The Sol Goldman Pancreatic Cancer Research Center

What's New 2006

2006 Oncology on Canvas Competition
December 14, 2006

At an awards finale hosted by Regis ("Live with Regis and Kelly") and Joy Philbin at New York's Metropolitan Pavilion, Johns Hopkins Multi-Disciplinary Clinic Nurse coordinator JoAnn Coleman won second place in the 2006 Lilly Oncology on CanvasSM: Expressions of a Cancer Journey International Art Competition and Exhibition for her photograph, "Tranquility." The award was presented by Eli Lilly and Company in partnership with the National Coalition for Cancer Survivorship (NCCS). JoAnn Coleman has been a nurse at the Johns Hopkins Hospital's Department of Surgery since 1974 and now serves as coordinator of the Multidisciplinary Pancreatic Cancer Clinic at The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. "Tranquility" shows a serene fountain in Hawaii containing water lilies with a reflection of a Japanese Tea House. JoAnn took the photograph while in Hawaii for a nursing conference.

"TRANQUILIY" by JoAnn Coleman
click photo to enlarge

"The photograph reminds me of how we treat patients when they go into surgery for the removal of cancerous tumors," said Coleman. "We should accept and respect patients as they journey through the cancer experience."

Patients faced with the challenges of cancer experience the gamut of emotions that reflect the mood of the ocean from peaceful laps of waves at the shore to waves of tumultuous, rolling fury. I care for patients with pancreatic cancer and follow their journey along the continuum of care. I see the complex and ever-changing combination of physical, sensual and spiritual elements encountered by these patients and their families/significant others.

This photo of a Japanese tea house reflected in a pond of elegant purple water lilies represents my philosophy of trying to create an aura of tranquility for my patients and their families/significant others. The lovely purple water lilies are a reminder of patients who have pancreatic cancer attempting to maintain harmony but always with a ripple of the reminder of the unknown that may be encountered in their cancer journey. My patients have taught me to respect the human qualities of sensitivity, awareness, respect and communication which are also those behaviors reflected in the ancient and elegant tradition of the Japanese tea ceremony.



Report of a pancreatic cancer susceptibility gene in a unique pancreatic cancer family
December 12, 2006

Investigators at the Universities of Washington and Pittsburgh have recently identified an inherited gene mutation that is the likely mutation that causes pancreatic cancer susceptibility in a unique family known as Family X. Family X is a unique pancreatic cancer family because individuals in the family develop pancreatic cancer at a young age (< age 40) typically after many years of pancreatic insufficiency (inadequate production of digestive enzymes by the pancreas) as well as diabetes mellitus and extensive structural alterations of the pancreas. The mutation in this family was found in a gene known as palladin. We are currently determining if mutations in this gene are responsible for inherited pancreatic cancer in our NFPTR families. Our current evidence based on a method known as linkage analysis applied to NFPTR families and additional families in the PACGENE (pancreatic cancer genetic epidemiology) consortium indicates that our families probably do not harbor inherited mutations in the region where the palladin gene is located. Notably, none of the families enrolled in the NFPTR have the clinical features that characterize Family X. Generally, in families that have multiple relatives with pancreatic cancer, affected members develop their cancer at an older age (typically over 40) and without pancreatic insufficiency. Further studies are required to determine if acquired mutations occur in the palladin gene. Hopefully, the discovery of the causal mutation in Family X will ultimately lead to additional discoveries that can be used for other families affected by pancreatic cancer. Indeed, understanding the function of Palladin may ultimately provide further insights as to how pancreatic cancer develops. If you have further questions, please feel free to contact NFPTR coordinator Emily Palmisano at pancreas@jhmi.edu.

These results are described in the current issue of Public Library of Science, Medicine.

Reference:
Kay L. Pogue-Geile, Ru Chen, Mary P. Bronner, Tatjana Crnogorac-Jurcevic, Kara White, Sally Dowen, Carol A. Otey, David A. Crispin, Ryan D. George, David C. Whitcomb, Teresa A. Brentnall. Palladin Mutation Causes Familial Pancreatic Cancer: Uncovers a New Cancer Mechanism.

