Dr. Nipun Merchant is director of the Pancreatic Cancer Research Institute at Sylvester Comprehensive Cancer Center, part of the University of Miami Health System. For more information about pancreatic cancer, call 305-243-1000 or Click Here to visit the University of Miami’s health news blog.
After a routine colonoscopy, Donna Lee Robinson learned she had what appeared to be a small tumor in her colon. But further investigation revealed something much more menacing—a large tumor sat on Donna’s pancreas, entangled among a web of arteries.
Due to its size and location, three doctors told Donna her tumor was inoperable. Chemotherapy was offered, but did not promise the best results. Unwilling to accept surgery was not an option, Donna continued to seek out a doctor who could give her more hopeful news. Her search led her to Dr. Nipun Merchant at Sylvester Comprehensive Cancer Center, who agreed to take Donna’s case.
“It’s an amazing feeling,” says Donna. “This man was such a caring individual. He was interested in the case he didn’t immediately turn me down and say it was impossible.”
During a complex surgery that lasted seven hours, Dr. Merchant removed Donna’s tumor. Using tissue samples from the tumor, doctors at Sylvester were able to match Donna with the chemotherapy that would most effectively treat her cancer. Today, almost four years later, she remains cancer free.
“At Sylvester, we have a high-volume center with multi-disciplinary specialists that focus in pancreas cancer,” says Dr. Merchant, who is the medical director for Sylvester’s Pancreatic Cancer Research Institute, “Our outcomes are better. We’re able to treat patients now that even five to seven years ago we never dreamed would be candidates for surgical resection.”
Pancreatic cancer, the third leading cause of cancer deaths, is on the rise. Although the cause is not completely understood, smoking and diabetes are risk factors. Early detection of pancreatic cancer is critical for increasing the chances of survival. Many patients misinterpret the symptoms of pancreatic cancer, or are asymptotic, resulting in more advanced stages of the disease at the time of diagnosis.
Sylvester’s Pancreatic Cancer Research Institute leads the US in pancreatic cancer research and funding. Doctors at the center perform 150 surgeries annually, including many cases that have been deemed “inoperable” by other physicians.
In addition to tackling complex surgeries, doctors at Sylvester work in teams to achieve the best result for the patient. “Treatment is not just surgery. It’s not just chemotherapy. It’s a combination of many different treatments where we treat the patient as a team of physicians,” says Dr. Merchant.
Improvements in chemotherapy over the past five years have opened up new avenues for patients. Large tumors can be reduced in size through chemotherapy treatment and more easily resected by surgeons.
As a result of advances in precision medicine, doctors at Sylvester now have a better understanding of the biologic mechanisms of pancreatic cancer. Patients like Donna are being matched with individualized treatments. Clinical trials are significant in the advancement of immunotherapy, a treatment that engages a patient’s own immune system to fight cancer.
“You hear pancreatic cancer and you think it’s hopeless and it really isn’t it,” says Donna, who now counsels patients in the early stages of diagnosis. “You really have to be your own advocate. This is your life, this is your own journey and you have to be in charge of that.”
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