Pancreas Tumor Center providing diagnosis, treatment plan in a day
Mays Cancer Center Annual Report
Many patients with an unexplained tumor or even a cancer diagnosis face days or weeks of medical appointments. But at the Pancreas Tumor Center, operated by University Health System in partnership with UT Health San Antonio, most patients learn their condition and treatment plan in one day.
The patient-centered, multi-disciplined facility is run as a one-day clinic that connects a variety of medical professionals with a patient instead of the patient having to visit six different clinics over the course of several days or weeks. In some cases, patients have a mass on the pancreas but lack a diagnosis.
Sukeshi Patel Arora, M.D., holder of the John Eiler Endowed Professorship in Cancer Research, is the medical oncologist and gastrointestinal malignancies leader who specializes in pancreatic cancer treatments and clinical trials at the center. The team also includes pancreatic and transplant surgeons, gastroenterologists specializing in advanced endoscopy, dietitian, social worker and geriatric and palliative care experts, among others.
“It’s a wonderful, collaborative approach to taking care of patients with cancer,” Dr. Arora says. “It’s our gold standard, and we’re so lucky we can provide that to our patients.”
On a typical day, a patient arrives in the morning to meet with Kathy Crow, PA-C, physician assistant and clinic coordinator, who conducts an assessment and determines if imaging is needed. Imaging is done that morning.
The patient also meets with dietitians and social workers for recommendations. When the patient breaks for lunch, specialists that include radiologists and pathologists meet to discuss the patient’s unique case.
During the multi-disciplinary tumor board, the gastroenterologist, surgeon and oncologist join the discussion to develop a specialized, personalized treatment plan to share with the patient before the day ends. “As a team, we are honored to care for these patients and do our utmost to ensure an excellent experience in very difficult circumstances,” Crow says.
Such a structure is unique, Dr. Arora says, because it is challenging to coordinate schedules for so many experts in one place on the same day. Doing so, however, keeps the focus on the patient, she says, adding, “We try to get it all done in one day. It’s nice to get this information for our patients, who often have many questions. It is a relief for patients.”
The Pancreas Tumor Center, launched in 2018 and patterned after the successful Texas Liver Tumor Center at the Mays Cancer Center, can see as many as six patients every Thursday, Dr. Arora said.
Irma Infante, M.S.N., RN, serves as director of the Pancreas Tumor Center, Texas Liver Tumor Center and Advanced Endoscopy Program. “We attempt to provide a worry-free experience so their only focus is the actual visit. They have enough to worry about; a clinic visit should not be one of them,” Infante explains.
She says having so many specialists form a Pancreas Tumor Board to review each case is “remarkable, to say the least. It is the type of care that most health care professionals can only dream about, and we have it here, in San Antonio, in our own backyard.”
The clinic also supports patients during their treatments and follow-up appointments.
San Antonio resident Mary Churchill, who was diagnosed with pancreatic cancer in 2017, sings the praises of both the clinic and Dr. Arora. “She takes her time when she checks me and reviews my lab reports. She’s very thorough, and that is greatly appreciated after you’ve had cancer,” Churchill says. “I really like her, she’s a good doctor.”
In the beginning, Churchill did not know she had cancer but was alarmed by several days of discolored urine. She went to an urgent care facility and was told she had a gall bladder infection. Her next stop was University Hospital, where doctors diagnosed cancer and removed one third of her pancreas, her gall bladder and sections of her stomach and bowel. Chemotherapy followed as did regular appointments with Dr. Arora. “She powered through it,” Dr. Arora says of Churchill. “Now, she’s three years out from her diagnosis.”
Working in Churchill’s favor was the fact that doctors detected the cancer at Stage 2. Symptoms do not appear for many pancreatic cancer patients until it reaches Stage 4. By that point, Dr. Arora notes that more than three-fourths of patients are not candidates for surgery.
Despite the fact that survival rates recently have increased at the five-years out benchmark from 5 percent to 10 percent, pancreatic cancer still is considered to have the lowest survival rate of any major type of cancer and is projected in the next decade to rise to the second-leading cause of cancer-related mortality, after lung cancer, in the United States.
Nevertheless, Dr. Arora says new drugs for pancreatic cancer are being developed every day, making clinical trials, including those offered by the Mays Cancer Center, essential. Dr. Arora also advocates genetic testing, which is offered at the center, where three genetic counselors are available to consult and screen high-risk patients.
“I chose to go into gastrointestinal malignancies because I love building relationships with patients,” Dr. Arora says. “With pancreatic cancer, there’s a lot of research to be done. My focus has allowed me to take care of patients who need a doctor who cares for them and who value that patient-physician relationship but who also pushes the limits. That’s why we are here.”
