Pancreatic Cancer and its Treatment

Abstract

Pancreas is an organ in the human body that is located in the abdomen. It plays very vital and crucial role in transforming the food we eat into fuel for the human body’s cells. It has two main functions; exocrine function that supports in digestion and other is an endocrine function that controls blood sugar. Cancer begins when cells in the body start to grow out of control. As a matter of fact, cells in nearly any part of the body can become cancer and can spread to other parts of the body. It is very vital to know that if the cancer is an exocrine or endocrine because they have distinct risk, causes and they also have different signs and symptoms; they are diagnosed, treated different ways and have different viewpoint. The two major types of cancer in pancreas are exocrine pancreatic cancer and endocrine pancreatic tumors which are also called as neuroendocrine tumors.
Below list discusses various treatment

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*Corresponding author: Manu Mitra, Department of Alumnus
with Electrical Engineering, University of Bridgeport, 126 Park
Avenue, Bridgeport, CT - 06604, USA
Accepted: November 20, 2018
Published online: November 22, 2018
Citaon: Mitra M (2018) Pancreac Cancer and its Treatment. J
Gastrointest Hepat Surg 1(1):9-13
Journal of Gastrointesnal and Hepac Surgery
Open Access | Page 9 |
Vol 1 | Issue 1 | Pages 9-13
Copyright: © 2018 Mitra M. This is an open-access arcle distributed under the terms of the
Creave Commons Aribuon License, which permits unrestricted use, distribuon, and
reproducon in any medium, provided the original author and source are credited.
SCHOLARLY PAGES
Pancreatic Cancer and its Treatment
Manu Mitra*
Department of Alumnus with Electrical Engineering, University of Bridgeport, USA
Introduction
Pancreas is an organ in the human body that is located in
the abdomen. It plays very vital and crucial role in transforming
the food we eat into fuel for the human body’s cells. It has two
main funcons; exocrine funcon that supports in digeson
and other is an endocrine funcon that controls blood sugar.
Cancer begins when cells in the body start to grow out
of control. As a maer of fact, cells in nearly any part of the
body can become cancer and can spread to other parts of the
body. It is very vital to know that if the cancer is an exocrine
or endocrine because they have disnct risk, causes and they
also have dierent signs and symptoms; they are diagnosed,
treated dierent ways and have dierent viewpoint. The two
major types of cancer in pancreas are exocrine pancreac
cancer and endocrine pancreac tumors which are also called
as neuroendocrine tumors (Figure 1) [1,2].
Below list discusses various treatment of pancreac
cancer including treatment through nanomedicine from
plenty of sources.
Stroma Provides a Novel Method for Treatment
of Pancreatic Cancer
One of the major reason why pancreac tumors are so
resistant to treatment because the “wound” like ssue that
surrounds the tumors, that is termed as stroma. It is much
denser than other stromal ssues surrounding other ssues.
Stromal ssue is understood to contain inuences that
aid tumor’s growth and its survival and most important, in
pancreac cancer, its density is thought to be a factor in
avoiding cancer killing drugs from reaching the tumor.
Sciensts at Cold Spring Harbor Laboratory made an
important step nearer in understanding why pancreac
cancers are so hard to treat. In their invesgaons reported,
organoid technology is taken a new level in which organoids
derivave from tumors are for the rst me “co-cultured”
with one component of stroma ssue in which tumors
develop. The outcome is more realisc of what take place in
the pancreas cancer, in this case from stroma, can be clearly
analyzed.
“We can imagine a pancreas tumor as a big oatmeal cookie
with the raisins represenng the cancer cells and oatmeal part
represenng the dense stroma that creates over 90% of the
tumor” was said by David Tuveson, M.D., Ph.D., Director of
the Cancer Center at Cold Springs Harbor Laboratory (Figure
2) [3,4].
A New Potential Therapeutic Strategy for
Pancreatic Cancer
Most of the studies have concentrated mainly on tumor
cells. Whereas the cells that form the stroma are signicantly
unknown, in spite of various research groups demonstrang
that some components of stroma promote tumor progression.
Various other researcher groups have tried to eliminate
the most of plenful cells in the stroma; they are so called
cancer associated broblasts (CAFs), but they achieved the
opposite eect to what it was expected. Tumor connued
to advancement with even greater aggressiveness. The
explanaon of this invesgaon report was that some of the
cells eliminated could have an-tumorigenic funcons.
Therefore, researchers concentrated on a sub populaon
of broblasts which are known to play a vital part in
inammaon the reason because inammaon nurtures
tumor growth. Their task was to analyze all the genes that are
otherwise expressed in the stromal broblasts of the tumor.
The analysis revealed that Saa3 gene was accountable for
CAFs assisng tumor cells to advance. And when the sciensts
eliminated the expression of this parcular gene in the
CAFs, these cells performed like normal broblasts, because
they lost the capability to assist tumor cells for further
advancement. Researcher managed to reprogram these cells
which had been stripped of their pro tumor properes.
“This method may represent a future therapeuc strategy
to combine with other strategies such as immunotherapy,
chemotherapy or inhibitors against specic indicang routes
of the tumor cells and opens the doors to new research at
reprogramming the stroma instead of eradicang it” was told
by Djurec [5,6].
Letter to Editor

