Amid the current challenges, we are looking forward to Pancreatic Cancer Awarenessmonth ThroughoutNovember,wehaveorganizedaneveninglecture seriesforpatientsandfamilieswhichrunsthegamutfromchemotherapyand surgerytohowtomanagedietanddiabetesIfyoulivenearby,severalrestaurants are participating in Giveback Days, where a portion of their proceeds will go towardssupportingpancreaticcancerresearchYou'llhavespecialchancestowin prizeslikeanautographedjerseyfromaMilwaukeeBrewersplayer.
Susan Tsai, MD, MHS Director, LaBahn Pancreatic Cancer Program
Picture: The Hoan Bridge in Milwaukee lit purple for pancreatic cancer awareness month
Purple Post Purple Post
Purple Post Newsletter is a quarterly publication by the LaBahn Pancreatic Cancer Program to provide patients, family, and loved ones with informative and current topics at the Medical College of Wisconsin.
Art + Production
Lori Keiser, BS, MA
Melissa Mena, BS, CCRC
Editing
Beth Krzywda, APNP
LaBahn Pancreatic Cancer Program Director
Susan Tsai, MD, MHS
LaBahn Pancreatic Cancer Program
8701 W Watertown Plank Rd Wauwatosa, WI 53226 mcwpancreas@mcw.edu
All rights reserved. No part of this publication may be reproduced by any means, prints, electronic, or any other, without prior written permission of the publisher.
For questions, comments, or to submit an idea for an upcoming newsletter, please contact us at mcwpancreas@mcw.edu or 414955-1423.
Five Ways to Take Action for Five Ways to Take Action for
Pancreatic Cancer Awareness Month Pancreatic Cancer Awareness Month
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Wear purple on World Pancreatic Cancer Day, November 18, 2021
Share photos of yourself wearing purple on social media and tag us!
Contact members of congress and ask them to fund pancreatic cancer research
Join any or all of our events featured on the following page
NOV 1 | 5:00PM - 6:00 PM CST
Susan Tsai MD: Pancreatic Cancer Staging and What to Expect After Surgery
NOV 2 | 5:00PM - 6:00 PM CST
Douglas Evans, MD: Hope and A Plan
NOV 3 | 5:00PM - 6:00 PM CST
Ben George, MD: Incorporation of Precision Medicine in Systemic Therapy for Pancreatic Cancer
NOV 4 | 5:00PM - 6:00 PM CST
Parag Tolat, MD: pancreas cancer Imaging: What we look for
NOV 8| 5:00PM - 6:00 PM CST
Amanda Jacquart CGC: Genetic Testing in Pancreatic Cancer
NOV 9| 5:00PM - 6:00 PM CST
Zach Smith, DO: Understanding the Role of Endoscopic Interventions in Pancreatic Cancer
NOV 10 | 5:00PM - 6:00 PM CST
Beth Erickson, MD: Radiation Therapy for pancreatic cancer
NOV 11 | 5:00PM - 6:00 PM CST
Douglas Evans, MD: How to Contribute to Pancreatic Cancer Research
NOV 15| 5:00PM - 6:00 PM CST
Olivia Cassiday DNP APNP: The ABCs of Diabetes Management
NOV 16 | 5:00PM - 6:00 PM CST
Michele Derdzinski RD: Nutritional Challenges in Pancreatic Cancer
17 | 5:00PM - 6:00 PM CST
Karen Kersting, PhD, LCP: Self-care and Emotional Wellness in Pancreatic Cancer Patients
Susan Tsai, MD: What's on the Horizon for Pancreatic Cancer Research NOV 18 | 5:00PM - 6:00 PM CST
Register: bit.ly/NovPanc | Lecture series co-sponsored by the Seena Magowitz Foundation
Join us for good eats and a chance to support pancreatic cancer research. The following restaurants have graciously agreed to donate a portion of the proceeds from sales during a giveback event
Date: November 6th
Locations: Brookfield, Milwaukee
Time: 8:00 AM - 3:00 PM
10% of proceeds from dine-in, online, and delivery orders will be donated to MCW
Social EVENTS Media
Date: November 10th
Locations: Brookfield, Greenfield, Waukesha
Time: 4:00 PM - 10:00 PM
20% of proceeds from dine-in, carryout, or delivery when you mention this fundraiser. Online orders use code FUNDMCW21
Like & follow our social media pages for a chance to win prizes like an autographed basketball from Jrue Holiday and so much more!
her doctor who noticed that her eyes were yellow Medical testing was started and the next day, Annie got a call telling her she needed to go to the hospital. Onceadmitted,additionaltestingleadtothediagnosisofpancreaticcancer.
