SANSUM CLINIC BLOG

Patient Michael Miller had no idea his life would be changed by pancreatic cancer until a case of jaundice revealed a tumor was constricting his bile duct. He required a physician team to relieve his symptoms and investigate the cancer. Gastroenterologist Vincent DeRosa, MD performed a stent procedure to release the bile and allow it to pass out of the liver properly. Fellowship-trained surgical oncologist William Charles Conway II, MD, FACS began to examine Michael’s pancreatic tumor. When pancreatitis (inflammation of the pancreas) set in, Dr. Conway carefully monitored the 69 year-old’s medical condition and worked to determine the way forward. Michael’s pancreatitis was virulent, painful and had affected his ability to absorb nutrients. Dr. Conway believed Michael needed surgery as soon as he could gain some weight. A Whipple procedure is an extremely complex operation. Outcomes are best with a surgeon who performs many of these procedures, like Dr. Conway. “I felt very lucky to have this option available in a smaller community like ours,” admits Michael. “Traveling would not have been easy at the time.”

Michael’s surgery by Dr. Conway was deemed a success, however he would still require chemotherapy and radiation

therapy to protect against any lingering cancerous cells. Dr. Conway joined forces with Ridley-Tree Cancer Center medical oncologist and hematologist Mukul Gupta, MD to manage his care alongside a team of specialists who would discuss his case — a process common for a multidisciplinary cancer center like Ridley-Tree.

Slightly more common in men than in women, pancreatic cancer has the highest mortality rate of all major cancers, and is currently the third leading cause of cancer-related death in the U.S. after lung and colon cancer. A former Raytheon electronic warfare systems engineer familiar with project management, Michael knew he’d need the unique perspective of each person on his medical team to fight this serious diagnosis. “I had an opportunity to ask questions and learn more, and get another expert’s opinion,” he explains about their collaborative process. When weekly infusion chemotherapy began, so did the tricky job of maintaining his nutritional status with a compromised pancreas. Michael consulted with oncology nutritionist Sarah Washburn, MS, RDN, CSO on which medications might impact his nutrition, and how to use food to minimize side effects from treatment. He also underwent genetic testing to find out if a genetic mutation could have caused his cancer. About ten percent of the estimated 57,000 adult cases of pancreatic cancer diagnosed in the U.S. each year are thought to be hereditary. Danielle Sharaga, MS, LCGC, a genetic counselor at Ridley-Tree, reviewed the results which exposed one gene mutation found in a small percentage of familial pancreatic cancer cases. This gene mutation also confers a moderately increased risk for breast cancer (24-48% lifetime risk) in women, something Michael was able to share with his two daughters. Leading Michael’s course of radiation therapy, Radiation Oncologist George Cheng, MD, PhD patiently answered his queries about the methodology, and didn’t mind debating the finer points of electromagnetics as they related to his care. With COVID-19 in full swing and visitor restrictions in place due to infection control, the entire radiation therapy team stood in for Michael’s wife, Bekki, across 28 visits, “a remarkable group to me, always positive,” he recalls.

Michael describes his cancer experience like a fast-moving train, each stop arriving quickly without time to review the

itinerary. A painting by local artist Arturo Tello of a railroad track with a road alongside it sparked a pondering of his own road to wellness. “I thought, ‘That’s where we’re headed. There may be rough spots, but that’s where we’re going.’” The phrase “on the road to wellness” stuck and he made it his regular salutation shared with his medical team members who became like family. “Everybody is expecting you to recover. You can feel it. I did not have to struggle to find the best people. They were all right here.”

Photo caption (top): Rhodes-Fleming Path, Carpinteria Bluffs, a gift from artist Arturo Tello, that inspired Michael Miller’s road to wellness.

Photo caption (bottom): Michael Miller