" The "need to think outside the box," as one specialist puts it, comes shortly after two drugs that had been seen as possible magic bullets fared poorly in high-profile trials and as the disease continues to kill most of its victims within a year after diagnosis. "

" "Morale's a little low," said Dr. James Abbruzzese, a specialist in pancreatic cancer at the University of Texas M.D. Anderson Cancer Center in Houston. "While there's been improvement in other cancers, we've made very little progress in pancreatic. We need to rethink strategies, go in different directions." "

" To that end, the National Cancer Institute has scheduled an invitation-only meeting for this fall in Bethesda, Md., where top researchers from around the world will brainstorm. An organizer promised the session will yield new plans of action and marching orders -- not just be a series of lectures. "

" The issue is of particular interest in Houston after pancreatic cancer this month claimed the life of furniture dealer Robert "Bobby" Finger and was diagnosed in TV consumer advocate Marvin Zindler. Outside of Houston, famed tenor Luciano Pavarotti is among those battling the disease. "

" Zindler, whose treatment recently moved from The Methodist Hospital to M.D. Anderson, is still doing reports for KTRK (Channel 13). But last week, reeling from chemotherapy's more toxic effects, he told the Houston Chronicle, "You don't beat (pancreatic) cancer." "

" Pancreatic cancer is widely considered the most lethal of cancers, with a survival rate of only about 5 percent in the five years after diagnosis. The American Cancer Society estimates that 37,170 people will be diagnosed with it this year and that 33,370 will die. "

" If pancreatic cancer isn't diagnosed early -- and it usually isn't -- most victims die within seven months. It's the fourth-leading killer among cancers, even though it is not one of the 10 most common cancers. "

" The problem in diagnosing the disease is the vagueness of its first symptoms: moderate pain around the stomach, difficulty eating and weight loss. By the time more severe gastritis prompts a visit to a doctor -- at least 80 percent of the cases -- patients usually are beyond surgical care. "

" By then, the tumor typically has grown large and spread to other organs because of the pancreas' location next to arteries, veins and nerves that serve as a fertile bed for growth. (Zindler's has spread to his liver.) "

" Even if the tumor is confined to the pancreas, it's difficult to attack, because the pancreas is sandwiched between the stomach and other organs. "

" Kent Osborne, director of Baylor College of Medicine's cancer center and the son of smokers who died of pancreatic cancer. "It's not amenable to an equivalent of mammography or Pap smears." "

" There were glimmers of optimism four years ago. Funding, never good, began climbing, both from public and private sources. And the first "smart" drug to target the disease at the molecular level, Tarceva, was added to doctors' regimens. "

" Five-year survival rates of those who undergo an operation -- just 10 percent 15 years ago -- now are 20 to 25 percent. Dr. Craig Fischer, a Methodist Hospital surgeon, attributes the improvement to concentrating new techniques into a smaller, more experienced group of doctors. "

" But the number of operable patients remains small. Funding continues to inch up but also remains comparatively low. And the improvement from Tarceva, along with chemotherapy, turned out to be modest. "

" Then, last month,
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