At the time of her diagnosis, Annie was the primary caregiver for both her mom andyoungerbrother.Shehadtoadjustfrombeingtheonetakingcareofothersto the one needing care Her cousin came to stay with her and to help take care of both Annie and her family. She shared it was a little difficult to make that transition,butwasverygratefulforthesupportduringhertreatment
Anniecan’tsayenoughgoodthingsaboutherclinicalteam Shedistinctlyremembershersurgeon,saying“I’mgoingtotake verygoodcareofyou,”whentheyfirstmet Annieappreciatedthathersurgeonwouldtakethetimetocheckonherinthe hospital in the morning and again in the evening. Along with her medical team, Annie credits her faith in God for keeping herpositivethroughouthercancerjourney Shesaysshenevergotupset,prayedalot,andknew“shehadthegoodLordon herside.”
IthasbeenthreeyearssinceAnnie'ssurgeryandtreatmentforpancreaticcancer Shespendsherdayshelpingherbrothers and staying active with her church family. She wants other patients to know that staying positive and having a good attitudereallymakesadifference.
Distinguished Honors & Awards
Douglas Evans, MD was selected as the 2021 Honorary Member of The American Society for Radiation Oncology (ASTRO) This is the highest accolade that this organization bestows upon distinguished physicians and researchers in disciplines other than radiation oncology, radiation physics, and radiobiology
Kulwinder Dua, MD, DMSc, FRCP (Edinburgh), FACP, FRCP (London), was selected by the American Society of Gastrointestinal Endoscopy as one of the 65 best endoscopists in the world He was also inducted into the inaugural class Masters of the American Society of Gastrointestinal Endoscopy, ASGE: MASGE
I’m Karen Kersting, a licensed psychologist and faculty member in the Division of Surgical Oncology. In my clinical work, I provide psychotherapy and behavioral health interventions to patients Total wellness encompasses both physical and mental wellbeing. Like any psychologist, I work with patients on issues around anxiety and depression, but, as a health psychologist specializing in cancer care, I also help people cope with the unique stressors related to going through treatment for a serious health problem
I work with patients when behavioral issues arise like difficulties with sleep and eating. I work with patients on maintaining positive communication and collaborative relationships with all the people in their life, providers, family, and friends. And I help patients find ways to incorporate relaxing and joyful activities activities into their lives during their treatment In a typical first session with me, I will ask questions about your activities and social connections, learn how you’ve coped with your diagnosis and treatment so far, screen for struggles with mood and excessive worry, and work with you to decide if ongoing or intermittent psychotherapy would be helpful and what our goals would be. Sometimes I meet with patients who are already coping incredibly well and don’t need my support; in these cases, it is my great pleasure to celebrate that success and offer an open door for further support as needed In other cases, I provide ongoing support by developing a treatment plan for anxiety or depression, engaging in problem solving with patients, or teaching strategies for integrating mindfulness into daily life At times, this may include planning on how to cope with recovery from surgery - almost like a coach!
It has been a particular privilege to work closely with pancreatic cancer patients and learn about the unique challenges they face in moving through treatment Through this work I’ve developed tailored strategies that have been helpful to a range of patients, and I am able to bring this familiarity into my work with new patients. But I also cherish the variety of experience among pancreatic patients and focus on what matter most to each individual.
I grew up in Wauwatosa and was happy to return to the area after graduate school in Virginia and a post-doctoral fellowship in Ohio. Now, I live in Milwaukee with my husband and two-year-old son, Gus. We enjoy biking around the area and are heavily involved in our neighborhood association – when we’re not chasing after Gus!
DID YOU KNOW?
Evidence from randomized trials shows that psychological interventions in cancer patients with distress may lead to a survival advantage over those who do not receive psychosocial care
For more information or to make an appointment with Dr. Kersting, please contact your surgical team for a referral.
targets and development of novel treatment strategies of paramount importance to help patients. The long-term goal in the Lomberk laboratory has been to uncover windows of opportunity leading to novel targets and treatment approachesforpancreaticcancer Ourmostrecentworkfocusesonvulnerabilities thatoccureachtimeacancercelldivides Allcellsareequippedwithmachineryto duplicate or replicate their DNA (genome) Cancer cells have driving forces to make this machinery work harder and more frequently, which is one reason why cancer cells proliferate in number more rapidly than normal cells. A common driving force behind this in pancreatic cancer is the abnormal activation of the proteinKRAS.
