| Photo by Olivier Gervault on Unsplash
Part XVI of a “Cancer/Medical Moonshot” Series
Pancreatic cancer is extremely challenging to treat. But medical reports say that it is incorrect to state there is no medicine or that chemotherapy and radiation do not work for pancreatic cancer. Public knowledge assumes that it has a low survival rate due to late detection and drug resistance. But thanks to modern medicine, standard treatments—including combination chemotherapy (e.g., FOLFIRINOX, Gemzar+Abraxane), radiation, and surgery—can shrink tumors, extend life, and in some cases, provide a cure.
Pancreas transplants are generally not a standard treatment for pancreatic cancer, as they are mainly used for type 1 diabetes. However, they are occasionally used in very specific, rare cases, such as for functional or neuroendocrine tumors of the pancreas, sometimes following a total pancreatectomy. While five-year survival for general pancreas transplants is high (up to 93%), using them for cancer remains experimental.
On the other hand, there had been many pancreas transplants as treatment for Type 1 diabetes. The transplant is typically reserved for individuals with severe, hard-to-control diabetes or complications like severe kidney disease. It involves transplanting a donor pancreas to restore insulin production, allowing for a life without insulin injections. Success rates are high, with many patients achieving normal blood-sugar levels.
Reference sites also report that more than 50,000 whole pancreas transplants have been performed worldwide since 1966, with over 30,000 in the U.S. alone. The vast majority of these (over 90%) are performed in patients with type 1 diabetes. Roughly 1,000 pancreas transplants are currently performed annually in the United States.
“… it is incorrect to state there is no medicine or that chemotherapy and radiation do not work for pancreatic cancer. Public knowledge assumes that it has a low survival rate due to late detection and drug resistance.”
Perhaps it is time to do more pancreas transplants for cancer patients, even on an experimental basis, especially if universal healthcare coverage provides for it. But again, the main problem is finding suitable organ donors who are willing to donate their pancreas and other organs at the time of their death. Another problem is how to transport the donated organs by helicopter or fixed-wing aircraft, especially in the Third World or developing countries. Most rural hospitals do not have heliports on the roofs of their main hospital buildings and often do not offer transplant surgery.
It is conceivable that the proposed modern version of the 1901 U.S. Medical Center in the Philippines could have heliports at its main hospital, where transplants could be performed in its surgical section. And specially-equipped ambulances for preserving the bodies of victims of fatal road accidents or victims of violent incidents for transport to heliports or to the appropriate hospital.
This column is a prime mover of such a new American-designed medical center in Sorsogon Province (Philippines). It is also advocating a new Filipino national program to encourage the participation of more donor families, which can be launched. Yes, with more incentives for the donors. Such as additional healthcare benefits like lower premiums, no co-pays for their regular check-ups (to make sure that they remain healthy or free from cancer and other major diseases). And even fully-paid for funeral or cremation — at the option of the grieving family — and memorial services as additional compensation. This suggestion may also reduce the incidence of indigent persons selling one of their kidneys for transplant purposes, as has been reported in the Philippines and other poor countries.
