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All right.

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Welcome to the

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next installment of Live Well

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with UCI Health.

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I'm Ryan Manno from KOST 103.5

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iHeart Radio.

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Thrilled to be joined today

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by Doctor Christopher Paiji.

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Board-certified

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UCI Health gastroenterologist

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who specializes

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in the treatments of

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various GI issues,

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pancreatic things of this nature.

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So we're going to talk

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about pancreatic cancer.

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It's obviously

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I would venture to say

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the most feared thing to hear.

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Right. If you get that diagnosis.

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Oh God. Right.

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I mean I know

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even just,

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you know, Alex Trebek,

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Steve Jobs, right?

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They're two

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of the most well-known,

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you know, celebrities

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that passed from it.

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Why is it so feared?

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And, you know,

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I guess the flip side of

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that is what gives you hope

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with what you do.

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Absolutely.

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That's a great question.

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So pancreatic cancer

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is one of the most

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challenging cancers that we face.

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And one reason

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is that typically

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we find it too late.

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Most patients who are given

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the news of pancreatic cancer

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are found to have it

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in advanced stages.

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And that limits treatment options

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and potentially lowers

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the chance for a cure. Sure. Yeah.

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And another reason

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that pancreatic cancer is feared

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is because the

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rates are increasing.

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It's predicted by 2030,

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pancreatic cancer

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will be the second leading

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cause of cancer

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related deaths in the US.

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Why is that?

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Why is it why is it increasing?

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Yes.

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I think there's

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a couple of reasons.

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It's probably due to,

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a number of risk factors,

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I think, that are still

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being studied.

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But potentially

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it may be related to,

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you know, increased body weight.

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Okay.

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Also related to smoking

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interesting, excessive

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alcohol use as well. Interesting.

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This might be a just

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a really silly question.

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And I clearly wasn't

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paying close enough

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attention in biology

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or health class.

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Where is the pancreas located? Yes.

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So the pancreas is an organ

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that's deep in the abdomen

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and actually sits

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behind the stomach.

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And due to its location,

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that makes it

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one of the more challenging cancers

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to diagnose. Sure.

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Because pancreatic tumors

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can grow very quickly,

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but also silently in this location

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without causing any major alarm

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symptoms at first.

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Got it.

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And, uh, just going to get all my,

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my silly questions out of the way.

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I mean,

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you're probably like,

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who is this guy

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who doesn't know

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anything about pancreas?

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What does it do?

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Yeah.

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So the pancreas has,

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very important functions.

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It produces

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enzymes that help us digest

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our foods.

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Well,

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it also makes hormones

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that help regulate our blood sugar

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and our overall metabolism.

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Is it one of those situations

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because I, you know,

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and I've learned a lot

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throughout the course

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of this series.

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Some of the things

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that we've

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discussed are they don't

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you don't know

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because the symptoms

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aren't there until it's

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stage four or, you know, advanced.

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Right.

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Is that

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is that another one

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of these situations?

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Yeah.

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That's what makes it difficult

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with pancreatic cancer.

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The symptoms may not be obvious

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in the beginning.

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Some symptoms

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to look out for include

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a loss of appetite, weight loss,

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lack of energy,

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discomfort in the upper portions

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of the belly and back.

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And jaundice,

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which is where the

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white portions of the eyes

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become yellow.

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The skin may turn yellow

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and the urine becomes dark.

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Yeah. What?

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Before we get back

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into the screenings and stuff,

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what drew you to this field?

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Just, personally, for you?

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While I was in medical school,

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I was fascinated

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by the digestive system

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and treating patients

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with digestive conditions,

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including pancreatic cancer.

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I worked with amazing professors

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who really inspired

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and guided me to work towards

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becoming a gastroenterologist.

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And while I was pursuing

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this interest in medical training,

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my own father

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was diagnosed

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with pancreatic cancer

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and he passed away from it.

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Oh my goodness.

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Through that experience,

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I gained an important perspective

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on what

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patients and their families

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go through

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with pancreatic cancer.

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And my goal is for every patient

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to help them

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achieve the best medical outcomes.

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But also genuinely empathize

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with the experiences

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that they and

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their families are going through.

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Sure.

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When you have to,

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you know,

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consult with patients that that may

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be fighting this

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or dealing with this.

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Do you share that

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with them like that.

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This is your

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this was your journey

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with your father?

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Yes. Yeah.

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You know, in

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certain circumstances

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where that would be appropriate.

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I think. Yeah.

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It does help,

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you know, help them to show that.

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I can understand the anxiety

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that they're going through. Yes.

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I can understand how

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important support is for a patient

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that goes beyond medical treatment.

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Yeah.

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Including social support.

