Interview: “Majority of PC patients remain untreated”

Interview for the EPCI Facebook forum with dr Michael. B. Mortensen, professor of Surgery, HPB Centre, Odense University Hospital, Denmark, and member of the 2014 Euro Pancreatic Cancer Index (EPCI) Expert Panel.

“Majority of pancreatic cancer patients remain untreated, says EPCI expert”

Professor Mortensen, the EPCI will be the first ever open comparison of pancreatic cancer care in Europe. What is crucial dealing with pancreatic cancer?

Firstly, it is important to perform a safe and accurate stratification of patients into the right treatment groups; and secondly, to ensure that all patients are treated sufficiently – not only those needing surgery. Cohort studies tell us that the majority of patients remain untreated and these patients tend to be forgotten.

It looks alarming that most patients are left without treatment! Can the EPCI in any way address this situation?

Comparisons among countries or benchmarking are always difficult, but EPCI 2014 may point out some international reference points and problems that should be addressed on a larger scale. In addition, the EPCI may inspire countries to improve and re-organize their general efforts towards both patients and their relatives.

What progress can we hope for in the years to come? Which are your priorities, being a specialist on pancreatic cancer?

More attention is needed towards a better monitoring of the entire pancreatic cancer population. Better patient stratification may enable a better and individual quality of care and an increased median survival for pancreatic cancer patients. Other focus points are:

Optimizing the care of patients before, during and after surgery and the care in relation to palliative treatment

Screening of high risk populations (e.g. hereditary chronic pancreatitis, familiar pancreatic cancer)

More studies on neoadjuvant therapy (chemotherapy and/or radiation treatment before surgery) in patients with resectable (surgically removable) and locally advanced tumours

Translational research is ongoing but research strategies should be internationally coordinated and would benefit from an increased flow of clinical data back to the basic molecular experiments.

The EPCI will point to a severe lack of outcomes information with regard to pancreatic cancer treatment. What does the information gap mean to the patient?

Lack of proper assessment and information may lead to sub-optimal care. The patient should be able to view and assess the treatment quality and overall results on a national (and regional) level. The patient should be able to feel confident that optimal care is provided regardless of where the care is given, ends professor Mortensen.

 

E-mail address of professor Mortensen: michael.bau.mortensen@rsyd.dk