I was diagnosed with inoperable pancreatic cancer in March, 2008.
Although the tumor located in the neck of my pancreas was small, being wrapped around my artery, the tumor infiltrated my vein, making it unresectable.
On the good side, I developed symptoms very early on, containing the tumor within my pancreas—at that point.
I began a series of aggressive treatments, beginning with chemotherapy alone, followed by simultaneous chemo and radiation for several months, the objective being to reduce the tumor enough for there to be adequate margins between the tumor and the artery, and thus be a candidate for resection.
In late August, after completing the treatments, I underwent MRI and CT scans, as well as an endoscopic ultrasound (EUS) to see if the treatments had worked.
My surgeon and oncologist sadly informed me that while my tumor had shrunk approximately 20%, it had not become operable.
My oncologist further informed me that he did not believe that I would ever become operable, and that there was not much else they could do for me.
It was at this point that I came to New York Presbyterian for a second opinion from Dr. John Chabot.
I met with Dr. Chabot in early October, 2008. Dr. Chabot had reviewed my scans and reports, and believed that there was a discrepancy.
In his opinion, there were adequate margins between the tumor and blood vessels for him to operate.
There was still no evidence of spread.
However, there was another problem. First, a total of 11 weeks had passed between the time my radiation treatments had ended and the time of Dr. Chabot's second opinion.
Additionally, the Whipple surgery was only performed on patients who were at a maximum of 6 weeks post treatment.
So while technically I was operable, I was not, in fact a candidate for the surgery.
Dr. Chabot and I then had a serious conversation about my prognosis without the surgery, and as expected, it was not good at all.
The only chance for a cure was the surgery.
I explained to him that I was not ready to give up just like that, and was ready to accept whatever additional risks existed in having the surgery.
After a long pause, Dr. Chabot agreed.
If I was willing, he would attempt the surgery.
I had the surgery on October 24th; 13 weeks after my radiation treatments had ended.
The surgery was as complicated as Dr. Chabot had feared it would be.
In addition to the "normal" Whipple procedures, I had a vein reconstruction using a vein from my neck, and there were several hundred micro sutures required-the surgery took 14 1/2 hours.
My post-surgical pathology reports were not what we had hoped for.
While the surgery had been successful in removing the visible tumor, the report showed that I did not have clean margins.
Thus, some cancer remained in my body, and the chance for cure gone.
After a recovery of several months, I began another cycle of very aggressive chemotherapy (5-FU and Oxiliplatinum, combined with daily oral Tarceva).
I completed the treatments in May of 2009.
My scans at that time showed no evidence of disease, even in the area within my pancreas where previous post-surgical scans had detected it.
It is now 2+ years post-surgery, and coming up on almost 3 years from initial diagnosis, and I have continued to take Tarceva daily, have MRI and CT scans every 3 months, I continue to show no evidence of disease.
My heartfelt thanks to Dr. Chabot for his courage and skill in performing the surgery on me, and to everyone at NYP for giving me a chance to be what I have become: a survivor.
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What to expect from an appointment with a specialist:
Pancreas Center patients have access to a highly experienced, multi-disciplinary team of gastroentorologists, oncologists, surgeons, radiologists, nurse practitioners, geneticists, genetic counselors and nutritionists.
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