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Pancreas Center coordinates care for complex cases

Jan. 10, 2013, 8:50 AM

Nipun Merchant, M.D., here with patient Rosario Argueta, directs the multi-disciplinary Vanderbilt Pancreas Center. (photo by Susan Urmy)

Patients with pancreatic diseases can now access a team of multi-disciplinary specialists with one phone call to the new Vanderbilt Pancreas Center.

“Pancreatic diseases, which include both benign and malignant conditions, are highly complex,” said Nipun Merchant, M.D., professor of Surgery and director of the new center. “It’s critical for these patients to be seen early and to be cared for by physicians who are experienced in the diagnosis and treatment of these diseases.

“We have a highly experienced team that cares for patients from diagnosis to therapeutic intervention to adjuvant therapy.”

Merchant, who specializes in Surgical Oncology, formulated the idea for the Vanderbilt Pancreas Center with three colleagues representing key areas of expertise: William Nealon, M.D., professor of Surgery (General Surgery), Patrick Yachimski, M.D., assistant professor of Medicine (Gastroenterology), and Jordan Berlin, M.D., Ingram Professor of Cancer Research (Medical Oncology).

Pancreatic diseases include inflammatory disorders like acute and chronic pancreatitis, along with malignant and pre-malignant diseases such as pancreatic cancer, cystic neoplasms of the pancreas (e.g., intraductal papillary mucinous neoplasm), and neuroendocrine tumors of the pancreas.

Vanderbilt’s team is nationally and internationally recognized for the number of patients with pancreatic diseases it treats, Merchant said. Vanderbilt’s physicians have performed more than 1,000 pancreatic surgical resections and more than 1,500 interventional procedures.

“We have national and international experts in general surgery, surgical oncology, gastroenterology and medical oncology, who work together to coordinate the best treatments and interventions for patients with these complicated conditions,” Merchant said.

In addition to these core areas of expertise, the multi-disciplinary team includes specialists in radiation oncology, interventional radiology and pathology.

Often, patients with complex problems resulting from pancreatitis are told that there are no therapeutic options for them, Nealon noted.

“When these patients are evaluated here at Vanderbilt, they are frequently offered hope and a solution to their problems using either endoscopic, interventional radiographic or surgical solutions,” Nealon said.

Translational research is also an important component of the new center.

“We’re using tumor and tissue samples from patients to do studies in the lab, and we are also bringing these findings from the lab back into clinical trials in patients,” Merchant said.

Merchant’s group, for example, has been studying how pancreatic cancer becomes resistant to chemotherapies, which makes it “the most difficult malignancy to treat,” he said. The researchers have discovered several mechanisms for overcoming the cancer’s resistance and are currently testing those ideas in clinical trials.

In another area, Vanderbilt investigators are leading national trials to understand cystic neoplasms – enigmatic lesions in the pancreas that are becoming more common as they are found during scans performed for other reasons.

Researchers are analyzing fluid from these cysts to identify markers that predict progression to malignancy.

“All of this works because we have some of the leading experts in the fields of proteomics, genomics and drug discovery at Vanderbilt, and we can move the findings quickly into clinical trials that may benefit patients,” Merchant said.

To refer a patient to the Vanderbilt Pancreas Center, call 936-7129.

For more information about the specific conditions treated and tests and procedures offered, visit the website:

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