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Yes. And and all those things.

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So I do let patients

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know that I'm here for them. Yeah.

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Because it is, like you said, it's

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a, you know, it's

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deep in the abdomen

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to say, abdomen or the stomach.

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Yes. Okay.

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How do we get it earlier?

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How do we see this earlier?

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What are some things

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that we can do

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to detect this before

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it gets to bad things?

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That's a great question, Ryan.

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So right now

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we do not have

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pancreatic cancer screening

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for the entire population. Okay.

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We have screening programs

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for those who are considered

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high risk for pancreatic cancer.

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And so I think it's important

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for every one in the community

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to be aware of medical conditions

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that run in their family,

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including cancers.

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There are two reasons

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why someone may be eligible

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for pancreatic cancer screening.

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Okay.

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One reason is due to

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a strong family history,

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including multiple relatives

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and at least one

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immediate family member

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with pancreatic cancer.

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And the second reason

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is because they underwent

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genetic testing,

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which shows that they have

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a change in their genetics

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that predisposes

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them to pancreatic cancer.

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And what types of changes

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are we talking about in that?

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Yes.

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So, you know, these are,

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what we call changes or mutations in genes.

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Oh, these include genes

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that you may have heard of before,

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including BRCA. Okay.

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And I've heard that. You've heard that

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in addition

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to the gene for Lynch syndrome.

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Okay.

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We typically think of some of these

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genetic changes

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related to other cancers.

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Like for BRCA,

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we think of breast cancer

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and ovarian cancer

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and Lynch syndrome

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We think of colon cancer.

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genetic changes will also put them

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at increased risk

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for pancreatic cancer.

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Interesting.

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In your position,

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doing what you do,

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do you wish that

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everyone had access to

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to pancreatic screening?

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Absolutely. I think that,

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we are still working on that.

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And I do foresee,

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a day in the future where that is,

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a more of an availability. Sure.

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I think that

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what we're working on is improved

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testing for screening.

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There are promising,

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blood-based testing

00:07:07:00 - 00:07:08:13
that are currently in the works

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but are still in

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more of a investigative phase.

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Yeah.

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But my hope is that in the future,

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we will have something

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that's more widely

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available as well.

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And, I mean, I'm

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basing that off of what you said.

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If, you know,

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you said by the year 2030, it's

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going to be the second leading.

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I mean, if that's the trend,

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you would think

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that the medical community or the

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however it works would say,

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wait a second,

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we have too many people.

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We're losing way

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too many people too.

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That's right. Absolutely.

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Yeah, absolutely.

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There's a big motivation

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in the community

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to continue performing research,

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in this area.

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So that we can detect

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pancreatic cancer earlier.

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Which we know that

00:07:46:05 - 00:07:48:23
this will be important in affecting

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overall outcomes

00:07:49:20 - 00:07:50:18
with respect to treatment.

00:07:50:18 - 00:07:51:08
Yeah.

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You mentioned,

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you know, the, the high risk

00:07:53:22 - 00:07:54:22
factors in terms of,

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you know, family history

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and change in genetics are the

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what type of lifestyle things are,

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you know,

00:08:00:07 - 00:08:01:17
possibly contributing to this.

00:08:01:17 - 00:08:02:10
Absolutely.

00:08:02:10 - 00:08:04:10
So there are modifiable factors

00:08:04:10 - 00:08:05:15
that we can control

00:08:05:15 - 00:08:08:02
to reduce our risk of cancer.

00:08:08:02 - 00:08:08:22
This includes

00:08:08:22 - 00:08:10:20
avoiding smoking and excessive

00:08:10:20 - 00:08:12:01
alcohol use.

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And maintaining a healthy weight.

00:08:14:01 - 00:08:16:12
So these are things we consider

00:08:16:12 - 00:08:18:08
important for maintaining

00:08:18:08 - 00:08:19:22
our overall health.

00:08:19:22 - 00:08:22:07
It's also good to note that

00:08:22:07 - 00:08:24:08
taking control of these factors

00:08:24:08 - 00:08:25:22
also lowers our risk for cancer.

00:08:25:22 - 00:08:27:15
Sure. Just in general. Right.

00:08:27:15 - 00:08:28:16
Yeah, absolutely.

00:08:28:16 - 00:08:30:13
Just like be healthier. Right.

00:08:30:13 - 00:08:31:17
You know.

00:08:31:17 - 00:08:33:06
Yeah. Yes. Yes.

00:08:33:06 - 00:08:34:03
So let's talk about,

00:08:34:03 - 00:08:34:21
you know, you

00:08:34:21 - 00:08:35:15
you have your,

00:08:35:15 - 00:08:37:13
your specialist here at UCI Health.

