Michael Wallace

JACKSONVILLE, Fla. — Most people know a colonoscopy requires some preparation by the patient. Now, a Mayo Clinic physician suggests an additional step to [...]

JACKSONVILLE, Fla. — August 29, 2012.  Removing the entire pancreas in patients with cancer or precancerous cysts in part of the organ does not result in unmanageable diabetes — as many physicians previously believed, research at Mayo Clinic in Florida has found. The study, published online Sunday in the journal HPB Surgery, evaluates how well patients who had their entire pancreas removed could control their resulting diabetes. The pancreas produces insulin to remove sugar from the blood, so when the organ is gone, insulin must be replaced, usually through an external pump or with injections. The researchers examined control of insulin over several years in 14 patients whose entire pancreas was removed. They compared their findings with 100 people with type 1 diabetes, and must use insulin replacement. They found both groups had little difficulty controlling their blood sugar, and no complications resulted. The findings should reassure physicians and surgeons that removing the entire pancreas is reasonably safe and effective, says senior investigator Michael B. Wallace, M.D., chair of the Division of Gastroenterology & Hepatology at Mayo Clinic in Florida. "What has confounded surgery for pancreatic cancers and precancerous cysts for a long time is the notion that if the entire organ is removed, patients will have great difficulty in controlling the resulting diabetes," Dr. Wallace says. "Most surgeons try to leave as much of the pancreas as possible". "What we have shown here is that, due to wonderful recent improvements in insulin therapy, patients without a pancreas can control their blood sugar as effectively as type 1 diabetes patients can," he says. Although this study was small, Dr. Wallace says the findings are mirrored in the experiences of patients treated at Mayo Clinic in Florida with total pancreas removal. Even though the approach of preserving as much of the pancreas as possible benefits most patients, leaving part of the pancreas in some patients may put them at risk of developing hard-to-detect cancer in the remaining organ, he says.

JACKSONVILLE, Fla. — May 17, 2012.  By simply shining a tiny light within the small intestine, close to that organ's junction with the pancreas, physicians at Mayo Clinic's campus in Florida have been able to detect pancreatic cancer 100 percent of the time in a small study. The light, attached to a probe, measures changes in cells and blood vessels in the small intestine produced by a growing cancer in the adjoining pancreas.

VIDEO ALERT: Video of Dr. Michael Wallace discussing the study is available on the Mayo Clinic News Network, our new method for delivering embargoed media content. The network requires a username and password, which can be obtained at http://NewsNetwork.MayoClinic.org. Learn about this new network by watching this short video.

This minimally invasive technique, called Polarization Gating Spectroscopy, will now be tested in a much larger international clinical trial led by the Mayo Clinic researchers. The preliminary study suggests it may be possible, one day, to use a less invasive endoscope to screen patients for early development of pancreatic cancer. The findings are being highlighted in a special address by Mayo Clinic gastroenterologist Michael Wallace, M.D., at the international Digestive Disease Week 2012, the world's largest gathering of physicians and researchers who treat, and study, disorders of the gastrointestinal tract. The pancreas is notoriously hard to reach and see due to its very deep location in the abdomen, surrounded by intestines. The study investigators theorized that there may be changes in the nearby "normal appearing" tissue of the small intestine which is much more accessible. "No one ever thought you could detect pancreatic cancer in an area that is somewhat remote from the pancreas, but this study suggests it may be possible," says Dr. Wallace, the chairman of the Division of Gastroenterology at Mayo Clinic in Florida. "Although results are still preliminary, the concept of detection field effects of nearby cancers holds great promise for possible early detection of pancreatic cancer." Pancreatic cancer is one of the most deadly of human tumors. It is only curable in 5 percent of cases, and even when it is surgically removed, 70 percent of patients have a recurrence that is fatal, Dr. Wallace says. There are no ways currently to detect the cancer early enough to cure a substantial number of patients, he says. Pancreatic cancer is now usually detected through an imaging scan, followed by an invasive biopsy. Tumors found in this way are usually at an advanced stage. In this study, the Mayo Clinic physicians tested a light probe developed by their long-time collaborators at Northwestern University.

Jorge Rivera raised his cell phone and took a self-portrait that showed an almost imperceptible scar on his neck. Rivera, an administrative [...]