In a nondescript room inside the massive Buffett Cancer Center, five brothers and sisters took turns last week donating blood to help unlock a medical mystery.
“I’m the good patient – I have a good vein,” joked Doug Geis, a linebacker-sized Army veteran from Leavenworth, Kansas, as he sat in the donor chair.
Up to twice a year, he and his siblings – from as far away as Arizona and Illinois – converge at the University of Nebraska Medical Center to provide a blood sample and answer a few questions about any unusual symptoms they might be experiencing.
Goal is early detection
The goal: To help researchers discover an early sign, an early “marker,” for pancreatic cancer.
Right now, there’s no way to tell if someone has the deadly cancer – which has only a 10% survival rate after five years – until it’s often too late for potentially life-saving surgery.
Geis’ oldest sister, Suzanne Kolterman of Seward, was among the unlucky victims of pancreatic cancer. Doctors gave her only six months to live by the time she experienced symptoms and was diagnosed in 2016.
However, she survived 18 months and was able to spend valuable time with her husband, former State Sen. Mark Kolterman, and her family.
So Kolterman’s siblings and her daughter are doing what they can, trekking to the Med Center and joining nearly 700 participants in the Early Detection in Pancreas Cancer Study.
‘War room’ at Medical Center
“I can’t go and kill pancreatic cancer – this is the best way I can do it,” Geis said.
In fact, there is a “war room” at the Medical Center’s nationally recognized “center for excellence” in research and treatment of pancreatic cancer.
It’s where the center’s director, Dr. Sunil Hingorani, a nationally recognized authority on the disease, huddles regularly with some of the 75 oncologists, surgeons and specialty nurses who staff UNMC’s Pancreatic Cancer Center of Excellence.
Weekly brainstorming sessions involve up to 30 specialists, who gather in a large conference room to gaze at tissue samples, discuss cases and dissect recent research findings.
But there’s a problem: The clinical needs more participants.
The pancreatic study could handle up to 1,250 participants, but now has about 688 regularly providing samples, according to Suzanne Wessling, the research project coordinator for the study.
It’s an important numbers game – pancreatic cancer occurs in only about 1% of the general population. So the more participants who are in the study – and these are people with a higher risk – the greater the chance that someone will contract the disease.
If that happens, researchers can dig back into their data to see if something changed in a patient’s blood samples, or if they reported new symptoms. Such an early marker would allow earlier treatment and save lives.
“It’s like finding a needle in a haystack,” said Christina Hoy, clinical program director for the study.
The study seeks participants who have a higher possibility of contracting pancreatic cancer, such as members of the Geis family, which has a history of pancreatic and related cancers.
Researchers are also seeking volunteers for the study who were recently diagnosed with diabetes, have a genetic mutation associated with pancreas cancer, have cysts in the pancreas or have chronic pancreatitis.
Such groups are at a slightly higher than average risk for pancreatic cancer, Hoy said.
She said there’s no need to “twist people’s arms who have been touched by this disease” to volunteer for the study. But it is important, Hoy said, to get the word out to people who could participate and who could help find an early marker for the disease.
“This is a highly motivated group of people,” she said of the volunteers.
Hingorani said there are a number of reasons to be optimistic that an early indicator for pancreatic cancer, and more effective treatments, will be found.
For one, he said that researchers are beginning to understand the “complex relationship” between the cancer and diabetes.
There are also new technologies that can detect minute amounts of DNA in the blood that came from cancerous and precancerous cells in the pancreas, Hingorani said.
“These technologies have the potential to detect a cancer long before it becomes visible on a CT scan,” he said.
Overall, Hingorani said, researchers have dramatically changed their approach to a complex and insidious disease. In some cases, past treatments were promoting, rather than inhibiting, the disease, the doctor said.
“The last 10 years or so have seen a complete reappraisal of our understanding of what pancreatic cancer is,” he said. “A pancreas cancer is a complex ecosystem that takes the normal rules and principles of cell biology and physiology and repurposes them to suit its own needs.”
Suzanne Kolterman’s siblings took turns recently providing blood samples – and sharing memories of their sister.
She was a picture of health, they said, who never missed a daily walk. She was a giving person, active in community and church affairs in Seward and in a group of women who donated $20 a month to provide an anonymous “random act of kindness” to a stranger.
Suzanne’s husband, Mark, who was a state senator when she was diagnosed, played a key role in helping continue the UNMC study.
He was approached by Dr. Jim Armitage – who also lost his wife to pancreatic cancer – after Suzanne Kolterman’s death and asked if the Nebraska Legislature might be able to help sustain the research, which began in 2018.
Mark Kolterman said Armitage had been a huge help as Suzanne went through cancer treatments, so when he was asked, Kolterman eagerly volunteered to see what he could do.
The result: The Legislature agreed to allocate $15 million of the state’s $1.04 billion in American Rescue Plan Act funds to the Med Center’s program, if private donors could match that amount.
Early detection and effective treatments have been discovered for other forms of cancers, so Kolterman said, it’s vital it also happens with pancreatic cancer.
“It’s called the silent killer,” he said. “Most people don’t know that they have it. And when they do, they don’t have a very good chance of surviving.”
