Episode Summary: "You Might Also Like: Tomorrow's Cure" Release Date: April 22, 2025
Host: Kathy Werzer
Guests: Dr. Ajit Goenka, Professor of Radiology at Mayo Clinic; Dr. Suresh Chari, Professor in Gastroenterology, Hepatology, and Nutrition at the University of Texas MD Anderson Cancer Center

Introduction: The Urgent Need for Early Detection

In this compelling episode of Tomorrow's Cure, host Kathy Werzer delves into the pressing challenge of early detection of pancreatic cancer—a disease notorious for its late diagnosis and poor prognosis. Featuring insights from leading experts Dr. Ajit Goenka and Dr. Suresh Chari, the discussion centers on groundbreaking advancements in AI-driven imaging techniques aimed at identifying pancreatic cancer up to a year before symptoms manifest.

The Elusive Nature of Pancreatic Cancer

Kathy Werzer opens the conversation by highlighting the grim reality: "No one wants to hear the words you have cancer, but if you do, you want to hear it was caught in its earliest stages." She underscores that certain cancers, like pancreatic cancer, are often detected too late for effective treatment.

Dr. Ajit Goenka emphasizes the critical role of early detection:
"Early detection is really our best hope, but also our biggest challenge when it comes to pancreas cancer."
(00:15)

Challenges in Early Detection

Detecting pancreatic cancer early is fraught with difficulties. Dr. Chari explains that symptoms typically arise only in the last three months before diagnosis, correlating with advanced disease stages:
"85% are all talking about something happening in the last three months. And symptoms is equal to advanced disease."
(02:33)

Dr. Goenka adds that up to 40% of small pancreatic cancers may go unnoticed on standard imaging because they resemble normal pancreatic tissue:
"These small cancers... look exactly similar to what the rest of the pancreas would look like... unless you are deeply suspicious and you're looking very carefully, you are likely to overlook that."
(03:34)

Innovations in AI for Early Detection

The advent of AI presents a promising solution to these detection challenges. Dr. Goenka discusses the development of an AI algorithm capable of identifying pancreatic cancers invisible to the naked eye:
"The answer is AI... what we did at the get go was we provided to the AI training module the most diverse data set that we could."
(12:52 & 16:49)

Dr. Chari highlights the algorithm's effectiveness, noting that it accurately detected cancers not visible through traditional methods:
"He saw every single cancer that was not seen with the eye, and he could tell you exactly where the cancer would appear."
(11:23)

Risk Factors and Rising Incidence

The conversation shifts to the increasing incidence of pancreatic cancer, particularly among individuals aged 55 and younger. Dr. Goenka attributes this rise to the prevalence of risk factors like smoking and lifestyle-related conditions:
"There is a rise in the incidence and the prevalence of the risk factors that Dr. Chari very eloquently highlighted, which is smoking and other lifestyle related conditions."
(10:29)

Dr. Chari elaborates on significant risk factors, including new-onset diabetes, which serves as a potential early symptom:
"If you have diabetes for the first time, are you at higher risk of pancreatic cancer."
(08:15)

Developing and Training the AI Algorithm

Creating an effective AI tool requires extensive and diverse data. Dr. Goenka explains the meticulous process of training the AI to recognize the pancreas and differentiate between normal and cancerous tissues:
"You have to make sure that you are thinking about the ultimate end goal... we provided to the AI training module the most diverse data set that we could."
(16:49)

Addressing concerns about data diversity, particularly the underrepresentation of high-risk groups like Black men, Dr. Goenka acknowledges the challenge:
"AI tends to perpetuate the disparities in healthcare that exist right now... we have to devise larger scale studies..."
(17:04)

Dr. Chari shares ongoing efforts to include diverse populations in research:
"We are doing another study... 65% minorities in there... answer this question, whether the findings in this study are applicable to those in the minority communities."
(17:57)

Clinical Trials and Future Prospects

The experts discuss the pathway from research to clinical application. Dr. Goenka outlines a five-year prospective trial aimed at validating the AI tool's effectiveness:
"We are doing a five year prospective trial... What we will be doing as part of that trial is that we will be taking those people who have new onset diabetes and weight loss... AI augmented CT."
(23:48)

Dr. Chari adds that integrating AI into clinical practice could rapidly enhance early detection without waiting for extensive trials:
"AI gives radiologists a heads up saying, spend 15 seconds more on the pancreas, will you please?... that missed lesion is not missed anymore."
(29:41)

Impact on Patient Outcomes

Early detection holds the promise of significantly improving survival rates. Dr. Goenka emphasizes that identifying cancer before it spreads allows for more effective treatment options:
"If we are able to pick up even at that stage, I think the word cure would still be on the table."
(19:31)

Dr. Chari envisions a future where early detection reduces the proportion of late-stage diagnoses from 93% to a more manageable number:
"If you diagnose all pancreatic cancers four months before they were clinically diagnosed, we would significantly shift the stage to an earlier stage."
(21:58)

Conclusion: A Hopeful Horizon

Both experts express optimism about the future integration of AI in early pancreatic cancer detection. Dr. Goenka anticipates tangible clinical improvements within five years:
"I am very optimistic that in the next five years we will see the difference into our clinical practice."
(28:57)

Dr. Chari echoes this sentiment, highlighting the simplicity and effectiveness of AI-assisted screening:
"What you are offering in the background is to be able to apply this to every patient who comes to the door and offering this as an additional tool... this will be there sooner rather than later."
(29:41)

Final Thoughts

This episode of Tomorrow's Cure underscores the transformative potential of AI in revolutionizing early detection strategies for pancreatic cancer. By combining advanced imaging techniques with comprehensive data analysis, researchers like Dr. Goenka and Dr. Chari are paving the way toward earlier diagnosis, better treatment outcomes, and ultimately, increased survival rates for one of the most challenging cancers.

Notable Quotes:

• "Early detection is really our best hope, but also our biggest challenge when it comes to pancreas cancer."
  — Dr. Ajit Goenka (00:15)

• "85% are all talking about something happening in the last three months. And symptoms is equal to advanced disease."
  — Dr. Suresh Chari (02:33)

• "We want to significantly shift the stage to an earlier stage."
  — Dr. Suresh Chari (21:58)

• "I am very optimistic that in the next five years we will see the difference into our clinical practice."
  — Dr. Ajit Goenka (28:57)

This summary captures the essence of the episode, providing a comprehensive overview of the discussions on early detection of pancreatic cancer through AI, the challenges faced, ongoing research, and the hopeful future that these advancements promise.