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Multi-Disciplinary Pancreatic Cancer Clinic
November 15, 2006

We are pleased to announce the opening of the Multi-Disciplinary Pancreatic Cancer Clinic at The Johns Hopkins Hospital.

The clinic will be held every Tuesday, and the first clinic day will be November 21st, 2006. In one day patients with known or presumed pancreatic cancer will have a comprehensive evaluation by nationally recognized pancreatic cancer clinicians and specialists.

It is our goal that all patients will be seen in the clinic within one week of the referral, as long as all the necessary clinical information has been obtained.

The Multi-Disciplinary Pancreatic Cancer Clinic is designed to evaluate patients with known or suspected pancreatic cancer. The clinic is committed to a comprehensive single day evaluation incorporating all the resources available for the education, diagnosis, treatment and research of pancreatic cancer.

A patient will:

1. Have access to the following specialists:

  • Medical oncology
  • Radiation oncology
  • Surgical oncology
  • Gastroenterology
  • Pathology
  • Radiology
  • Genetics counseling
  • National Familial Pancreas Tumor Registry
  • Nutrition
  • Clinical trials
  • Oncology Nurses
  • Pastoral care
  • Pain management
  • Social Work

2. Have a recommended plan of treatment provided in writing at the end of the visit
3. Rapid reports to the patient's primary care and/or referring physician.

To make an appointment at the Multi-Disciplinary Pancreatic Cancer Clinic, please call 410-933-PANC (410-933-7262).

Click here for printable PDF

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Dr. Ralph Hruban awarded the 2006 PanCAN Medical Visionary Award
November 4, 2006

Ralph H. Hruban, M.D., Director of the Sol Goldman Pancreatic Cancer Research Center at The Johns Hopkins University School of Medicine, was awarded the 2006 Medical Visionary Award from PanCAN, the national pancreatic cancer patient advocacy group. The Medical Visionary Award honors a prominent individual in the medical or scientific community whose outstanding achievements advance the cause of pancreatic cancer research. Dr. Hruban received this award at PanCAN's annual "Evening with the Stars" gala in Hollywood California on November 4, 2006. Nancy Daly Riordan, wife of the former Mayor of Los Angeles Richard Riordan, was also honored at the gala with the Emily Couric Public Service Award.

To see the full press release, click here, and click an image below to see pictures:

click to view click to view click to view

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Mouse Tests Predict Drug Response In Relapsing Pancreatic Cancer Patients
October 9, 2006

Dr. Antonio Jimeno, M.D., instructor in Oncology at the Sol Goldman Pancreatic Cancer Research Center reported in a recent issue of Clinical Cancer Research (Pub Med PMID: 16899615) a new approach to individualizing therapy for patients with pancreatic cancer. By slicing up bits of patient tumors and grafting them into mice, Dr. Jimeno has figured out how to accurately "test drive" chemotherapy drugs to learn in advance which drug treatments offer each individual pancreatic cancer patient the best therapeutic journey.

Although "xenografting" with either cells or fresh tissue is already used widely to study cancer in the lab, the Hopkins design is personalized to each patient who has relapsed after an initial course of chemotherapy. "Eventually our approach offers a promising way to individualize therapy earlier in treatment instead of first giving everyone the standard drug gemcitabine, which has a success rate of less than 10 percent," says Dr. Jimeno, M.D.

To see the full press release, click here.

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PanCan Visit
September 9, 2006

On Saturday, September 9, 2006, 24 members of the Washington DC PanCAN group visited The Sol Goldman Pancreatic Cancer Research Center at Johns Hopkins. The visit was organized by Mary Zapor and Marsha Garil from PanCAN. The PanCANvisitors toured some of the labs and listened to talks on the ongoing pancreatic cancer research and clinical treatment of pancreatic cancer at Johns Hopkins. After rotating through the labs, the group had an informal lunch with the doctors and scientists. Three members of the PanCAN group that had visited in 2003 returned to visit the new location in the Cancer Research Building II. A number of people in the group commented on how informative the visit was, and several of the doctors and scientists said that meeting patients and family members provides an inspiration for their work. Below are pictures from this wonderful visit which demonstrates the value of patient advocates, physicians and scientists working together.

