Joel and Arlene Chair in Pancreatic Cancer Research Director, Basic Science Research Department of Surgery Associate Professor of Surgery and Pharmacology & Toxicity Leader, Precision Oncology Initiative, Cancer Center
AsaresultofthisfrequentacceleratedDNAreplication,themachineryincharge of this process starts making mistakes or accidentally collides with other complexes that are transcribing the information contained within our genome. These mistakes and accidents during DNA replication lead to signals of stress within the cell, known as replication stress. A normal cell would respond to replicationstressbypausingtorepairtheproblemoriftheerrorissevereenough, enteraprogramofcelldeath.However,cancercellsfinddeviouswaysto compensate for these stress signals and continue dividing at rapid rates. Notably, DNA does not exist in the nucleusofthecellonitsown,ratheritgetspackagedbywrappingaroundproteinstoformchromatin,whichwe refer to as the epigenome. So, when DNA replicates, our epigenome also needs to duplicate at the same momenttopackagethenewlymadeDNAappropriately.
The current studies in our lab are centered on better understanding this process. Our experiments have found thattoleranceofreplicationstresswhenabnormalactivationofKRASispresentinthecellissustainedbyone regulatoroftheepigenome,calledG9a.WehypothesizethatifwetargettheG9aepigenomicregulator,wecan interrupt this compensation of KRAS-driven replication stress and ultimately destroy the cancer cell. Furthermore, we can enhance the effectiveness of this approach by increasing the levels of replication stress using pharmacological agents available for this specific purpose. Together, the combined targeting of the epigenomic regulator and a modulator of replication stress represents a previously unrecognized vulnerability forpancreaticcancercells.Oursincerehopeisthatwecanharnessthisknowledgetoprovidepotentialfuture avenuesformuch-needed,noveltreatmentstoimprovethelivesofpancreaticcancerpatients.
Physicians at the LaBahn Pancreatic Cancer Program work with surgical fellows and residents on cutting-edge research for the treatment of pancreatic cancer
Several exciting projects were recently shared at the international Americas Hepato-Pancreato-Biliary Association (AHPBA) 2021 meeting. The AHPBA is the largest international organization of surgeons with the purpose of improving the care of patients with diseases of the liver and pancreas. There is always an interest in the work being done at the Medical College of Wisconsin and specifically, the LaBahn Pancreatic Cancer Program at these meetings. Some of the highlights include:
Sam Thalji, MD (General Surgery resident) presented a study on evaluating tumor response to chemotherapy for patients with pancreatic cancer. The goal for patients treated at MCW is to receive four months of chemotherapy prior to radiation and surgery. The tumor’s response to therapy is evaluated at multiple time points along the treatment process. The study focused on a pancreatic tumor marker called CA19-9. In many patients with pancreas cancer, CA 19-9 levels are elevated. In this study, CA 19-9 levels that declined during treatment were seen in patients with more controlled disease The findings in this study show the importance of following the CA19-9 trends during treatment This information may be used to help design the best treatment plans for each individual patient
Ben Seadler, MD (General Surgery resident) and Osamu Yoshino, MD (Surgical Oncology fellow) presented a study on patients with pancreatic cancer who have tumor involvement of the major arteries in the abdomen These patients require complex operations that are performed only at expert centers like the Medical College of Wisconsin When the tumor involves important arteries, the surgeon may be able to carefully dissect the tumor away from the artery If this is not possible, the artery may have to be removed and then replaced The study examined nearly 100 patients treated with these advanced operations at the Medical College of Wisconsin The data showed that these operations are both safe and effective for the treatment of advanced pancreatic cancer
Erin Ward, MD (Surgical Oncology fellow) presented a study on the use of radiation treatment prior to surgery for pancreatic cancer. Patients who received chemotherapy and radiation prior to surgery at the Medical College of Wisconsin were compared to patients who received just chemotherapy (without radiation) at other institutes. Patients who received radiation prior to surgery experienced a higher rate of complete microscopic resection of the pancreas cancer and had lower rates of cancer present in lymph nodes. Over time, patients who received radiation prior to surgery had lower rates of disease recurrence at the site of surgery The study provides evidence that the use of radiation prior to surgery for pancreatic cancer has important benefits
