Research and Detection
Genetics
Scientists are learning more about some of the changes in DNA that cause cells in the pancreas to become cancerous. Inherited changes in genes such as BRCA2, p16, and the genes responsible for hereditary non-polyposis colorectal cancer (HNPCC) can increase a person’s risk of developing pancreatic cancer.
They have discovered that pancreatic cancer does not form suddenly. It develops over many years in a series of steps known as pancreatic intraepithelial neoplasia, or PanIN. In the early steps, such as PanIN 1, there are changes in a small number of genes, and the duct cells of the pancreas do not look very abnormal. In later steps such as PanIN 2 and PanIN 3, there are abnormalities in several genes and the duct cells look more abnormal.
Researchers are using this information to develop tests for detecting acquired (not inherited) gene changes in pancreatic cancer precancerous conditions. New diagnostic tests are often able to recognize this change in samples of pancreatic juice collected during an endoscopic retrograde cholangiopancreatography (ERCP).
The National Familial Pancreas Tumor Registry (NFPTR)
​The NFPTR was established in 1994 to find the causes of pancreatic cancer. Johns Hopkins’ pancreas team is interested in both the genetic and non-genetic causes of pancreatic cancer. They are particularly interested in finding the genes that cause pancreatic cancer to cluster in some families. Up to 10% of pancreatic cancer patients have another close relative who has also developed pancreatic cancer. There isn’t an explanation in the clustering of pancreatic cancer in most families; however, studies continue to identify new familial pancreatic cancer genes that explain this clustering in subsets of families. The NFPTR is a family history of both maternal and paternal sides of the family, along with smoking habits, and other family medical information. For more information, email: pancreas@jhmi.edu
Cancer of the Pancreas Screening Study (CAPS)
The Johns Hopkins Pancreas team works very closely with an ongoing early detection screening study called the Cancer of the Pancreas Screening Study (CAPS). The study involves a dose of Secretin (a synthetic human hormone) that will enable JHH medical research teams to collect pancreatic fluid to analyze as a potential way to find early indications of pancreatic cancer or pre-cancer. This study will take place at Johns Hopkins Hospital, in Baltimore, Maryland. This study involves a pancreas screening which incorporates a gastroenterology consultation, possible MRCP (Magnetic resonance cholangiopancreatography), EUS (Endoscopic ultrasound), and an optional genetic counseling session into your visit. For more information, email: caps5@jhmi.edu
Rapid Autopsy
Throughout her life, Nikki Mitchell gave herself to those in need. She wanted to continue that giving spirit after death with the selfless act of donating to the Rapid Autopsy Program at Johns Hopkins Hospital.
This is a unique program in which patients who lose their battle with cancer volunteer to have a rapid autopsy so that investigators can study their tumors, cells, and genes to find answers that may save the lives of future patients. This research program helps decipher how pancreas cancer originates and spreads, as well as identifies potential new ways to treat the disease.
In the past, researchers looking for circulating tumor cells were able to harvest just one or two cells in the donations. For the first time ever, they harvested multiple cells from Nikki’s donation. The data collected from Nikki’s donation was impactful.