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Pancreatic Cancer Q&A with Dr. Stauffer, Mayo Surgeon: May 29

Posted by Colleen Young, Connect Director @colleenyoung, May 19 1:09pm

Allow me to introduce you to Dr. John Stauffer, a hepatobiliary and pancreas surgical oncologist at Mayo Clinic in Florida, one of the country's highest-volume surgical programs for advanced pancreatic cancer.

On Thursday, May 29 from 1:30-2:30pm ET, Dr. Stauffer will host a Q&A about surgical management of pancreatic cancer.

After a pancreatic cancer diagnosis, many people have questions about treatment options, including surgical and nonsurgical approaches. You may also want to know how an integrated team – including surgical oncology, medical oncology, radiation oncology and gastroenterology specialists – works together to prevent further cancer complications and preserve your quality of life.

Please note that this hour-long Q&A is for informational purposes only, and any concerns you have should be addressed to your treating physician. If you would like to learn about pancreas cancer care at our integrated program in Florida, please visit this page for information.

Submit your questions in advance in the comments below and Dr. Stauffer will reply during the hour-long Q&A event. See you back here on May 29.

Go ahead, ask away!

Interested in more discussions like this? Go to the Pancreatic Cancer Support Group.

John Stauffer, MD | @johnstauffermd | May 29 12:48pm
In reply to @carneydh "Are there any studies that suggest fasting will kill cancer cells?" + (show)
@carneydh

Are there any studies that suggest
fasting will kill cancer cells?

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Not to my knowledge.

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John Stauffer, MD | @johnstauffermd | May 29 12:49pm
In reply to @gamaryanne "Is there immunotherapy on the near horizon for stage IV patients that can take the place..." + (show)
@gamaryanne

Is there immunotherapy on the near horizon for stage IV patients that can take the place of chemotherapy in trying to clear our system of Pcan?
It seems there must be a careful balance of chemo and other options to not “ruin” our bodies with the toxic drugs in chemo.

Thank you for your time!

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Unfortunately, current immunotherapy is only helpful for a very small percentage of PDAC patients with microsatellite instability high tumors.

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John Stauffer, MD | @johnstauffermd | May 29 12:55pm
In reply to @mnewland99 "Hello Dr! Thank you for doing this Q&A, as it is much appreciated. If one has..." + (show)
@mnewland99

Hello Dr! Thank you for doing this Q&A, as it is much appreciated.
If one has 1 or 2 nodules say in segment 5 of liver, which I’ve been told is a good candidate area for surgery as far as not impacting other organs, why don’t more drs remove the lesions or nodules surgically since it’s a permanent solution, rather than recommend chemo or SBRT as most do?

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It depends on the tumor type, biology, location, and treatment response. Overall, liver lesions are very complex and require a multidisciplinary team to treat. Seeing a single person can be limiting because that single person oftentimes only offers what they can do. Seeing a whole team of people (like here at Mayo Clinic) is an advantage because we offer whatever treatment is best for the patient no matter who of the team can deliver it.

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John Stauffer, MD | @johnstauffermd | May 29 12:58pm
In reply to @lisn "Thank you for this opportunity! Our experience is that pdac is slow growing and often not..." + (show)
@lisn

Thank you for this opportunity!

Our experience is that pdac is slow growing and often not found until it has grown/spread. Our surgeon said that it was most likely here for several years before presenting symptoms.

For those lucky enough to find it early and undergo surgery and treatment, I'm wondering why then is the risk of recurrence within two years so high if it's a slow growing cancer?

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The growth rate is relative. PDAC is an aggressive and fast growing cancer overall but some people may call 1-3 years slow growing. It is oftentimes only detected in the final stages where it appears to progress rapidly but in fact had been developing for several years.

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John Stauffer, MD | @johnstauffermd | May 29 12:59pm
In reply to @kofarmer "I am 57 years old with stage 4 adenocarcinoma diagnosed 10/24. Started standard of care 11/24..." + (show)
@kofarmer

I am 57 years old with stage 4 adenocarcinoma diagnosed 10/24. Started standard of care 11/24 and switched to a clinical trial 2/2025. I have 2 questions:
1. Does procedures outside the standard of care disqualify you from clinical trials?
2. I have vein involvement with primary tumor(pancreas). Would I be a possible candidate for your non-invasive procedure?

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Each clinical trial have their own inclusion and exclusion criteria but all of them will have concessions that would allow for alternating the treatment plan (or leaving a trial) if a more effective method would become available.

Each case is highly unique, but we generally have a surgical treatment plan if the tumor is localized, not metastatic, and has shown good biology even if there is vein or arterial involvement.

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John Stauffer, MD | @johnstauffermd | May 29 1:01pm
In reply to @dalegantous "For lesions in section 5 and 8 of the liver, can you compare surgery vs SBRT..." + (show)
@dalegantous

For lesions in section 5 and 8 of the liver, can you compare surgery vs SBRT vs histotripsy as treatment options? Does Jacksonville Mayo perform histotripsy? Thank you!

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It depends on the tumor type, biology, location, and treatment response. Overall, liver lesions are very complex and require a multidisciplinary team to treat. Seeing a single person can be limiting because that single person oftentimes only offers what they can do. Seeing a whole team of people (like here at Mayo Clinic) is an advantage because we offer whatever treatment is best for the patient no matter who of the team can deliver it.

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John Stauffer, MD | @johnstauffermd | May 29 1:03pm
In reply to @sandyk62 "What are your thoughts on having SBRT performed on a handful of small liver lesions and..." + (show)
@sandyk62

What are your thoughts on having SBRT performed on a handful of small liver lesions and doing chemo at the same time? Is SBRT ever an option while you are participating in a clinical trial that is testing a new drug (RMC-6236 or IMM-1-104, for example)?
Thank you for taking precious time out of your day to answer these questions..
Sandy

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We use SBRT frequently for our resectable PDAC patients. SBRT in the setting of metastatic is controversial and unlikely to provide anything other than side effects except in very special circumstances (1 or 2 isolated sites of disease after prolonged systemic therapy) and under a clinical trial.

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John Stauffer, MD | @johnstauffermd | May 29 1:04pm

We at Mayo Clinic in Florida use IRE for unresectable PDAC in combination with systemic chemotherapy and radiation treatment. This modality is not widely used or have available trials due to the lack of efficacy against cancer when compared to standard treatment. It is employed occasionally for patients who are not candidates for standard treatment. IRE should only be used for patients that have no other options based on sound evidence, not for theoretical benefits touted by the manufacturer or those who stand to gain financially from its use.

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John Stauffer, MD | @johnstauffermd | May 29 1:05pm
In reply to @lulu789 "I a wondering if there are surgeons at Mayo Clinic who have had a lot of..." + (show)
@lulu789

I a wondering if there are surgeons at Mayo Clinic who have had a lot of experience doing Nanoknife procedure?

THANK YOU, BETTE DAVIS

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Yes, I have used the Nanoknife over the past 6 years to help treat patients with unresectable PDAC.

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John Stauffer, MD | @johnstauffermd | May 29 1:06pm
In reply to @ashley2235 "Apologies if this is addressed in study, but have you seen a lower recurrence rate with..." + (show)
@ashley2235

Apologies if this is addressed in study, but have you seen a lower recurrence rate with Nanoknife vs total Pancreatectomy? Are you an advocate for adjuvant chemotherapy for all surgical patients, irregardless of pathology report findings or type of surgery?

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Nanonkife and total pancreatectomy are used occasionally, but not if they do not offer a better outcome with less chance of recurrence than any other type of operation. Yes, adjuvant therapy is almost always recommended.

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