Pancreatic diseases inflict a huge burden of suffering on patients and dramatically impact their quality of life as well as that of their family members. Patients with pancreatitis frequently have severe pain that prolongs hospitalization and significantly limits their activities once discharged, and even after recovery often suffer from chronic malnutrition. In cancer patients, even small pancreatic tumors will induce cachexia (muscle wasting, anorexia, fatigue, lethargy), a major barrier during treatment but also to quality of life.
Ongoing research projects
Cachexia and lethargy are exceptionally prevalent in pancreatic cancer patients. While the exact mechanisms linking this cancer to cachexia are not known, our physicians and researchers are expanding our program to investigate and combat this wasting with the goal of increasing patient resiliency. We anticipate that increasing resiliency will decrease lengths of patients' post-surgical hospital stays and will increase their overall survival time. Our goal is to identify and validate an anti-cachexia agent to ultimately integrate into our prehabilitation program. Current research is directed at understanding the role of PDAC exosomes and their effect on neuroinflammation. We are also interested in neurocognitive deficits in PDAC patients and developing improved management of visceral pain.
To incorporate cachexia metrics into both the Pancreas Translational Tumor Board and into the clinical workflow, the Marks lab is optimizing a method to quantify sarcopenia, or muscle wasting. By analyzing pre-surgical CT images of PDAC patients, we aim to implement a metric to quantify lean body mass. As cachexia is a primary determining factor in morbidity and mortality in PDAC patients, incorporating sarcopenia indices into the clinical workflow at OHSU would provide vital prognostic information to clinicians, and could also prospectively or retrospectively be related to patient outcomes.
- Activity monitors as early surrogate for therapeutic response indicator
- CT muscle mass indicators of cachexia
- Extracellular vesicles as endocrine signals in PDAC cachexia
- Identifying the molecular events that are associated with cachexia in PDAC patients
- Myc and PP2A in pancreatic cancer cachexia