Pancreatic cancer is the third deadliest cancer in the United States and might even get worse in the next few years.
But in the San Fernando Valley, the disease faces a formidable adversary in Dr. Babak “Bobby” Eghbalieh of Providence Holy Cross Medical Center (PHCMC).
A certified robotic surgeon and instructor who is the medical center’s director of hepatobiliary pancreatic surgery, and also director of Liver and Pancreatic Surgery and Robotic Surgery, Eghbalieh has performed the highest number of robotic general surgeries in the Los Angeles basin.
He combines his knowledge of the daVinci Surgical System of robotic surgery — a minimally invasive alternative using fewer incisions than both open surgery and laparoscopy — with a celebrated support group to help save lives from a type of cancer whose symptoms usually don’t show until the disease has advanced.
“Pancreatic cancer is one of those silent cancers in its early stages, its symptoms vague and occasional,” said Eghbalieh during a phone interview between surgeries at PHCMC. With Pancreatic Cancer Awareness Month coming up in November, the surgeon is eager to get the word out early.
“It will help us make the public more aware of this rare cancer,” he said, adding the month-long annual commemoration helps to raise funds for research, clinical trials, treatments and options for patients.
The surgeon has his work cut out for him.
Pancreatic cancer has an extremely disproportionate death rate, accounting for about 3 percent of all cancers in the US. But it is the third highest cause of cancer-related deaths, according to the American Cancer Society (ACS). It affects the pancreas, an organ located behind the stomach that produces insulin and digestive enzymes.
About 60,000 people will be diagnosed with pancreatic cancer in 2021 and nearly 48,000 will die of the disease, the ACS estimates.
“It’s a very aggressive cancer that has progressively increased over the last two decades,” Eghbalieh said. He points out that just five years ago, it was the fourth deadliest cancer. Now, the doctor said, it could become the second deadliest cancer within a decade, according to projections.
Not all pancreatic cancers are the same. The two main types are pancreatic ductal adenocarcinoma and neuroendocrine tumors.
The first forms in the cells that line the ducts of the pancreas responsible for producing digestive enzymes. The other forms in the cells responsible for producing insulin, among other hormones from the pancreas.
Eghbalieh refers to the two cancers as “the Patrick Swayzes versus the Steve Jobses,” two famous people who got the disease and whose deaths exemplify the starkly different mortality rates of both cancers.
Jobs, founder of the computer company Apple Inc., was diagnosed with a neuroendocrine tumor in 2003 but survived for several years with treatment. He died in 2011 at age 56. Eghbalieh says Jobs’ cancer is less common, accounting for about 5 percent of all cases.
“It has a much longer survivability of anywhere between 12 and 15 years,” Eghbalieh said.
In contrast, Swayze, an actor who starred in the musical film “Dirty Dancing,” was diagnosed with stage-four adenocarcinoma pancreatic cancer in early 2008 and died less than two years later at age 57.
This type of cancer accounts for up to 80 percent of all cases, according to Eghbalieh.
“Unfortunately, it’s more aggressive and the response rate to our treatment is not so great,” he said, but adds that treatments have gotten better.
Fighting pancreatic cancer can be more difficult because, often, no symptoms appear until the disease is advanced. In fact, it is often found incidentally, when patients are being tested or getting a scan for different reasons, Eghbalieh said.
The exact causes of pancreatic cancer are difficult to define but smoking is believed to be among them, notes Eghbalieh. He recommends genetic testing for those with familial cancer within multiple members of the family or multiple generations.
This predisposition accounts for between five and 10 percent of all pancreatic cancers, he said.
Scientists have identified other risk factors including genetics, diabetes, obesity and aging. Race could also play a role.
According to the American Cancer Society, African Americans are slightly more likely to develop pancreatic cancer than whites, possibly in part to having higher rates of diabetes, smoking and being overweight. No clear numbers are available for Latinos.
A recent article published on the National Center for Biotechnology Information website states that few studies have assessed other ethnic minorities and “observed that Hispanics and Asians/Pacific Islanders have lower incidence rates of pancreatic cancer compared to whites and African Americans.”
Lifestyle improvements could help reduce the chances of developing the disease, Eghbalieh said. He recommends eating healthy organic foods, maintaining an ideal body weight ,and avoid smoking.
The risk of developing pancreatic cancer increases with age. “Almost all patients are older than 45,” the ACS states on its website, adding that nearly two-thirds are at least 65 years old. The average age at the time of diagnosis is 70, according to the website.
When symptoms appear, they can include occasional nausea, diarrhea and back pain. But sudden health changes in people over age 50 should be a reason for concern, Eghbalieh said
“If you suddenly develop diabetes after the age of 50 when you have a normal weight, you definitely have to get evaluated,” he said. “One in four could potentially have an underlying type of pancreatic cancer.”
The journey through cancer is not easy, one that cannot be navigated without support. About three years ago, Eghbalieh started the Pancreatic Cancer Support Groups at Providence Holy Cross.
The Mission Hills-based hospital is one of only three in California designated as a Center of Excellence for Pancreatic Cancer by the National Pancreas Foundation. The medical center’s support group, one of only five in California, meets the third Thursday of every month, currently on Zoom because of the Covid pandemic.
Facilitated by nurse navigator Vivian Gonzalez, along with Eghbalieh, the gathering brings in experts and is open to cancer patients and survivors and their loved ones to share their experiences, nutrition tips, coping mechanisms and emotional and psychological support.
“Patients with pancreatic cancer need to know that they have a family in our group, to guide you all the way through. You are not alone,” Eghbalieh said.
The doctor is proud of his creation. “This is probably one of my most favorite things that we do here at Providence Holy Cross,” he said. “I mean, it is one of the most successful support groups that we have in town.
“It’s the apple of my eye. It’s helped so many going through this difficult journey of cancer.”
Eghbalieh is looking forward to Pancreatic Cancer Awareness Month to get more people to join the effort to defeat a disease that not long ago was almost a death sentence, but still remains a threat.
“It will allow us to let the public know that we need to have more funds to do more research,” Eghbalieh said, “and try to come up with more treatment options that may not yet be available for the public and patients at large.”
For more information about Pancreatic Awareness Month, visit www.pancan.org/news/5-ways-to-take-action-on-world-pancreatic-cancer-day.
For more information about cancer services at PHCMC visit https://www.providence.org/services/cancer.