A win-win situation

Each year about 5,200 Canadians are diagnosed with pancreatic cancer, which is referred to as a “silent killer” because by the time symptoms appear, the disease is advanced. For those who are diagnosed early, surgery offers the best chance of long-term survival.

Surgery to remove pancreatic tumours involves excising the head of the pancreas and nearby lymph nodes, the gallbladder, and parts of the small intestine and stomach. Researchers at Sunnybrook Research Institute, led by clinician-scientist Dr. Natalie Coburn, are studying how to prevent a common complication of surgery called pancreatic fistula. Characterized by leaking fluid, a pancreatic fistula is an abnormal connection between the pancreas and other organs and spaces in the body that can cause infection, bleeding, longer hospital stays and even death.

Coburn and colleagues analyzed the cost-effectiveness of giving pasireotide, a drug that, while pricey, decreases the incidence of pancreatic fistulae. They compared the cost of giving the drug versus not giving it in patients who’d had the surgery. In spite of the drug’s high cost, giving it was associated with an average reduction of one-and-a-half days in hospital and a savings of $1,685 due to shorter stays and fewer readmissions. They looked only at hospital costs, and not broader costs, such as rehabilitation services and lost productivity of patients and caregivers; had these been factored in, the savings from treatment would have been even greater, the researchers noted. Thus, they said, due to benefits to patients and cost savings, giving pasireotide to patients undergoing pancreatic resection should be considered.