Faith, Hope, and Perseverance

Maryanne Winchester

• Sudden sharp pains in lower right abdomen led to diagnosis
• FOLFIRINOX, FOLFIRI, Gemzar for chemo
• Y90, pancreatectomy, two liver resections
• Life Is Good!

When I was diagnosed with stage IV pancreatic adenocarcinoma in November 2021, I was stunned and shocked.

My symptoms struck me one day, then nothing. It had to be a testy appendix!

From a full life to a life with no hope. Stage IV cancer. Hopeless. Then I changed my thinking. Stage IV is just a label. It does not mean immediate death. I would be living proof of that. A 12 percent survival rate is grim, until you think about how many people that represents. Perhaps I could be one of them!!

Three Types of Treatment

Very sudden pains in my lower right side one day took me to Urgent Care. Blood tests there and later at my primary doctor found nothing. I was healthy! But was I? An angel, Dr. Megan Bowles (Roswell, Georgia), said, “Let’s just get a CT scan anyway.” Shock of shocks, tumor in my pancreas and numerous tumors all over my liver. She made an immediate appointment with a wonderful, caring oncologist, Dr. Harpaul Gill (Atlanta Cancer Care), that confirmed it—I had STAGE IV pancreatic cancer.

My disbelief led me to MD Anderson (Houston, Texas) for a final diagnosis and recommendation. “FOLFIRINOX and get your affairs in order.” The oncologist was reluctant to discuss steps after FOLFIRINOX.

I returned home to begin the chemotherapy immediately. But I needed more. A goal, a plan B. Dr. Eddie Abdalla, at Atlanta Liver and Pancreas Surgical Specialists (a National Pancreas Foundation Center of Excellence) gave me that plan B. He, along with my incredible oncologist, Dr. Gill, said surgery could be in my future! Tumor biopsy and genetic testing showed only one mutation, KRAS G12D.

I exhausted FOLFIRINOX chemotherapy after eight months then stopped to have Y90 embolization to my liver, followed by more rounds of FOLFIRINOX. Tumor markers were up and down but ultimately trended down. I relished those days of positive CA 19-9 postings on my portal! The liver tumors were growing smaller and some were necrotic. Good news! And, my pancreas tumor in the tail was shrinking.

In December 2022, I had a pancreatectomy to remove the pancreas tumor and my spleen along with a few lymph nodes and adrenal glands. In February 2023 a liver resection rendered me NED (No Evidence of Disease) for several months. Scans in June 2023 revealed a tumor growing in my liver again. Chemo time again! This time Gemzar/Abraxane. By October 2023, Dr. Abdalla was able to remove the tumor and also my gall bladder. Recovery was quick and I went back on Gemzar for 3 months for insurance. I even took a month off to greet my first grandchild!

To tolerate all of the treatments I took larger doses of over-the-counter vitamin D and a multivitamin combination ADEK, which is supposed to help patients who have had surgery on their digestive system. I also ate very dark chocolate every day to keep my platelets up! Working with my surgeon’s dietician, my diet became focused on protein and green vegetable intake to avoid discomfort and hopefully, Creon! To date, I have not needed it.

A daily regimen of deep breathing, walking, and enforced quiet time armed me with a peace to get through each day no matter what the world or my medical portal brought my way. My loving husband, sons, and special friends never let “giving up” be in my vocabulary.

My Life Now

I will be stopping my Gemzar treatment while it is working! I want to stop the chemo before it stops working so that it may be a resource if needed later. My CA 19-9 is in the normal range and now it’s time to look towards clinical trials and maintenance drugs. I have applied to a clinical trial specific for people with the KRAS G12D mutation and am hopeful to be accepted, to take part in bringing better therapies to the forefront.

My upcoming PET scan will tell the real story. No matter what it shows, I feel great and feel such excitement about all the research in clinical trials now. Finally!

I’d like to tell others who have been diagnosed with pancreatic cancer not to be scared of the stage of your disease. It’s just a label! Plan to fight! If you aren’t healthy already, it is time to start! Getting healthy will arm you for the fight. I have had a lot of treatments, and none were a party, but “off” days for recovery became a new normal. With regularity I have been able to pop back up and resume life. I have continued to do the work I love, both in the professional world and volunteering where my passions lie. Stay involved! Appreciate others. You will not have time to indulge in pity—and you will always see reasons to be grateful.

Lastly, choose a doctor that believes in you, one who works in a center of excellence and is willing to think out of the box. After meeting with several surgeons, I was led to Dr. Abdalla. He gave me hope and that’s all I needed to launch my personal battle and become my own advocate. I learned all I could, kept working, and kept loving the life around me. I still find the best in every day!

Faith breeds hope, hope breeds perseverance, and perseverance opens doors; faith names me a thriver, not just a survivor!