00:08:37:13 - 00:08:38:16
There's a whole team of you guys.

00:08:38:16 - 00:08:40:15
What does care for a patient,

00:08:40:15 - 00:08:42:01
You know, from a teamwork

00:08:42:01 - 00:08:43:02
perspective, once,

00:08:43:02 - 00:08:43:21
once they're with you,

00:08:43:21 - 00:08:44:04
and once

00:08:44:04 - 00:08:45:13
you guys have gotten this

00:08:45:13 - 00:08:46:02
figured out

00:08:46:02 - 00:08:47:13
with what they're dealing with,

00:08:47:13 - 00:08:49:11
how does the care look from there?

00:08:49:11 - 00:08:50:00
Absolutely.

00:08:50:00 - 00:08:51:20
So I feel very fortunate

00:08:51:20 - 00:08:54:02
to be working at UCI,

00:08:54:02 - 00:08:55:20
where I work with a team

00:08:55:20 - 00:08:57:02
of specialists and

00:08:58:02 - 00:08:59:23
for every patient, the

00:08:59:23 - 00:09:01:19
plan of treatment is discussed

00:09:01:19 - 00:09:03:01
as a team

00:09:03:01 - 00:09:03:21
that includes

00:09:03:21 - 00:09:05:05
oncologists,

00:09:05:05 - 00:09:07:18
surgeons, radiologists,

00:09:07:18 - 00:09:09:10
gastroenterologists like myself

00:09:09:10 - 00:09:11:04
and other specialties.

00:09:11:04 - 00:09:12:10
There are formal meetings

00:09:12:10 - 00:09:13:03
that are occurring

00:09:13:03 - 00:09:14:12
to discuss plan of care.

00:09:14:12 - 00:09:15:11
So you guys will sit down

00:09:15:11 - 00:09:17:16
with each other first before going.

00:09:17:16 - 00:09:18:06
Okay. Got it.

00:09:18:06 - 00:09:19:03
So we have these regular

00:09:19:03 - 00:09:20:00
tumor boards. Yep.

00:09:20:00 - 00:09:20:22
And on top of that,

00:09:20:22 - 00:09:21:18
Ryan, we're

00:09:21:18 - 00:09:24:00
constantly communicating

00:09:24:00 - 00:09:24:15
with regards

00:09:24:15 - 00:09:25:17
to the care of our patients.

00:09:25:17 - 00:09:27:16
We are always discussing

00:09:27:16 - 00:09:28:19
what are the next steps

00:09:28:19 - 00:09:29:20
to help provide

00:09:29:20 - 00:09:31:19
the best care for our patients.

00:09:31:19 - 00:09:32:11
And let's talk about

00:09:32:11 - 00:09:33:12
some of those next steps.

00:09:33:12 - 00:09:34:08
Innovative treatments

00:09:34:08 - 00:09:35:21
I know you guys are constantly

00:09:35:21 - 00:09:37:12
like looking forward to you know

00:09:37:12 - 00:09:38:15
what's coming. What's next.

00:09:38:15 - 00:09:39:01
I mean

00:09:39:01 - 00:09:40:21
what are some of those treatments

00:09:40:21 - 00:09:41:20
that you're

00:09:41:20 - 00:09:43:16
you're really behind right now.

00:09:43:16 - 00:09:44:06
Absolutely.

00:09:44:06 - 00:09:46:20
So there is an increasing number

00:09:46:20 - 00:09:48:01
of advances in treatment

00:09:48:01 - 00:09:49:06
that gives us hope

00:09:49:06 - 00:09:50:00
To improve care.

00:09:50:00 - 00:09:50:20
And that's important.

00:09:50:20 - 00:09:51:11
You hope. Right.

00:09:51:11 - 00:09:52:04
You all you're

00:09:52:04 - 00:09:52:22
looking for at that point.

00:09:52:22 - 00:09:54:10
Just some hope. Absolutely. Yeah.

00:09:55:09 - 00:09:56:10
One of

00:09:56:10 - 00:09:57:03
the important

00:09:57:03 - 00:09:59:02
advancements is the increasing role

00:09:59:02 - 00:10:01:03
of robotic surgery. Okay.

00:10:01:03 - 00:10:02:13
To remove pancreatic tumors.

00:10:02:13 - 00:10:05:00
So our surgeons can use robots

00:10:05:00 - 00:10:06:16
to help

00:10:06:16 - 00:10:09:02
perform highly complex operations.

00:10:09:02 - 00:10:11:10
with smaller incisions,

00:10:11:10 - 00:10:12:23
quicker recovery time,

00:10:12:23 - 00:10:14:01
and potentially less pain

00:10:14:01 - 00:10:15:08
than traditional surgeries.