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Dr. Cameron on Baltimore Sun
August 13, 2006

The Baltimore Sun has a two-part article on Johns Hopkins pancreatic cancer surgeon Dr. John Cameron. The article can be found on www.baltimoresun.com. Part one describes Dr. Cameron's surgery and part two describes the impact his work has had forming a basis for the Johns Hopkins pancreatic cancer research team. Additional audio and photos are also available. Enjoy!

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Dr. Elizabeth Jaffee Wins Award
July 16, 2006

Dr Jaffee Photo

Congratulations go out to Dr. Elizabeth Jaffee. Dr. Jaffee was awarded the Outstanding SPORE Investigator today at the annual meeting of the National Cancer Institutes SPORE (Specialized Program of Research Excellence) investigators meeting. The award, "in recognition of pursuit of excellence in translational research," was given to Dr. Jaffee for her work developing the vaccine treatment for pancreatic cancer. Dr. Jaffee is a Professor of Pathology and Oncology at Johns Hopkins.

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Johns Hopkins Is Number One Again!!!
July 2006

America's Best Hospitals 2006

THE JOHNS HOPKINS HOSPITAL TOPS U.S.NEWS & WORLD REPORT'S "HONOR ROLL" FOR THE 16th YEAR IN A ROW

The Johns Hopkins Hospital has again earned the top spot as "Best of the Best" in U.S. News & World Report's annual Honor Roll of American hospitals, placing first in five of 16 ranked medical specialties and in the top four in 10 others. Only 14 hospitals nationwide made it to the Honor Roll this year out of 5,189 institutions graded.

This year's annual guide reports results of a survey of a hospital's reputation among a national sample of physicians, along with analysis of objective indicators such as death rates, technology, nurse staffing, service mix and discharge planning.

For a detailed list of all rankings, go to www.hopkinsmedicine.org or to the U.S. News and World Report.

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Hopkins Researcher Wins Maryland Outstanding Young Scientist Award
June 2006

Dr. Maitra receiving the 2006 Maryland Outstanding Young Scientist Award Photo
Robert J. Cotter (left), Chairman, Scientific and Educational
Advisory Council, Anirban Maitra (center), and
Van Reiner (right), President and CEO, Maryland Science Center

Anirban Maitra, Associate Professor of Pathology and Oncology at The Sol Goldman Pancreatic Cancer Research Center has been awarded the Maryland 2006 Outstanding Young Scientist Award. The award is sponsored by the Maryland Academy of Sciences and conferred by the Maryland Science Center in the hopes of encouraging the important work of young scientists in the state of Maryland, and to increase public awareness of their accomplishments.

The Maryland Outstanding Young Scientist award program was established in 1959 to recognize and celebrate extraordinary contributions of young scientists in Maryland. Many previous recipients of these awards have gone on to distinguished careers in science including one recipient who is now a Nobel laureate.

Along with a monetary award, the Maryland Outstanding Young Scientist receives the Allan C. Davis medal. Mr. Davis was a distinguished chairman of the board from 1959 until1966, and a gift from his family allowed the Science Center to build the Davis Planetarium as part of the current Maryland Science Center that opened at the current location in 1976.

The award had been given annually until 1998 when the program was suspended while the Maryland Science Center entered into a strategic planning and capital expansion program. Now, as we mark the Science Center's 30th anniversary, it is only fitting to return the award to its annual status.

While it is the accomplishments of the Maryland Outstanding Young Scientist that ultimately decide which nominee is given the award, there are two other qualifications that must be met: He or she must be a Maryland resident and he or she can be no older than 35. The nominees are reviewed and discussed at length by judges from our Scientific and Educational Advisory Council and it is their group who chooses the award winner.

