Pancreatic cancer is particularly deadly — mostly because by the time patients present with symptoms such as back pain and lack of appetite, the cancer has already spread too widely for a surgical cure, and for radiation and chemotherapy to be effective. The five-year survival rate is a dismal 13%, according to the American Cancer Society.
But what if pancreatic cancer could be caught much earlier?
“It’s been shown that about 40% of pancreatic tumors under 2 centimeters are missed,” notes Johns Hopkins radiologist Elliot Fishman, the newly named Sarah Miller Coulson CIM Scholar. “If we could catch these patients with low-stage disease, when surgical resection is possible, we could save 20,000 lives a year in the United States.”
That’s the quest that Fishman and a multidisciplinary team of researchers at Johns Hopkins and Microsoft have been doggedly pursuing in recent years, by tapping into the power of data analytics and artificial intelligence — and they are tantalizingly close to achieving this holy grail in cancer research. A paper recently submitted for publication details algorithmic advances “that accurately pick up small tumors in the range of 90%,” he says. “This can have a major impact on detection and survival. It’s truly state-of-the art.”
For Fishman, a longtime member of the Miller Coulson Academy of Clinical Excellence and regular participant in CIM Seminars, this latest breakthrough is just one of many trailblazing advances that have marked his 46-year career in medicine at Johns Hopkins — all aimed at improving care and outcomes for patients. The throughline of his innovative achievements: an eagerness to capitalize on the latest technology while soliciting expertise well beyond radiology, and even outside medicine.
In the late 1990s, for example, as he recognized that the internet was transforming communication, Fishman had the foresight to establish a website dedicated to providing radiology professionals with all the latest information on computed tomography and CT scanning. Today, “CT is Us” (CTisus.com) has more than 386,000 followers across its primary social media accounts.
Then there’s the legendary speaker series he launched in 2013, “Perspectives from Outside of Medicine,” which annually brings to Hopkins a wide array of innovators, entrepreneurs and industry leaders to share insights with the medical community. Over the years, speakers have included NVIDIA president Jensen Huang, PIXAR co-founder Ed Catmull, and David Isbitski, chief evangelist for Amazon’s Echo and Alexa.
“In the field of medicine, we tend to hear the same voices over and over,” says Fishman. “The Leading Change series provides a rare opportunity to listen and learn from the ‘best of the best’ and then apply their strategies into our world to improve the experiences of our ‘guests.’”
Fishman’s knack for soliciting advice and forging relationships outside medicine has been key to broadening the team currently pushing to advance early detection of pancreatic cancer — an effort supported by the Lustgarten Foundation, which recently renewed grant funding for three years.
While the project’s team includes an impressive array of Johns Hopkins’ heavy hitters — including oncologist Bert Vogelstein, molecular geneticist Ken Kinzler, radiologists Linda Chu and Satomi Kawamoto, and pathologist Ralph Hruban — Fishman has also tapped leading visual imaging and machine learning companies like Nvidia. Most recently, Microsoft has stepped up to provide expertise in deep learning and algorithm development through its “AI for Good” outreach program.
“I hope to be able to help other people move into the AI space, and to use the experience
I’ve gained to help them move faster into that space.” – Elliot Fishman
While excited to continue leading this research forward, Fishman says the support he’s received as a Sarah Miller Coulson CIM Scholar will free him for vital new work: sharing the wisdom he’s gained in AI with Johns Hopkins Medicine scholars in other specialties.
“I hope to be able to help other people move into the AI space, and to use the experience I’ve gained to help them move faster into that space,” says Fishman, adding, “I’ve already heard from several researchers — in fields including diabetes and maternal health — who are eager to collaborate.”
For Fishman, whose ties to the Center for Innovative Medicine are long and deep, this latest pursuit reflects what makes CIM so successful in promoting medicine as a public trust.
“In medicine as in life, you’ve got to keep moving and trying to do great things,” says Fishman. “CIM keeps evolving and is doing a wonderful job of changing as medicine changes — of asking: Where are we going? Where do we need to be?”