00:10:15:08 - 00:10:16:03
Yeah.

00:10:16:03 - 00:10:18:19
With regards to cancer treatment,

00:10:18:19 - 00:10:20:01
there are an increasing

00:10:20:01 - 00:10:21:01
number of treatments

00:10:21:01 - 00:10:22:15
that are becoming available

00:10:22:15 - 00:10:24:11
for pancreas cancer

00:10:24:11 - 00:10:26:21
that may more effectively treat it

00:10:26:21 - 00:10:28:07
and be better tolerated

00:10:28:07 - 00:10:30:07
with less side effects.

00:10:30:07 - 00:10:31:13
This includes treatments

00:10:31:13 - 00:10:33:12
such as targeted therapies

00:10:33:12 - 00:10:36:04
and immunotherapies, which help

00:10:36:04 - 00:10:37:17
enhance the body's

00:10:37:17 - 00:10:39:07
own immune response

00:10:39:07 - 00:10:41:22
to target cancer cells and,

00:10:41:22 - 00:10:44:22
destroy it, and, lastly, from

00:10:45:17 - 00:10:47:08
gastroenterology perspective,

00:10:47:08 - 00:10:48:02
which is sort of

00:10:48:02 - 00:10:49:19
my field of interest,

00:10:49:19 - 00:10:52:19
there is a role for ablation

00:10:52:19 - 00:10:54:04
or delivering treatment

00:10:54:04 - 00:10:56:11
for pancreatic tumors.

00:10:56:11 - 00:10:57:17
So I think there are

00:10:57:17 - 00:10:59:12
a number of treatments

00:10:59:12 - 00:11:01:10
that are developing that,

00:11:01:10 - 00:11:04:05
increase the optimism for,

00:11:04:05 - 00:11:05:19
treating this cancer. Yeah.

00:11:05:19 - 00:11:06:10
How do you

00:11:06:10 - 00:11:07:16
how do people come find you?

00:11:07:16 - 00:11:08:17
How do people

00:11:08:17 - 00:11:10:05
how do they get to you?

00:11:10:05 - 00:11:10:11
Yeah.

00:11:10:11 - 00:11:13:04
So I see patients,

00:11:13:04 - 00:11:14:11
for pancreatic cancer

00:11:14:11 - 00:11:15:22
in a number of different ways.

00:11:15:22 - 00:11:16:12
I think

00:11:16:12 - 00:11:17:20
probably the most common way

00:11:17:20 - 00:11:19:20
is a patient underwent

00:11:19:20 - 00:11:20:11
a scan

00:11:20:11 - 00:11:22:11
to investigate their symptoms,

00:11:22:11 - 00:11:24:02
and they were found to have a tumor

00:11:24:02 - 00:11:25:08
of their pancreas.

00:11:25:08 - 00:11:26:20
So I perform a procedure

00:11:26:20 - 00:11:29:00
called, endoscopy,

00:11:29:00 - 00:11:30:22
specifically endoscopic ultrasound.

00:11:30:22 - 00:11:31:06
Okay.

00:11:31:06 - 00:11:33:04
To get detailed images

00:11:33:04 - 00:11:36:04
of the pancreas, identify the tumor

00:11:36:11 - 00:11:38:04
and take a sample of tissue,

00:11:38:04 - 00:11:40:07
also known as a biopsy,

00:11:40:07 - 00:11:42:04
to confirm the diagnosis

00:11:42:04 - 00:11:43:15
and help them

00:11:43:15 - 00:11:45:06
get to the right specialist,

00:11:45:06 - 00:11:45:22
get treatment.

00:11:47:11 - 00:11:47:18
There are

00:11:47:18 - 00:11:48:23
other reasons why I might see

00:11:48:23 - 00:11:51:00
patients, including,

00:11:51:00 - 00:11:53:00
overseeing a pancreatic cancer

00:11:53:00 - 00:11:54:01
screening for patients

00:11:54:01 - 00:11:55:14
who are high risk,

00:11:55:14 - 00:11:57:13
monitoring precancerous growths

00:11:57:13 - 00:11:58:11
at the pancreas.

00:11:58:11 - 00:11:59:04
Yeah.

00:11:59:04 - 00:12:00:20
And lastly, patients

00:12:00:20 - 00:12:02:23
with more advanced cancers,

00:12:02:23 - 00:12:04:02
with complications

00:12:04:02 - 00:12:06:11
because of the tumor enlarging,

00:12:06:11 - 00:12:08:15
they may develop blockages,

00:12:08:15 - 00:12:10:06
of their digestive tract.