Dr. Maitra's research has led to several new potential treatments for pancreatic cancer. His work focuses on genetics since pancreatic cancer is fundamentally a genetic disease. His research has provided key insights into the mechanisms underlying the genetic changes that characterize pancreatic cancer. He then develops new therapies which exploit these changes to target pancreatic cancer cells selectively, without harming normal cells. His award winning writings on his work have been published in Nature, The American Journal of Pathology, Genome Research, and many other noteworthy journals.

For the full script of the Maryland Science Center President and CEO Van Reiner's remarks, please click here.

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Patients Help Fight Cancer After Death
June 2006

Dr. Christine Iacobuzio-Donahue's Rapid Medical Donation Program was recently written up in the Baltimore Examiner.

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Animation Illustrating How Precursor Lesions in the Pancreas Produce Changes in the Pancreas that can be Detected by Endoscopic Ultrasound
May 2006

Lauren O'Malley, a student in the Division of Art as Applied to Medicine at Johns Hopkins recently completed a unique animation as a part of her Masters thesis. This animation beautifully illustrates the changes that occur in the pancreas before an invasive cancer develops, and how these changes can be detected by endoscopic ultrasound (see the May 11, 2006 What's New below). Ms. O'Malley's work was supported by a generous grant from the Vesalius Trust. We hope you find this animation educational.

Click here for the animation

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Screening for Early Pancreatic Neoplasia in High-Risk Individuals
May 2006

Dr. Marcia Canto and colleagues from Johns Hopkins report the results of the “CAPS 2” screening for early pancreatic cancer program in the June issue of Clinical Gastroenterology and Hepatology (link to PMID: 16682259). Dr. Canto screened 72 individuals with a strong family history of pancreatic cancer, 6 patients with the Peutz-Jeghers Syndrome, and 149 controls using a combination of endoscopic ultrasound (EUS) and computerized tomography (CT scanning). If something abnormal was identified the patients also underwent endoscopic retrograde cholangiopancreatography (ERCP). All of the patients were asymptomatic. Remarkably, 8 of the patients were found to have a tumor in their pancreas (10% yield of screening); 6 patients had 8 benign intraductal papillary mucinous neoplasms (IPMNs), 1 had an IPMN that progressed to invasive ductal adenocarcinoma, and 1 had pancreatic intraepithelial neoplasia. Endoscopic ultrasound (EUS) and computerized tomography (CT scanning) also diagnosed 3 patients with 5 extrapancreatic neoplasms. Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography abnormalities suggestive of chronic pancreatitis were more common in high-risk patients than in control subjects. From these studies, Dr. Canto concluded that screening EUS and CT diagnosed significant asymptomatic pancreatic and extrapancreatic neoplasms in high-risk individuals (people with a strong family history of pancreatic cancer and people with the Peutz-Jeghers Syndrome). Dr. Canto also concluded that abnormalities suggestive of chronic pancreatitis are identified more commonly in high-risk individuals. Dr. Canto plans to start “CAPS 3.” More information about this research screening protocol will be posted on this web site as it becomes available.

Reference:
Clin Gastroenterol Hepatol. 2006 May 5.

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DNA methylation alterations in the pancreatic juice of patients with suspected pancreatic disease
March 2006

