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Pinpointing Pancreatic Cancer

Ask the Doc: Why Johns Hopkins?

Marcia Canto, M.D., Director of Endoscopy answers...

There are so many advantages Johns Hopkins offers its patients. First, we have one of the largest programs for screening for familial pancreatic cancer and are one of the world leaders in prevention of pancreatic cancer. We are now leading an international consortium of about 24-25 centers in a collaborative, worldwide screening effort. Johns Hopkins also boasts the largest multidisciplinary program, in which experts from all areas of pancreatic cancer treatment come together to brainstorm the best individual treatment plan for each patient. In addition, pancreatic cancer experts such as I conduct a large number of clinical trials on the disease.

Marcia Canto

Endoscopic ultrasound is a technique in which my fellow physicians and I can pass a thin, lighted tube called an endoscope through a patient's mouth and stomach, down into the first part of the small intestine. At the tip of the endoscope is a device that uses ultrasound -- sound waves that produce a pattern of echoes as they bounce off internal organs. Doctors slowly withdraw the endoscope from the intestine toward the stomach to make images of the pancreas and surrounding organs and tissues.

The technique traditionally is used to identify small cancers that cannot be detected by a CT scan. Here at Hopkins, we work together with radiation oncologists to use the technique for additional purposes. For example, we can use the ultrasound technology for fiducial placement, which is the placement of markers to more precisely measure a tumor before a patient undergoes targeted radiation therapy or stereotactic radiosurgery – a single high-dose of radiation precisely targeted to the tumor. We also use endoscopic ultrasound in palliative care patients, to place stents that keep blood vessels open; to guide delivery of anesthetic medication in a celiac plexus nerve block. And, we also use the technique during a treatment called photodynamic therapy, in which a light-sensitive medication is activated to kill cancer cells.


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