00:12:10:06 - 00:12:12:20
And I could perform procedures,

00:12:12:20 - 00:12:16:05
to place these flexible tubes

00:12:16:05 - 00:12:17:11
called stents

00:12:17:11 - 00:12:19:09
to help improve their symptoms.

00:12:19:09 - 00:12:21:06
And their overall quality of life

00:12:21:06 - 00:12:22:08
is incredible.

00:12:22:08 - 00:12:24:07
You do you do these procedures?

00:12:24:07 - 00:12:24:17
Yes.

00:12:24:17 - 00:12:25:20
And, thankfully, again,

00:12:25:20 - 00:12:27:16
with the advances

00:12:27:16 - 00:12:28:15
in the techniques

00:12:28:15 - 00:12:29:15
of what we're doing,

00:12:29:15 - 00:12:32:01
we can do things

00:12:32:01 - 00:12:32:19
that provide

00:12:32:19 - 00:12:35:02
great help to our patients.

00:12:35:02 - 00:12:35:20
Can do it

00:12:35:20 - 00:12:37:23
in minimally invasive manners.

00:12:37:23 - 00:12:38:20
And help patients

00:12:38:20 - 00:12:40:17
enjoy meaningful activities. Yes.

00:12:40:17 - 00:12:41:20
Like sitting down

00:12:41:20 - 00:12:42:17
with a family member

00:12:42:17 - 00:12:43:12
to enjoy a meal.

00:12:44:22 - 00:12:47:07
What are the benefits,

00:12:47:07 - 00:12:48:03
to coming to

00:12:48:03 - 00:12:49:05
an academic health system

00:12:49:05 - 00:12:50:16
like this. Great.

00:12:50:16 - 00:12:51:15
I mean all the people here.

00:12:51:15 - 00:12:52:01
Incredible.

00:12:52:01 - 00:12:52:12
By the way,

00:12:52:12 - 00:12:54:09
have you been to that new

00:12:54:09 - 00:12:55:22
campus in Irvine, the new hospital?

00:12:55:22 - 00:12:57:17
Yes. Holy moly.

00:12:57:17 - 00:12:59:15
Yeah. Place is unbelievable.

00:12:59:15 - 00:12:59:23
Are you going

00:12:59:23 - 00:13:00:22
to start working out of there?

00:13:00:22 - 00:13:02:04
I'll be working out of there.

00:13:02:04 - 00:13:03:12
Lucky.

00:13:03:12 - 00:13:03:22
Gosh.

00:13:03:22 - 00:13:04:16
I wanted to stay there

00:13:04:16 - 00:13:05:10
for a weekend.

00:13:05:10 - 00:13:06:01
You know,

00:13:06:01 - 00:13:07:11
it’s like an Airbnb situation.

00:13:07:11 - 00:13:08:00
Yeah.

00:13:08:00 - 00:13:08:23
What are the benefits, though,

00:13:08:23 - 00:13:09:07
of coming

00:13:09:07 - 00:13:10:11
to an academic health system

00:13:10:11 - 00:13:11:08
like UCI Health?

00:13:11:08 - 00:13:12:01
Absolutely.

00:13:12:01 - 00:13:12:16
So,

00:13:12:16 - 00:13:15:07
we have multiple renowned centers,

00:13:15:07 - 00:13:17:16
that include treatment providers

00:13:17:16 - 00:13:18:20
that provide,

00:13:18:20 - 00:13:21:14
care for pancreatic cancer.

00:13:21:14 - 00:13:22:18
One of them includes

00:13:22:18 - 00:13:25:01
the Chao Digestive Health Institute,

00:13:25:01 - 00:13:27:09
which is composed of surgeons

00:13:27:09 - 00:13:28:15
and gastroenterologists

00:13:28:15 - 00:13:30:16
who manage complex

00:13:30:16 - 00:13:31:15
digestive conditions

00:13:31:15 - 00:13:33:09
such as pancreatic cancer.

00:13:33:09 - 00:13:35:11
We also have the Chao Family

00:13:35:11 - 00:13:37:02
Comprehensive Cancer Center,

00:13:37:02 - 00:13:39:16
which is one of the few

00:13:39:16 - 00:13:41:18
nationally recognized centers

00:13:41:18 - 00:13:43:00
for providing

00:13:43:00 - 00:13:44:18
truly comprehensive care. Yeah.

00:13:44:18 - 00:13:45:20
For cancer.

00:13:45:20 - 00:13:46:20
So,

00:13:46:20 - 00:13:48:06
you know, with pancreatic cancer,

00:13:48:06 - 00:13:49:06
we should think of it

00:13:49:06 - 00:13:51:07
as it's important for every patient

00:13:51:07 - 00:13:55:00
to have a team of providers

00:13:55:00 - 00:13:55:21
who are dedicated

00:13:55:21 - 00:13:57:09
to providing personalized

00:13:57:09 - 00:13:59:04
and compassionate care.

