Advancing the Cure

In the past, treatment of pancreatic cancer included surgery and then chemotherapy or radiation. “This was the standard method of care for many years,” Dr. Johnson explains. “But the pancreas is very important, and removing any part of it significantly impacts life after surgery. It can take months to fully recuperate, and so, it can be hard for patients to tolerate chemo after surgery.” This practice today has shifted to doing chemo treatments before surgery. There are also different combinations of new drugs that have proven effective in treating pancreatic disease post-surgery. “In 2011, trials of a novel drug combination extended survival, and in 2018, the same regimen used for patients after surgery helped make them disease free.”

Of course, what type of treatment a patient receives depends on the pancreatic cancer type and the stage or severity of the cancer. Treating pancreatic cancer at an early stage will offer a better prognosis and improve chances of survival. “The goal is always to prevent the development of pancreatic cancer. For example, we know there is a strong association between pancreatic cancer and obesity,” he says. Lifestyle changes, like completing more exercise and eating healthier foods, are great ways to help prevent the development of pancreatic cancer.

Diabetes
Before recent advances in treatment options, diabetes interventions focused mainly on control of blood sugars. Emily Schroeder, MD and PhD, an Endocrinologist at Parkview Health, explains there have been several major improvements with the treatment of diabetes, including the introduction of new classes of medications, an improved access to continuous glucose monitors and, finally, the patient’s ability to access improved insulin pumps with hybrid closed loop technology. 

Two important new classes of medications are glucagon-like peptide-1 receptor agonists and sodium glucose transport 2 inhibitors. Dr. Schroeder says that the first class of medications are helpful in lowering blood glucose, promoting weight loss and preventing cardiovascular disease. “The first new medication in this class was approved back in 2005 and there have been many more since then.” Dr. Schroeder says of the second class of medications, “These were approved in 2013 by the FDA, and the medicine helps kidneys excrete more glucose. They’ve had positive impacts on slowing progression of kidney disease and treating congestive heart failure.” 

There have also been significant improvements in continuous glucose monitors. “They are worn by patients for 10 to 14 days and test glucose levels every five minutes,” says Dr. Schroeder. “In recent years, these have become smaller, more accurate and more affordable.” Finally, insulin pumps with hybrid closed loop technology allow an algorithm to make changes to insulin delivery based on blood glucose levels from continuous glucose monitors. 

Heart Disease
According to Dr. Thomas Gutwein, Allen County Health Commissioner and ER physician, there have been many strides in the treatment of heart disease. “The biggest thing has been the change in tech, with the ability to do procedures less invasively,” he says. “The equipment used today is much more refined and allows for procedures that weren’t able to be done before.” For example, the wires used to complete heart catheterizations are 

now smaller and more flexible. “With less invasive procedures, there is a quicker recovery time.”

The way doctors test for heart disease has improved as well. “In the past, different blood tests were used that had vague results, not necessarily specific to cardiac problems,” he explains. These tests looked at markers from muscles in the heart, but these markers can also be found in other tissues in the body. Because of this, the results weren’t always indicative of heart disease. “Today’s Troponin tests are more sensitive and specific to cardiac problems,” he says.

But the best treatment for heart disease has and continues to be prevention. “If you manage your overall health and lifestyle better, heart disease is reversible,” he says. Hypertension, diabetes and obesity all contribute to the development of the disease. “Even just walking a little bit a day helps, we are finding, in treating these conditions and by extension, preventing heart disease before it starts.”