At Regional One Health Cancer Care, surgical oncologist Dr. Evan Glazer leads a high-risk pancreatic cancer clinic for patients who have a strong family history of the disease.
Through genetic testing and counseling, he can help patients manage their risk through screening and even prevent cancer using targeted surgical procedures.
For patients like Will, who lost his mom and brother to pancreatic cancer, it is way to take charge of his health and live without constant worry.
After losing his mother and brother to pancreatic cancer, Will feared his own diagnosis could come at any time.
Until recently, there was no routine screening for pancreatic cancer, and many patients don’t have symptoms until the disease is advanced – making it one of the deadliest forms of cancer.
That weighed heavily on Will, 72. “I used to think, ‘It’s any day now. I’m going to wake up with symptoms and it’s going to be the beginning of the end,’” he said. “I was living with a weight on my shoulders that I was constantly trying to push to the back of my consciousness.”
That changed when he was referred to Evan Glazer, MD, PhD, FACS, FSSO, Regional One Health Cancer Care surgical oncologist and University of Tennessee Health Science Center associate professor of surgery. As a nationally-known leader in treating pancreatic cancer and an academic oncologist through UTHSC, Dr. Glazer offers patients in the Mid-South an advanced level of expertise and access to the latest research and treatment options.
At Regional One Health Cancer Care, Dr. Glazer leads a high-risk clinic for patients who have a strong family history of the disease.
Dr. Glazer noted screening programs have been developed and recommended over the last 10 to 15 years by national organizations such as the National Comprehensive Cancer Network. As a member of the NCCN Pancreatic Adenocarcinoma Panel that publishes recommendations every year as to the best standard of care to treat patients, Dr. Glazer can help patients like Will who have a hereditary risk of cancer access genetic testing.
Regional One Health offers a unique setup to improve access to genetic testing.
Patients with a strong family history of cancer have access to nurse practitioners who specialize in genetics. By seeing a nurse practitioner rather than a genetic counselor, the process is streamlined, Dr. Glazer said.
Surgical oncologist Dr. Evan Glazer said genetic testing helps patients take charge of their health: “The goal is not just to find cancer early, but to prevent the diagnosis from ever happening.”
“As clinical providers, our nurse practitioners can provide genetic counseling and also order the tests, whereas a genetic counselor would have to refer the patient to a clinical provider for testing. When we need additional expertise from genetic counselors, we work with them hand-in-hand,” Dr. Glazer said. “That’s unique to Regional One Health Cancer Care. Our nurse practitioners can handle everything, so it’s a one-stop shop.”
Once patients have the results of their testing, they can see an oncologist who specializes in their cancer type to discuss monitoring and treatment options.
Insurance typically pays for testing, Dr. Glazer said, and Regional One Health offers programs to help patients who don’t have insurance.
For Will, the process was a game-changer.
Will had previously taken an over-the-counter genetics test that came back positive for the BRCA2 gene mutation, which is most commonly associated with breast and ovarian cancer but can also significantly increase a patient’s risk of pancreatic cancer especially if those patients have a family history of pancreatic cancer.
He talked to several doctors about the results. They all said there was no screening test available for pancreatic cancer, and advised him all he could do is be vigilant about his health.
Instead of taking that at face value, Will continued to advocate for himself and find a way to take charge of his cancer risk. At Regional One Health Cancer Care, he finally found access to advanced resources he needed.
Dr. Glazer’s team went over Will’s family history in detail and determined that he qualified for genetic testing based on guidelines established by the NCCN. He had a blood draw that was sent to a genetic testing lab to follow up on his previous tests, and it came back positive for BRCA2.
His next step was the consultation with Dr. Glazer. During a consultation, Dr. Glazer focuses on helping patients understand their risk and how they can manage it.
“I tell patients, ‘A positive genetic test is not the end of your life.’ Most patients with a BRCA mutation or another mutation will not develop cancer,” he said. “However, the risk is higher than the general population – and that means we have to be thorough about testing and screening.”
For most patients, genetic testing involves a simple blood draw that is then sent to a lab to look for known gene mutations linked to various types of cancer.
That news would finally start to lift that weight from Will’s shoulders. “He told me I qualified to have regular diagnostic testing for the four most common types of cancer associated with BRCA2 – pancreatic cancer, prostate cancer, male breast cancer, and melanoma,” Will said.
Will was already being monitored twice a year by a dermatologist due to a prior melanoma diagnosis, and that was increased to three visits each year. His other screenings, which are done on a rotating cycle, include an endoscopy and MRI for pancreatic cancer, mammography and ultrasound for male breast cancer, and MRI for prostate cancer.
“He had been told there’s nothing that could be done, but it turns out the opposite is true,” Dr. Glazer said. “Not only is there something that can be done for his pancreatic cancer risk, we can screen for other cancers linked to BRCA.”
“I had all of my problem areas scanned, and it was affirmed that at this point I’m cancer-free,” Will said. “It’s a huge load off my mind. It doesn’t mean I won’t get cancer in the future, but the theory is we’ll catch it early rather than it presenting when things are already out of hand.”
Even better, Dr. Glazer said, he can help prevent a cancer diagnosis.
“If we see a change in the pancreas on the scans, not only do we identify that sooner, we can recommend that we remove the tissue before it becomes cancerous,” Dr. Glazer explained. “The goal is not just to find cancer early, but to prevent the diagnosis from ever happening.”
Will said his experience at Regional One Health’s East Campus, 6555 Quince Rd., exceeded his expectations. He was impressed by how Dr. Glazer’s team coordinated his care with multiple physicians: “They took responsibility for everything. To me, it’s quite remarkable. It shows that Dr. Glazer runs his practice with a level of care and competency that is not often achieved.”
Patients with a higher hereditary risk of cancer often quality for enhanced screening, including MRI, CT, ultrasound and more.
Will was also pleased to have the opportunity to support better care for patients everywhere by participating in a study Dr. Glazer is doing that aims to help pinpoint blood markers that indicate whether a patient is cancer-free.
Most importantly, when Will thinks about the future, a devastating cancer diagnosis isn’t the focus. “I don’t have that tune in my head anymore,” he said. “I’m 72, and now I’m confident I’ll live into my 80s.”
Will wants to help others achieve similar peace of mind.
“I consider myself to be a fairly intelligent guy, and what’s remarkable is I had never heard this paradigm existed for diagnostics. I was happily shocked that, based on my family history, it is possible to do all these tests in an ongoing manner,” he said. “It almost seems like a dream come true. I think it’s important for other people to know this is available here in Memphis.”
Dr. Glazer said Regional One Health wants to make sure all patients can access the genetic testing they need to manage their cancer risk. “Our goal is to provide a service to the community so everyone around us has access to this level of expertise should they need it,” he said.