00:13:59:04 - 00:13:59:22
And, thankfully,

00:13:59:22 - 00:14:02:22
patients can receive all of that

00:14:02:22 - 00:14:05:02
with leading experts

00:14:05:02 - 00:14:06:15
all in one place at UC Irvine.

00:14:06:15 - 00:14:07:09
Yeah,

00:14:07:09 - 00:14:08:17
given your family history,

00:14:08:17 - 00:14:09:16
your risk factors,

00:14:09:16 - 00:14:11:05
have you been screened?

00:14:11:05 - 00:14:12:05
I have been screened.

00:14:12:05 - 00:14:12:22
Good.

00:14:12:22 - 00:14:14:13
And genetic counselors

00:14:14:13 - 00:14:15:19
help patients

00:14:15:19 - 00:14:17:05
who are at higher risk

00:14:17:05 - 00:14:19:08
get access to screening tests.

00:14:19:08 - 00:14:20:07
And also help them

00:14:20:07 - 00:14:21:15
better understand their risk

00:14:21:15 - 00:14:23:00
for pancreatic cancer

00:14:23:00 - 00:14:23:21
and other cancers.

00:14:23:21 - 00:14:24:05
Yeah.

00:14:24:05 - 00:14:25:04
Was that nerve-racking to you

00:14:25:04 - 00:14:26:17
to get your screening

00:14:26:17 - 00:14:27:16
to some degree.

00:14:27:16 - 00:14:28:21
Initially, it was. Yeah.

00:14:28:21 - 00:14:31:04
But you know I came down to realize

00:14:31:04 - 00:14:32:08
that it's just really important

00:14:32:08 - 00:14:33:15
to have that knowledge.

00:14:33:15 - 00:14:33:21
Right.

00:14:33:21 - 00:14:35:22
And so I'm very grateful

00:14:35:22 - 00:14:37:11
to have had that experience.

00:14:37:11 - 00:14:38:05
You can't be out here

00:14:38:05 - 00:14:39:04
telling everyone else to do it.

00:14:39:04 - 00:14:40:07
And you're, you know,

00:14:40:07 - 00:14:41:04
I don't want to do it.

00:14:41:04 - 00:14:41:22
You got to do it.

00:14:41:22 - 00:14:43:18
That's that's very true. Yeah.

00:14:43:18 - 00:14:44:09
Doctor Paiji,

00:14:44:09 - 00:14:45:12
let's talk about the

00:14:45:12 - 00:14:47:09
screening process.

00:14:47:09 - 00:14:48:13
What would you suggest

00:14:48:13 - 00:14:49:08
is the right age

00:14:49:08 - 00:14:49:23
for someone to start

00:14:49:23 - 00:14:50:12
getting screened?

00:14:50:12 - 00:14:52:14
And once they do, let's say I'm.

00:14:52:14 - 00:14:53:18
Let's say I'm nervous. Right?

00:14:53:18 - 00:14:56:04
It's in my family history.

00:14:56:04 - 00:14:58:02
What is the process like if I have

00:14:58:02 - 00:14:59:03
if I'm going in for my screening

00:14:59:03 - 00:15:00:03
today at 10 a.m..

00:15:00:03 - 00:15:01:10
What is that?

00:15:01:10 - 00:15:02:17
So that's a two-part question.

00:15:02:17 - 00:15:03:14
Let's start with the age.

00:15:03:14 - 00:15:04:16
Absolutely. So,

00:15:06:02 - 00:15:07:06
the age really depends

00:15:07:06 - 00:15:08:20
on a number of factors.

00:15:08:20 - 00:15:12:12
That includes, the earliest age,

00:15:13:01 - 00:15:14:04
at which a family member

00:15:14:04 - 00:15:15:22
was diagnosed,

00:15:15:22 - 00:15:17:18
the type of genetic change

00:15:17:18 - 00:15:18:19
that the patients

00:15:18:19 - 00:15:20:01
are found to have on

00:15:20:01 - 00:15:22:00
genetic testing.

00:15:22:00 - 00:15:24:19
Those are multiple factors because,

00:15:24:19 - 00:15:25:17
genetic changes

00:15:25:17 - 00:15:26:22
that are associated

00:15:26:22 - 00:15:27:16
with a higher

00:15:27:16 - 00:15:30:12
risk of pancreatic cancer are,

00:15:30:12 - 00:15:31:17
advised to

00:15:31:17 - 00:15:32:04
undergo

00:15:32:04 - 00:15:33:15
screening even earlier.

