 One of the major problems in pancreatic cancer is the small subset of patients that potentially can have cures through surgery, about 20 percent, have their primary tumors removed, and then within two years have metastatic disease appearing in their liver most ordinarily. Can we understand this process? It means that at the time of surgery they already had cancer cells in the liver, but those cancer cells were not growing. The question was why are they not growing and then what leads to their growth? So we created a mouse model showing that the immune system held in check cancer cells that were actually silent and sleeping, just sitting here, not doing anything, and occasionally one would awaken and start to grow, but the immune system would kill them. If you take away the immune system, then these metastatic diseases grow out and cause disease. So the key issue here is what might cause suppression of the immune system. And it's been actually published that pancreatic cancer surgery itself elevates the level of an immune-suppressive hormone, cortisol, for up to a week to 10 days. So we think that might be the explanation for the outgrowth of metastatic disease within the years following surgery. This then needs, can we interact with the surgeons to prevent that rise in cortisol levels and prevent the occurrence of metastatic disease?