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U.VA. DOCTORS FIND POTENTIAL BREAKTHROUGH TO DETECT SOME GASTRO-INTESTINAL CANCERS

Doctors at the University of Virginia's division of gastroenterology have discovered a diagnostic method that may detect early cancer of the bile duct, or cholangiocarcinoma. It is one of the deadliest cancers of the gastrointestal tract, with a five-year survival rate of less than ten percent, and can spread to the liver and other parts of the abdomen. Bile duct cancer is also one of the hardest cancers to detect since today's diagnostic tests are inadequate, with success rates ranging from thirty to seventy percent. The findings were reported today at the annual scientific meeting of the American College of Gastroenterology in Seattle, Washington.

U.Va. doctors Tarun Mullick and Paul Yeaton, working with colleagues Jason Tasch, Ph.D., and Dr. Darwin Conwell at the Cleveland Clinic Foundation, found that testing bile duct cells for the presence of telomerase can determine if the cells are cancerous or benign. Telomerase is an enzyme that makes cancer cells immortal, enabling them to divide indefinitely. The testing procedure, telomerase enzyme assay, can be used with current brush cytology techniques where doctors use a special brush to gather bile duct cells for testing, usually through a routine endoscopic proceedure.

This is an emerging concept that has the potential to revolutionize how we detect bile duct tumors and detect them earlier, thereby allowing for improved patient survival and earlier medical and surgical therapies, Mullick said. More research is needed to find out if telomerase testing might be a new tool to detect another deadly cancer- pancreatic cancer, Mullick said. Pancreatic cancer and cholangiocarcinoma already involve the use of brush cytology and fine needle aspiration for diagnosis,

which may be enhanced by a test for telomerase and other biomarkers, which are an indicator of possible cancer progression. About 7,200 people in the U.S. are diagnosed every year with cancer of the biliary tract (bile duct and gall bladder.)

Mullick won the prestigious Governor's Award for Excellence in Clinical Research from the American College of Gastroenterology at today's Seattle meeting for his current and past work on telomerase and bile duct cancers.

October 21, 2002