Making a Risky Choice

Judith Zitiello

• A choice between chemotherapy or a tricky surgery
• Laparoscopic Whipple procedure
• Chemotherapy and radiation after recovery

My pancreatic cancer journey began April 29, 2014 when I visited my doctor because of a sudden weight loss, lethargy, amber-colored urine, and a terrible itching on my torso.

After a sonogram on the following day, my doctor explained that I was jaundiced and that my itching was caused by bilirubin that was invading my body. The bile duct to my pancreas was blocked by a large mass in the head of the pancreas.

Choosing a Risky Surgery

I met with Dr. Horacio Asbun, a surgeon (now at Baptist Health South Florida), and Dr. Raimando Mossimo, a gastroenterologist, both at the Mayo Clinic in Jacksonville. Dr. Asbun is world-renowned for his knowledge of pancreatic cancer, and is one of the few surgeons who perform the Whipple procedure laparoscopically.

The tumor was located in and around the head of my pancreas and it had not metastasized, so Dr. Asbun wanted to perform a Whipple resection. After the surgery I would be referred to oncology, where additional chemotherapy and radiation would be set up.

An MRI showed that the tumor had wrapped around the hepatic artery. This was a game-changer. We were offered two options. 1) Chemotherapy would be administered in an attempt to shrink the tumor. By shrinking the tumor, it might prevent the need to stent the biliary artery, which would be life-threatening. 2) Go on with the surgery praying I didn’t bleed out on the table while Asbun stented the artery. After much discussion my decision was to go ahead with the surgery, which was scheduled for the following Monday.

After a long surgery Dr. Asbun emerged to report a 3.5 cm adenocarcinoma had been removed along with 30 lymph nodes, 5 of which tested positive for cancer. Stage IIb, with a CA 19-9 of 31.

Chemotherapy After Recovery

I developed a serious post-surgical infection that delayed my recovery but finally I was strong enough to be able to begin my chemotherapy and radiation. I began with one month of gemcitabine administered through a Power Port that was surgically installed. After that month, I began radiation therapy along with a chemo pump filled with 5-FU. This regimen continued for 30 days. Then it was back to the gemcitabine for the following four months. My treatment was complete on December 24th, 2014 and a CT scan revealed I was cancer free.

I am celebrating! I have completed my 5th quarterly CT scan and blood work and Dr. Stephen Ko, my radiologist, my oncologist, and my surgeon all declared me “cancer free.” I am feeling really good.

Judith passed away after a 10-year battle with pancreatic cancer. During that time she helped guide other families through this disease, and raising funds for pancreatic cancer research and for adaptive  equipment for people with spinal card injuries, all while spending time with her family. We offer our deepest condolences to her family.

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