Ep. 69: Dr. Anirban Maitra, A Pinnacle of Dedication to the Treatment and Research of Pancreatic Cancer
Pancreatic cancer expert, Dr. Anirban Maitra, is the first Co-Director and Scientific Director of M.D. Anderson Center for Pancreatic Cancer Research at the University of Texas in Houston. As well, Dr. Maitra is the center’s Deputy Division Head of Academic Science and a Professor of Pathology and Translational Molecular Pathology. His time at both John Hopkins and the University of Texas has solidified his position as a leading expert in the field of pancreatic pathology. Dr. Maitra's passion is to improve patient’s survival by discovering and developing ways to detect and treat pancreatic cancer. His conversation is candid, personal, and showcases the widespread effects of this illness. To see Dr. Maitra speak on the importance of progress in the pancreatic cancer research community, follow this link: https://www.youtube.com/watch?v=crt1wvXZN3Q.
More on Dr. Anirban Maitra
M.D. Anderson Profile: https://faculty.mdanderson.org/profiles/anirban_maitra.html
LinkedIn: https://www.linkedin.com/in/anirban-maitra-10087b2/
Twitter: https://twitter.com/aiims1742
Books Mentioned
When Breath Becomes Air: https://www.amazon.com/When-Breath-Becomes-Paul-Kalanithi/dp/081298840X
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Show Notes
[00:27] Dr. Maitra's passion is to improve patients survival by discovering and developing ways to detect and treat pancreatic cancer. Please welcome Dr. Anirban Maitra to Health Gig.
[00:45] Tricia and I know your work well, and it is so remarkable for our listeners. We want you to know we have a personal connection to Anirban Maitra because Tricia's husband, my brother in law, died of pancreatic cancer, the disease you're working so hard to eliminate. You are an amazing support for Tricia and her family and her extended family, which includes all of us. And so, we want our listeners to know you the way we do. So, we're particularly glad you're with us today.
[01:45] So the word pancreatic cancer has been in the news a lot recently because of Mr. Alex Trebek. He's been wonderful, very open in terms of his diagnosis.
[02:10] So the pancreas is actually an organ that's located deep inside your abdomen, or your belly, behind the stomach. So you really can't feel it like a lump on the skin or in the neck or anything like that. And so that's one of the reasons why when pancreatic cancer happens, unfortunately, by the time it's diagnosed, it's often quite late in the disease process. This is not like a mole on your skin or the lump in the breast or something that you can see or feel very easily. Unfortunately, because of that, many patients present quite late in the disease when the cancer has already spread beyond the pancreas.
[03:21] It is actually more common than breast cancer as of last year and only stands behind lung cancer and colon cancer in terms of cancer related deaths in this country. So, this is clearly a disease that there is a lot we need to do about in terms of improving outcomes for our patients.
[05:21] Why do you think pancreatic cancer is on the rise?
[05:57] You know, I mean, life expectancy in the United States is rising and pancreatic cancer is a disease of the elderly. The most common age group is in the 60s and 70s.
[07:02] We are unfortunately in the middle of a diabetes and obesity epidemic in our country and, pancreatic cancer is one of the cancers that is associated with obesity, with higher body mass index, lack of exercise, all of the stuff that we kind of passively tell, as physicians, our patients not to do, but which unfortunately is one of the contributors to pancreatic cancer and other cancer types, too, not just pancreatic, but it is one of the cancers that is associated with obesity and long standing diabetes.
[07:41] Obesity, it's not just something that, you know, manifests itself externally as fat, but there's a lot that happens inside your body that you can't see. So when you are obese, there's also fat that gets deposited in and around the pancreas and these fat cells, the scientific term for that is adipose cells or adipocytes. These are not just bystanders that are sitting there. They are living, breathing cells that make a lot of stuff for lack of a better word. And this stuff is made by these cells and they are released into the surrounding organs, including the pancreas, and they damage the organ. And when you have organ damage over time, it causes abnormalities in the DNA to accumulate. And that's sort of how cancer begins.
