As you’ve no doubt heard by now, actor Patrick Swayze died yesterday at age 57 after a battle with pancreatic cancer. In March, blog founder Jeremy Manier interviewed University of Chicago Medical Center physician Dr. Irving Waxman about pancreatic cancer, one of the deadliest and hardest to treat cancers. The challenge, as Waxman explains, is twofold - the symptoms of pancreatic cancer typically do not present until the disease is in advanced stages, and the organ’s location deep behind the abdomen makes makes surgical treatment more difficult. The statistics are sobering: even with treatment, only about 5% of those diagnosed with pancreatic cancer survive 5 years.

But doctors are hopeful that the momentum could be shifting in the battle against pancreatic cancer. “Smart chemotherapy” with less severe side effects, new imaging techniques to detect pancreatic cancer in its early stages, and new drug treatments - a study released just yesterday found that an already-existing diabetes medication may be effective in combination with chemotherapy for selectively killing tumor cells.

Here again is the interview with Dr. Waxman where he discusses the clinical challenges of pancreatic cancer and some of the promising frontiers of research to reduce those challenges.

Pancreatic cancer has made an unusual amount of news lately, with the very public struggles of Supreme Court Justice Ruth Bader Ginsburg, Apple Inc. CEO Steve Jobs, and actor Patrick Swayze. The diagnosis can be dire news; the mean survival time following diagnosis is often measured in months, though that can vary depending on how far the tumor has progressed.

I recently talked with Irving Waxman, M.D., about why the disease is so difficult to treat, and how he finds hope in this relatively bleak arena. Here’s a snippet:

Q: We’re attuned to thinking that pancreatic cancer is a very bleak diagnosis, and clearly it is. So how do you and patients keep up hope in a seemingly hopeless field?

Waxman: That’s a very good question. I think that chemotherapy today has entered in my opinion, in the last decade, what we call smart chemotherapy. We’ve stopped using some of the “one agent kills everything” drugs, and now we try to be a little bit smarter, doing targeted therapy that affects a specific part of the growth. Every day there are new protocols, new clinical trials, and we have some going on here. The new therapies may not cure the disease, but they can definitely slow its progression. And with better imaging modalities we can now detect growths at a smaller size.

But in general your point is well taken. It is still a devastating disease. There is a wonderful organization, Pancan [the Pancreatic Cancer Action Network], and they do an amazing job of giving support and information for the patients, and they are also involved in philanthropy and research grants. It’s really a tremendous organization that gives a lot of hope for patients, and that’s an important resource.

Below you can see more of Waxman’s explanation of why pancreatic cancer is so difficult to detect and treat. He describes the organ’s location as a highway junction within the body where numerous arteries and veins crisscross, making it difficult to operate if a tumor is locally advanced. He also discusses the encouraging prospects for better early screening of the disease.

There’s a fine pancreatic cancer piece in the Chicago Tribune today by Robert Mitchum, a friend of the blog who recently got his Ph.D. in neurobiology at the University of Chicago. Rob uses a new study on a potential method of detecting pancreatic cancer to talk about the urgent need for such early screening methods. Pancreatic cancer typically causes few symptoms until a relatively late stage, when the tumor has spread and treatment options are limited. The statistics are stark - each year, more than 37,000 people get pancreatic cancer and 34,000 die from it.

Despite the grim numbers, some people do survive, and new efforts at early detection could boost their chances further. What I find amazing is how patients - and doctors - find the hope to continue their fight in the face of such daunting odds. How do you muster the energy for a struggle you know you’re unlikely to win, though future progress may depend on lessons learned from your failure? Many diseases that are now treatable once seemed hopeless. Most of those successes are built on knowledge gained from countless tragedies.

We hope to write a lot about pancreatic cancer in this blog. I’ll return later this week to the subject of finding hope in a seemingly hopeless field.