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Doctors fight back, tackle uncommon cancer

She was known for her style and grace, and admired for her humor. As a state senator, Emily Couric fought tirelessly for the University's causes and for common citizens' needs.

But as a patient with pancreatic cancer, Couric also fought an uphill battle with life. Last Wednesday, she lost that battle.

Now, the University she helped serve is returning the favor, with promising research that may shed some light into the causes and treatment of the cancer that plagued her and another respected member of the University community, women's basketball coach Debbie Ryan.

Pancreatic cancer accounts for 2 to 3 percent of all cancers but is the fifth-most frequent cause of cancer deaths. Patients who receive the diagnosis of pancreatic cancer usually have grim prospects.

The pancreas is an organ in the abdomen that makes insulin and other enzymes that help the body use or store energy from food. Cancer in the pancreas generally starts in the ducts that carry these enzymes, or pancreatic juices.

Michael Weber, director of the University Medical Center's Cancer Center says the pharmaceutical company Pfizer currently is working on a drug that will target an enzyme discovered by Pharmacology and Medicine Professor Thomas Sturgill. The drug will not be available to the public for several years, but University clinical trials soon will allow patients access to it. Couric died before having the chance to receive this experimental treatment.

"The timing was very unfortunate, but in six months or a year we should be able to have it for clinical trial," Weber said.

The enzyme, MAP kinase, may hold the key to halting the growth of pancreatic cancer cells. Studies have confirmed that the enzyme consistently is activated in prostate, colon and pancreatic cancers.

"You can't say it alone causes cancer, but it is strongly correlated to the proliferation and growth," Sturgill said.

The experimental drug will not inhibit the enzyme itself, but the activator of the enzyme, called MAP kinase kinase.

Doctors generally treat all cancer patients with chemotherapy and radiation therapy to prevent further growth of the cancer. These treatments usually have not worked in the case of pancreatic cancer because diagnosis of the disease often comes too late.

University doctors say pancreatic cancer in its early stages has vague symptoms -_ pain in the upper abdomen, nausea, loss of appetite, weight loss and weakness. People with pancreatic cancer often ignore these symptoms, allowing the cancer to wreak havoc on the body. By the time doctors discover the cancer, the patient's chance of survival are extremely small.

Ryan, on the other hand, was one of the uncommon cases. Her cancer was diagnosed early and surgery successfully removed the cancerous tumor before it could spread to other organs.

"I was really, really lucky," she said.

Because her cancer was caught in its early stages, Ryan's life was spared.

But Internal Medicine Associate Professor Paul Yeaton, whose research centers on pancreatic cancer detection, said that most often it isn't until patients experience jaundice - yellowing of the skin caused by excess bile in the blood - that the diagnosis is made. By then, the tumor may have spread to other organs and grown out of control.

As the cancer grows, the tumor may invade organs that surround the pancreas, such as the stomach or small intestine. If that happens, Weber said the patient's time left is measured in months, not years. Pancreatic cancer patients at this point live on average another six months after diagnosis.

Because Couric's cancer was at that stage, he said the 15 months following her diagnosis was "quality time."

While she still was alive, Couric, with help from fellow cancer-sufferer Ryan, spearheaded an effort to support the University Cancer Center's patient education and support services.

This past May, they attracted Grammy-award winning singer/songwriter Mary Chapin Carpenter to the University for a benefit performance in Old Cabell Hall. The $100,000 they raised benefited the Cancer Center, where Ryan and Couric underwent surgery and follow-up treatment for their cancers.

Cancer Center patient education coordinator Diane Cole said it gave a needed boost to the Center's patient education and support services office, which has no continual income.

In response to Couric's death and Ryan's diagnosis, the Cancer Center also has added a pancreatic hotline, which keeps patients informed about the different clinical trials and treatments available to them.

Cole remarked, "Their [Couric and Ryan's] effort was tremendous. They helped increase education for all cancer patients"