Citaon: Mitra M (2018) Pancreac Cancer and its Treatment. J Gastrointest Hepat Surg 1(1):9-13
Mitra. J Gastrointest Hepat Surg 2018, 1(1):9-13 Open Access | Page 10 |
on improving new catheter technologies to provide this
ablave therapy to paents.
“If a very thin catheter can be made to target tumor and
if we understand how pancreac cancer reacts to ablaon
at molecular level, then we can develop a new therapy that
can kill tumor in a very dicult place such as pancreas” was
conrmed by Van Buskirk (Figure 3) [7,8].
Nanomedicine for Pancreatic Cancer
Pancreac cancer is among most aggressive cancers
Novel Approach of Treating Pancreatic Cancer
Sciensts at Binghamton University heated and froze
tumor cells and observed at the eect using various techniques
to decide the level of cell death, on regrowth as well as which
cell stress pathways were triggered. According to Van Buskirk,
modulang these stress pathways is the signicant trail to
make heang and freezing ablaon process more eecve.
This could lead to the new development to remove cancerous
pancreac tumors. In addion to cell molecular research,
several other group members of the study team are working
Pancreatic duct Pancreas
Liver
Gallbladder
Common
bile duct
Duodenum
Ampulla
of Vater
Duct to
pancreatic
duct
Exocrine cells
secrete pancreatic
enzymes into the
pancreatic duct
Endocrine
cells secrete
hormones into
blood vessels
Figure 1: Illustrates the locaon of endocrine and exocrine pancreas in the human body [2].
Figure 2: Illustrates dense stromal ssue that envelops pancreac tumors. One of these dierence is seen in le image: broblasts (red)
close to proliferang cancer cells (green) that express high levels of a protein called aSMA. In the image at right, red color indicates the
presence of the immune-signaling molecule IL6, which a second subclass of tumor-related broblasts secretes. Image Credit: Tuveson
Lab, CSHL [4].

Citaon: Mitra M (2018) Pancreac Cancer and its Treatment. J Gastrointest Hepat Surg 1(1):9-13
Mitra. J Gastrointest Hepat Surg 2018, 1(1):9-13 Open Access | Page 11 |
chemotherapy drug called Gemcitable most commonly used
to treat paents who have pancreac cancer. In preclinical
trials and experiments, the team of researchers injected mice
with anbiocs to take a note if it would migate the eect of
bacteria. In more than 70 percent in mice, anbiocs proved
eecve in killing the bacteria. And if anbiocs are found to
kill bacteria in pancreac paents then chemotherapy may
become more eecve to paents giving more hope and
more life.
“The goal is to use novel techniques for social good and
to improve the health of many people” was said by Danino,
a biomedical engineering professor at Columbia Engineering
[11,12].
Nanomedicine for Treating Pancreatic Cancer
Scienst performed RNA proling and analysis of sample
taken from pancreac cancer paents and analyzed the
results that an inverse correlaon between the signatures of
miR-34a, a tumor suppressant and PLK1 a known oncogene.
The intensity of oncogene was high. This correlaon made
sense for an aggressive pancreac cancer.
Then Sciensts devised a new method nanoparcle that
known today. There are signicant majority of pancreac
cancer paents die within just a year of diagnosis. Considering
the issue research team invesgated pancreac cells and
invented an inverse correlaon between the signatures of
miR-34a, a tumor suppressant and PLK1 a known oncogene.
The levels of miR-34a were low in pancreac cancer mouse
models whereas the levels of oncogene were high. This
correlaon was made clear for such an aggressive cancer.
But researcher’s team had to understand to see if it was
same in humans. Then experts performed RNA proling
and invesgaons of samples taken from pancreac cancer
paents. The molecular proling exposed the same genomic
paern that was found earlier in mouse models of pancreac
cancer.
The researchers then devised a new method of
nanoparcle that delivers genec material to a tumor and
avoids side eects in surrounding healthy ssues. “The
nanoparcle is like a taxi, transporng two important
passengers” was conrmed by Prof. Satchi-Fainaro [9,10].
Combating Pancreatic Cancer
In a study, working with group of expert researchers,
Danino proved that bacteria in pancreac tumors reduce a
Figure 3: Illustrates pancreac cancer cells stained with live/dead uorescence dyes, with live cells in green and dead cells in red.
Pictured are control cells (top le), frozen cells (top right), heated cells (boom le) and DTA treated cells (boom right). Image Credit:
Credit: Kenneth W Baumann [8].