[08:36] So, the relationship between body fat and many cancers is driven by the fact that fat cells make stuff that is not good stuff that is released and it causes damage over time. This is not something that happens overnight. I'm talking about years, decades. But over time, that damage eventually leads to accumulation of damage in the DNA, which we call mutations. And that is how cancer begins.
[09:19] I think a common refrain from many patients that we encounter is, "Well, Doc. I am not obese. I don't eat a lot of red meat. I don't smoke. Why did I get pancreatic cancer?" And that's the unfortunate truth when we talk about risk factors for cancer, it's not an all or non phenomenon. Obesity is associated with a higher risk of pancreatic cancer. But the amount of the number of pancreatic cancer that are attributable to obesity is probably about 25 percent or so, which means in 75 percent of individuals, you can't say, well, obesity was one of the risk factors.
[12:43] There are millions of Americans who have low back pain. We just sit too much and we type all day. So all of us suffer from low back pain. That is not the pain of pancreatic cancer. The pain in pancreatic cancer that radiates to the back is more sort of in the middle of your belly. It's higher up than the low back pain, which comes from bad posture.
[16:07] Every year in the United States we have 2 million adults who are diagnosed with new onset diabetes.
[17:31] There are patients who have been reported to have suddenly developed depressive symptoms or other mental health symptoms before a diagnosis of pancreatic cancer.
[18:59] If pancreatic cancer is a 100 meter race and we're just seeing the last five meters, well, there's this 95 meters before. That gives us a window of opportunity to intervene and stop the cancer, a term that we now call interception. You intercept the cancer and potentially prevent it from being fatal in the patient.
[19:42] For most patients, unfortunately, by the time they have actual symptoms of pancreas cancer, the disease is already in a place where it's spread beyond the pancreas or even if it's in the pancreas, it might still spread despite surgery.
[21:40] So if you have a family where there was pancreatic cancer or breast ovarian cancer and that particular patient carries an abnormality in that gene, other family members should be tested to see if they have that abnormality as well.
[00:22:05] And then you could ask them to join a screening program where they could be monitored over time and potentially the mere occurrence of the cancer could be prevented through the screening program. So that's one example of what we call cancer interception.
[22:33] Interception means defining who is at risk before they even have cancer and then putting them on screening programs where we can prevent the cancer from actually even happening.
[24:00] I encourage any of your listeners who have a family history of pancreatic cancer and where they may be an underlying abnormality or mutation that's causing that disease to check out generatestudy.org.
[27:10] I think it was hypocrisy. Said said food is medicine. What's the role of nutrition in prevention and the treatment of pancreatic cancer?
[29:13] What about the role of sugar in your mind?
[30:50] What about the role of stress from your viewpoint?
[38:01] So the Cancer Moonshot and now there is a National Cancer Moonshot that was initiated by Joe Biden and others and funded through the NCI, the National Cancer Institute. But before that, before the national level cancer moonshot, there was the M.D. Anderson Moonshot.
[41:22] What is your favorite book these days? It's a book called When Breath Becomes Air by Paul Kalanithi.
Thank you for joining us on HealthGig. We loved having you with us. We hope you'll tune in again next week. In the meantime, be sure to like and subscribe to this podcast, and follow us on healthgigpod.com.
“We are unfortunately in the middle of a diabetes and obesity epidemic in our country and, pancreatic cancer is one of the cancers that is associated with obesity, with higher body mass index, lack of exercise, all of the stuff that we kind of passively tell, as physicians, our patients not to do.” - Dr. Anirban Maitra
“The relationship between body fat and many cancers is driven by the fact that fat cells make stuff that is not good stuff that is released and it causes damage over time.” - Dr. Anirban Maitra
“Every year in the United States, we have about 53,000 plus Americans who get pancreatic cancer. And unfortunately, despite many of the advances we have made ... this continues to be a challenging disease.” - Dr. Anirban Maitra
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