Pancreatic & Liver Cancer

Pancreatic Cancer

Pancreatic cancer makes up about 3% of all diagnosed cancer cases.  Yet it's the 4th leading cause of cancer death in women and the 5th leading cause of cancer death in men.  It is often viewed by doctors and patients alike as a veritable death sentence.  

But even with advanced Stage 4 pancreatic cancer, it doesn't have to be.

Challenges in Diagnosis and Treatment

Cancers arising in the pancreas may not exhibit any noticeable symptoms in the early stage. Because of this, pancreatic cancer is typically diagnosed at a late stage making treatment difficult and prognosis poor.  

Surgery is the most effective way to manage pancreatic cancers if the disease remains confined to the pancreas (Stage I). If the disease has progressed, then radiation or combinations of radiation plus chemotherapy are typically employed.

Unfortunately, pancreatic cancers are often advanced when first diagnosed and the only option left is chemotherapy. Despite years of study, there are no curative therapies for metastatic pancreatic cancer.

Nonetheless, some patients have dramatic and durable benefit from chemotherapy.

Known / Probable Causes

Oncogenes (genes that are mutated or expressed) such as K-RAS, p16, or p53

BRCA mutations (found in patients with family history of breast and ovarian cancer)

Mismatch repair deficiencies associated with Lynch syndrome

Life style and dietary associations including cigarette smoking, alcohol consumption, processed food intake and obesity

Treatment Options

Surgical Procedures

While radical surgery is potentially curative, only a minority of patients are candidates.   Patients with advanced, metastatic pancreatic cancer spread to the liver or the abdominal cavity will require systemic therapy.

Most common chemotherapy drugs:


Platins (Cisplatin or Oxaliplatin)

Taxanes (Taxol, Docetaxel, Abraxand)



Capecitabine (oral formulation of 5FU)

Most common chemotherapy combinations:

FOLFIRINOX (oxaliplatin & irinotecan & 5-fluorouracil (5-FU)/leucovorin)

Gemcitabine & Nab-Paclitaxel (Abraxane)

Gemcitabine & Erlotinib

Gemcitabine & Cisplatin

GTX (gemcitabine & docetaxel & capecitabine)

5FU/leucovorin & Capecitabine

5FU/leucovorin & Oxalilatin

Targeted Therapies Available:

Erlotinib (Tarceva)

What Our Research Has Shown

We find that advanced metastatic pancreatic cancer patients fall into several broad categories:

1)  The truly drug sensitive patients who will respond to numerous treatments and can benefit from the least toxic drug combinations.

2)  A small minority of patients who are sensitive to "targeted agents" like Erlotinib (Tarceva)

3)  A large group of patients have distinct sensitivity to one of the three standard drug regimens used in this disease:  Platinum-based (GemOx, Cisplatin & Gemcitabine), Taxane-based (GTX, Abraxane/Gemcitabine), or Irinotecan-based (FOLFIRINOX, FOLFIRI)

4)  A final group of patients are resistant to standard chemotherapeutics and should be considered for experimental therapies as early as possible.

Without testing, how do you know which group you may be in?


Our Difference - Functional Profiling Testing

If you have cancer, it is as unique as your fingerprint.  

We offer a functional profiling ANALYSIS that measures, in the laboratory, how your pancreatic cancer cells respond to various drugs BEFORE you receive them.

This test helps select the most effective and least toxic drug regimen for your pancreatic cancer.  

Call us today at 1-800-542-4357 or contact us via email HERE. to see how the Nagourney Cancer Institute can help you identify the most effective pancreatic cancer treatment based on your unique tumor makeup.  

Liver Cancer

The liver is not typically a primary tumor site, especially in the United States.

More often, cancer in this organ has originated elsewhere and metastasized. But, in adult primary liver cancer there are three subtypes.

The majority – about 90 percent – are hepatocellular carcinoma, which can either begin as a single tumor that increases in size or as a collection of tumors (multifocal). Hepatocellular carcinoma is particularly common in patients with underlying liver disease associated with hepatitis and cirrhosis.

Cancer of the bile duct, known as cholangiocarcinomas, occur in less than 10 percent of all cases. The cancer starts within the tubes that course through the liver carrying bile fluids and can then spread throughout the liver and to distant sites. These tumors also arise in the gallbladder itself.

The last type is even more rare, starting in the blood vessels within the liver. It can either be classified as angiosarcomas or hemangiosarcomas. These types of cancers are sometimes associated with exposures to hepatotoxins and typically grow rapidly.

Common Treatments for Liver Cancer

Surgery is usually the first form of treatment.

Other liver cancer treatment options are also used in conjunction with surgery: Including thermal ablation, radiation, transplantation, alcohol injection and chemoembolization.

Partly because the liver is so active in its role as a detoxifying organ, it is characteristically resistant to many forms of "cytotoxic" chemotherapy.

As a result, many active forms of therapy have little effect on this disease.

Nonetheless, doxorubicin, cisplatin, Mitomycin-C, 5-FU, FUDR, gemcitabine and some of the newer targeted therapies like sorafenib and bevacizumab have shown favorable results in select patients.

Call us today at 1-800-542-4357 to see how the Nagourney Cancer Institute can help you identify the most effective liver cancer treatment based on your unique tumor makeup.  

Stage 4 Pancreatic Cancer Patient Stories


In April 2010, Steve Lockwood was diagnosed with Stage 4 pancreatic cancer. Steve met with a local oncologist, as well as experts at UCLA and City of Hope. All spoke of conventional treatments and advised Steve to get his affairs in order. Then Steve met Dr. Nagourney.  Steve is alive and well today, eight years later.




Ken Baumheckel was experiencing pain in the area just above the lumbar curve in his spine.  An abdominal ultrasound revealed that Ken’s pain was caused by a tennis-ball sized pancreatic tumor and five growths in his liver.  An endoscopic exam with biopsy confirmed that Ken had Stage 4 pancreatic cancer that had spread to his liver.

Ken made an appointment with Dr. Robert Nagourney at Rational Therapeutics (now Nagourney Cancer Institute), after learning about his work from a friend in the health care system. 




As a nurse, Margaret Johns is aware of protocols and “Best Practices.”

But there she was in the doctor’s office hearing about the only treatment available to treat the Stage 4 Pancreatic Cancer she had. Fortunately for Margaret, she learned that standard protocols aren’t really the only or the even the best option.

 "Six months or less is the prognosis my oncologist gave me as I sat in her office on May 4, 2009. My stage 4 pancreatic cancer had metastasized to my liver. All of this happened without having pain or symptoms.

Around the same time, I just happened to listen to a radio show where the host talked about Rational Therapeutics (now Nagourney Cancer Institute).  It made perfect sense to hear about having chemo tailored to an individual. My daughter Googled some info and I knew immediately that I wanted to do this.



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Pancreatic Cancer Guide

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