fight against pancreatic cancer.
“For the first time in India, we have a test that can tell us the future of a patient’s cancer. The test will show whether cancer from the pancreas will travel to the liver or reach the lymph nodes. We will also be able to find out whether chemotherapy will work at all for the patient concerned,’’ Dr Maydeo said during a press conference held at Abheraj Baldota Cancer Detection Centre in south Mumbai.
The new test is a combination of two applications—the endoscopic ultrasonography and genomic analysis. “Our centre was the first to get endoscopic ultrasonography in the city. Now, an upgradation in this technology means that we can reach the cancer cells and draw out samples to establish their genetic patterns,’’ he said. As the process of drawing cancer cells is a skilled one, only a few centres across the world practise it, he said.
Having evolved in Japan two years ago, the genetic predictor test is only available for pancreatic cancer. “But tests are under way in Japan and we, too, will soon start establishing protocols for cancers of other digestive organs.’’
Pancreatic cancer is counted among the worst cancers because in 85% of the cases it is detected in the last stage,.
“But our 15-minute test not only helps in early detection, but also gives an idea about its aggressive nature.’’
According to GI and oncosurgeon Nilesh Doctor from Jaslok Hospital, the new test sounds attractive and can prove beneficial for patients.
But a senior oncologist said, “Surgery along with chemotherapy is the best bet, but even this doesn’t work for about two-third of the patients.’’
HOW THE TEST IS DONE
The patient is given mild anaesthesia before the endosonography endoscope is inserted into the stomach via the mouth
Then, once the cancer site is located, a fine needle is introduced through the endoscope into the cancer site
Cancer cells are taken out and stored in special test tubes before being sent for genetic testing to a Bangalore lab
THE ADVANTAGES
Even cancer cells missed out by CT and MRI can be spotted by the endosonography endoscope
The cancer cells brought out by the fine needle aspiration cytology method are micro-dissected and their DNA extracted
The genetic analysis shows abnormalities that indicate higher chance of the cancer progressing to the liver or the lymph nodes. If the chromosome/DNA tests show abnormality on sequences marked out as 1q, 5p, 7p and 8p, the cancer can progress to the lymph nodes. If abnormality is detected on the 20q band, then there is a possibility of it progressing to the liver
A protein test at this stage can predict if chemotherapy will help the patients

Source : The Times of India, Mumbai, 14th Jan 2009

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