00:15:33:15 - 00:15:34:03
Okay.

00:15:34:03 - 00:15:35:14
Furthermore, patients

00:15:35:14 - 00:15:37:08
who have family members

00:15:37:08 - 00:15:38:15
with pancreatic cancer

00:15:38:15 - 00:15:41:01
that were diagnosed really early,

00:15:41:01 - 00:15:44:01
are also eligible for,

00:15:44:09 - 00:15:45:05
cancer screening,

00:15:45:05 - 00:15:46:20
potentially up to ten years

00:15:46:20 - 00:15:47:22
before their

00:15:47:22 - 00:15:49:20
family member was diagnosed. Okay.

00:15:49:20 - 00:15:51:06
So then walk us through

00:15:51:06 - 00:15:52:07
what happens, right?

00:15:52:07 - 00:15:52:19
Like, like

00:15:52:19 - 00:15:53:16
if I have an appointment

00:15:53:16 - 00:15:54:02
for a screening,

00:15:54:02 - 00:15:56:00
what is the actual physical process

00:15:56:00 - 00:15:57:05
of the screening?

00:15:57:05 - 00:15:58:01
Yes, exactly.

00:15:58:01 - 00:16:00:03
So, screening programs

00:16:00:03 - 00:16:01:19
may differ from place to place.

00:16:01:19 - 00:16:03:00
Sure.

00:16:03:00 - 00:16:06:16
We use a combination of imaging,

00:16:07:04 - 00:16:08:19
to perform that,

00:16:08:19 - 00:16:11:18
one modality is doing an MRI.

00:16:13:11 - 00:16:15:00
And alternating

00:16:15:00 - 00:16:16:19
that with another procedure

00:16:16:19 - 00:16:17:19
called an endoscopic

00:16:17:19 - 00:16:18:09
ultrasound,

00:16:18:09 - 00:16:20:00
which is a specialized procedure

00:16:20:00 - 00:16:21:12
that I perform. Got it.

00:16:21:12 - 00:16:23:16
This combines,

00:16:23:16 - 00:16:25:17
the technologies of endoscopy

00:16:25:17 - 00:16:27:01
and ultrasound

00:16:27:01 - 00:16:28:12
to allow us to create

00:16:28:12 - 00:16:29:04
very detailed

00:16:29:04 - 00:16:31:02
images of the digestive tract. Wow.

00:16:31:02 - 00:16:32:15
Including the pancreas.

00:16:32:15 - 00:16:35:10
So, typically, we recommend

00:16:35:10 - 00:16:37:07
undergoing a study once a year

00:16:37:07 - 00:16:38:22
for pancreatic cancer.

00:16:38:22 - 00:16:41:22
And, typically, for my patients

00:16:42:06 - 00:16:42:19
one year,

00:16:42:19 - 00:16:43:19
I may recommend doing

00:16:43:19 - 00:16:45:08
the endoscopic ultrasound.

00:16:45:08 - 00:16:46:09
And then the following year

00:16:46:09 - 00:16:48:15
I may recommend getting an MRI.

00:16:48:15 - 00:16:49:22
So you mentioned the age

00:16:49:22 - 00:16:50:14
portion, right.

00:16:50:14 - 00:16:52:13
So the age at which

00:16:52:13 - 00:16:53:08
it was detected

00:16:53:08 - 00:16:53:18
and someone else

00:16:53:18 - 00:16:54:23
might be the right age for you.

00:16:54:23 - 00:16:56:15
What is

00:16:56:15 - 00:16:58:09
Does this typically affect,

00:16:58:09 - 00:17:00:11
you know, people higher in age?

00:17:00:11 - 00:17:01:14
And then what's the youngest

00:17:01:14 - 00:17:02:05
that you've ever seen?

00:17:02:05 - 00:17:03:15
This present itself.

00:17:03:15 - 00:17:04:19
It's a pancreatic cancer

00:17:04:19 - 00:17:06:09
that occurs in patients

00:17:06:09 - 00:17:09:11
without a known genetic change or

00:17:09:11 - 00:17:10:10
a family history.

00:17:11:12 - 00:17:12:11
Most of these

00:17:12:11 - 00:17:13:10
new cases will

00:17:13:10 - 00:17:16:08
come at an older age. Okay.

00:17:16:08 - 00:17:17:16
But pancreatic cancer

00:17:17:16 - 00:17:18:21
that may be related

00:17:18:21 - 00:17:21:05
to a genetic condition

00:17:21:05 - 00:17:22:10
may present earlier.

00:17:22:10 - 00:17:23:18
Like how early?

00:17:23:18 - 00:17:24:17
Well,

00:17:24:17 - 00:17:25:22
it really depends on

00:17:25:22 - 00:17:27:11
the type of genetic condition.