The biggest challenge of pancreatic cancer is to try to detect the cancer at an early stage when it can be surgically removed. Dr. Michael Goggins’ Early Detection Laboratory is dedicated to identifying new markers for the early detection of pancreatic cancer. Just as there is mammography for breast cancer and the PSA test for prostate cancer, so too do we need a test for early pancreatic cancer. Scientists working in The Early Detection Laboratory at Johns Hopkins examined the DNA in pancreatic juice samples that were collected from pancreatic cancer patients to determine if the DNA from these samples showed an abnormal amount of methylation. Methylation is the addition of an additional carbon to specific areas of the DNA. Hypermethylation (or too much methylation) of certain genes will stop the genes from working properly. In particular, hypermethylation of genes whose normal function is to protect a cell from developing into a cancer (tumor suppressor genes) or whose function is to repair damaged DNA (mismatch repair genes) have been associated with the development of cancer. The scientists found that there was more methylation in the pancreatic juice samples collected from pancreatic cancer patients than there was in the samples collected from chronic pancreatitis patients and patients with no history of pancreatic disease. This finding is important because it suggests that the detection and quantification of methylated DNA in pancreatic juice may provide a promising approach to the diagnosis of pancreatic cancer.

Reference:
Matsubayashi H, Canto M, Sato N, Klein A, Abe T, Yamashita K, Yeo CJ, Kalloo A, Hruban R, Goggins M. DNA methylation alterations in the pancreatic juice of patients with suspected pancreatic disease. Cancer Res. 2006 Jan 15;66(2):1208-17.

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The effect of a Frequently Asked Questions module on a Pancreatic Cancer Web site patient/family chat room
February 2006

When a person is diagnosed with pancreatic cancer, the web can be a powerful resource to gather information. Patients often turn to the web to gather information that will help them to make decisions regarding their treatment and to find support from other individuals who are experiencing similar issues. It is therefore imperative that the information provided is accurate, easy to find, and that it addresses the questions patients have. Joanne Coleman R.N. at Johns Hopkins and her colleagues looked at the posts on our discussion board to determine if the “Illustrated Frequently Asked Questions” (FAQ) section of the Pancreatic Cancer Webpage was helpful to patients and caregivers who were seeking information about this cancer. The group found that the FAQ section was helpful to individuals who wanted more information about this disease. She also identified ways in which the FAQ section could be improved. More information was needed on pain management and care giving during the final stages of the disease. This information has since been added to our FAQ section. Ms. Coleman’s study was recently published in Cancer Nursing. It is our hope that the Johns Hopkins Pancreatic Cancer Webpage provides important and useful health information and that our discussion board provides a supportive environment for patients and caregivers. If you have any suggestions for topics that you would like addressed in our FAQ section, please send us an email via the feedback link on the discussion board.

Reference:
Coleman J, Olsen SJ, Sauter PK, Baker D, Hodgin MB, Stanfield C, Emerling A, Hruban RH, Nolan MT. The effect of a Frequently Asked Questions module on a pancreatic cancer Web site patient/family chat room. Cancer Nurs. 2005 Nov-Dec;28(6):460-8.

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A Fish Oil Supplement to Maintain Body Weight in Patients With Cancer
January 2006

Protocol Title: AAFA Fish Oil Nutritional Supplementation in Patients with Disease Related Weight Loss

Protocol Number: J0275

Type of Cancer: Multiple: Solid Tumors

Physician: Adrian Dobs

Phase Number: II General

Eligibility: Diagnosis of cancer, except esophageal cancer. 18 years of age and older. Must be 6 weeks after surgery. Concurrent chemotherapy or radiation therapy is okay. Good blood counts and kidney function. No use of fish oil supplements in the past 3 months. No vitamin usage greater than 150% RDA. No use of medicinal herbs in past month. No HIV or hepatitis. Women must not be pregnant or breastfeeding.

Purpose: The overall goal of this project is to evaluate the safety and efficacy of nutritional supplementation with fish oil in the maintenance of weight in cancer patients. Patients with some cancers have a high occurrence of cancer cachexia with resultant weight loss and since mainstream treatment does not sustain weight, fish oil supplementation will be tested in this trial because there is data to suggest that fish oil can affect the underlying inflammatory response that leads to weight loss.

Treatment:Qualified individuals are treated with fish oil supplements or placebo. The fish oil is packaged in the form of small tubes of oil that can be added to either juice or sports drinks or liquid nutritional supplements. Treatment is for 12 weeks. The study has 5 visits.

Please contact Anne Munson: amunson@jhmi.edu

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