Citaon: Mitra M (2018) Pancreac Cancer and its Treatment. J Gastrointest Hepat Surg 1(1):9-13
Mitra. J Gastrointest Hepat Surg 2018, 1(1):9-13 Open Access | Page 12 |
Conicts of Interest
There is no conict of interest as per Author’s point of
view.
References
1. http://columbiasurgery.org/pancreas/pancreas-and-its-
funcons
2. https://www.cancer.org/cancer/pancreatic-cancer/about/
what-is-pancreac-cancer.html
predominantly delivers genec material to tumor and avoids
aer eects for neighboring healthy ssues (Figure 4 and
Figure 5) [9,10,13,14].
Acknowledgment
Author would like to thank Prof. Navarun Gupta, Prof.
Hassan Bajwa, Prof. Linfeng Zhang and Prof. Hmurcik for their
academic support. Author also thanks anonymous reviewers
for their comments.
Figure 4: Illustrates experimental nanomedicine approach employs a model of glioblastoma in which nanoparcles (red), injected
intracranially, are taken up by tumor cells (green). Image Credit: Eric Song (Yale University, New Haven, CT) [14].
Figure 5: Illustrates confocal laser scanning microscope images show nanoparcles (red) releasing a payload of gene-silencing RNA into
cervical cancer cells. Image Credit: Xia-Ding Xu (Harvard Medical School, Boston) [14].

Citaon: Mitra M (2018) Pancreac Cancer and its Treatment. J Gastrointest Hepat Surg 1(1):9-13
Mitra. J Gastrointest Hepat Surg 2018, 1(1):9-13 Open Access | Page 13 |
9. Hadas Gibori, Shay Eliyahu, Adva Krivitsky, et al. (2018) Amphiphilic
nanocarrier-induced modulaon of PLK1 and miR-34a leads to
improved therapeuc response in pancreac cancer. Nat Commun
9: 16.
10. www.sciencedaily.com/releases/2018/01/180102114228.htm
11. Leore T Geller, Michal Barzily-Rokni, Tal Danino, et al. (2017)
Potenal role of intratumor bacteria in mediang tumor
resistance to the chemotherapeuc drug gemcitabine. Science
357: 1156-1160.
12. www.sciencedaily.com/releases/2017/10/171005161127.htm
13. Mitra M (2018) Editorial on Advanced Nanomedicine. Int J
Nanotechnol Nanomed 2: 1-2.
14. Bourzac K (2016) News Feature: Cancer nanomedicine,
reengineered. Proc Natl Acad Sci U S A 113: 12600-12603.
3. Daniel Öhlund, Abram Handly-Santana, Giulia Bi, et al. (2017)
Disnct populaons of inammatory broblasts and myobroblasts
in pancreac cancer. J Exp Med Jem 214: 579-596.
4. www.sciencedaily.com/releases/2017/02/170223124234.htm
5. Magdolna Djurec, Osvaldo Graña, Albert Lee, et al. (2018) Saa3
is a key mediator of the protumorigenic properes of cancer-
associated broblasts in pancreac tumors. Proc Natl Acad Sci
USA 115: E1147-E1156.
6. www.sciencedaily.com/releases/2018/02/180201115728.htm
7. Kenneth W Baumann, John M Baust, Kris K Snyder, et al. (2017)
Dual thermal ablaon of pancreac cancer cells as an improved
combinatorial treatment strategy. Liver and Pancreac Sciences 2.
8. www.sciencedaily.com/releases/2018/02/180226131424.htm
Copyright: © 2018 Mitra M. This is an open-access arcle distributed under the terms of the
Creave Commons Aribuon License, which permits unrestricted use, distribuon, and
reproducon in any medium, provided the original author and source are credited.
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