00:17:27:11 - 00:17:27:19
Okay.

00:17:27:19 - 00:17:28:19
I love that that was,

00:17:28:19 - 00:17:29:15
you know, your passion.

00:17:29:15 - 00:17:30:08
I mean, obviously,

00:17:30:08 - 00:17:31:16
the situation with your with

00:17:31:16 - 00:17:33:10
your dad is horrible,

00:17:33:10 - 00:17:34:00
but I love that

00:17:34:00 - 00:17:35:00
you followed your passion

00:17:35:00 - 00:17:37:01
and you're able to keep it alive.

00:17:37:01 - 00:17:37:20
And really,

00:17:37:20 - 00:17:38:17
to some degree,

00:17:38:17 - 00:17:40:12
you know, doing that for, for him.

00:17:40:12 - 00:17:40:20
Right.

00:17:40:20 - 00:17:43:00
It’s neat that you get to help

00:17:43:00 - 00:17:44:14
others that that, you know,

00:17:44:14 - 00:17:45:17
or maybe in that situation

00:17:45:17 - 00:17:47:17
that you were in. So absolutely.

00:17:47:17 - 00:17:47:22
Yeah.

00:17:47:22 - 00:17:49:06
It just that personal experience

00:17:49:06 - 00:17:49:18
continues

00:17:49:18 - 00:17:51:16
to drive my passion,

00:17:51:16 - 00:17:53:14
to try to spread awareness.

00:17:53:14 - 00:17:53:23
Yeah.

00:17:53:23 - 00:17:54:23
And,

00:17:54:23 - 00:17:56:11
you know, help every patient

00:17:56:11 - 00:17:57:15
make sure they get connected

00:17:57:15 - 00:17:58:15
with the right resources,

00:17:58:15 - 00:17:59:13
sure that they

00:17:59:13 - 00:18:01:12
so that they feel supported. Yeah.

00:18:01:12 - 00:18:02:12
What would be your,

00:18:02:12 - 00:18:03:15
your final takeaway,

00:18:03:15 - 00:18:04:20
you know, to somebody that,

00:18:04:20 - 00:18:05:08
you know,

00:18:06:11 - 00:18:07:01
maybe is

00:18:07:01 - 00:18:08:12
high risk or, you know,

00:18:08:12 - 00:18:09:01
watching this

00:18:09:01 - 00:18:10:04
that doesn't know much about it.

00:18:10:04 - 00:18:10:12
What's your

00:18:10:12 - 00:18:11:17
what's your message to somebody

00:18:11:17 - 00:18:13:16
about about what you do.

00:18:13:16 - 00:18:16:06
So I want everyone to recognize

00:18:16:06 - 00:18:17:06
pancreatic cancer

00:18:17:06 - 00:18:20:17
as being a serious condition.

00:18:20:17 - 00:18:21:04
Yeah.

00:18:21:04 - 00:18:22:14
One that is

00:18:22:14 - 00:18:23:00
a leading

00:18:23:00 - 00:18:26:00
cause of cancer related deaths.

00:18:26:04 - 00:18:28:06
But we do have hope

00:18:28:06 - 00:18:29:09
for improved care

00:18:29:09 - 00:18:31:14
with significant advances

00:18:31:14 - 00:18:32:01
in treatment,

00:18:32:01 - 00:18:33:15
especially in recent years.

00:18:33:15 - 00:18:34:12
I think it's important

00:18:34:12 - 00:18:35:19
for every patient

00:18:35:19 - 00:18:37:03
to be closely aware

00:18:37:03 - 00:18:38:12
of their symptoms,

00:18:38:12 - 00:18:39:21
of the risk factors

00:18:39:21 - 00:18:41:09
and their own family history.

00:18:41:09 - 00:18:41:17
Yeah.

00:18:41:17 - 00:18:43:23
So that if

00:18:43:23 - 00:18:45:14
they get pancreatic cancer

00:18:45:14 - 00:18:47:12
we detect it early.

00:18:47:12 - 00:18:49:23
And we are able to obtain

00:18:49:23 - 00:18:51:16
the best medical outcomes for them.

00:18:51:16 - 00:18:53:02
Yeah. Good stuff doctor.

00:18:53:02 - 00:18:53:17
Thank you so much.

00:18:53:17 - 00:18:54:22
Very very insightful

00:18:54:22 - 00:18:55:17
I appreciate you.

00:18:55:17 - 00:18:56:11
Thanks so much for having me.

00:18:56:11 - 00:18:57:04
Right. Got it.

00:18:57:04 - 00:18:58:10
Live Well with UCI Health.