A Story that Began During COVID-19, with a Preview Seven Years Before

Penelope Dixon

• Hepatitis and liver monitoring lead to diagnosis
• Distal pancreatectomy and FOLFIRINOX
• Surgery to treat recurrence two years later
• Y90 procedure for liver recurrence
• Radiation and chemo for another recurrence

Prelude: My cancer journey really began just after I turned 65. 

I had been told by my doctors that I had a five percent chance of developing a tumor in my liver because I am a chronic hepatitis B carrier. I’ve always been good at chances because I did develop a tumor. In 2018 I had the tumor on my liver removed at Cleveland Clinic Florida. Thank goodness for Medicare, the best supplemental insurance, and my great insurance broker in Florida.

My pancreatic cancer story begins during the first surge of COVID-19, in 2020. I had been trying to return home to Massachusetts from Guatemala, where we usually spend a few months every winter and have a house of our own. Because of COVID-19 all the flights were canceled for a couple of months. I finally managed to get home just before my birthday in early June. As soon as I returned home, I had my labs done and the results came in on my birthday, June 1. I was still being monitored for chronic hepatitis. My blood work included a CA 19-9, a test that was new to me; it showed an elevation of about 90. I learned that it was a tumor marker for pancreatic cancer. That was the beginning of this journey. I was in stage IIb. 

Resection, Treatment, and Recurrence

I had a resection on the tail of my pancreas with Dr. Rohit Chandwani at Weill Cornell Medicine (New York City) in July of that year. When I recovered I started FOLFIRINOX chemotherapy with Dr. Tara Soumerai at Massachusetts General Hospital (MGH) in Boston in September. At the end of six months I got an “all clear” from my doctors and for the next two and a half years I was good. Then there was the first reoccurrence—cancerous nodules in my lungs, which were resected by Dr. Ashok Muniappan at MGH in May 2023.

In August 2023, a new tumor appeared. This time it was pancreatic cancer that had spread to my liver. I was treated by Dr. Thomas An at MGH in November 2023 with a procedure called Y90, which uses radioactive gold beads to surround the tumor and zap it. That procedure was deemed a success!

Treat and Repeat

In mid-2024 I was having a lot of pain when I coughed. It was so severe that I thought I cracked a rib. At the time I was living abroad for a few months and was unable to get an MRI easily. I actually flew back to the States, where the machine broke down the morning of my appointment! I finally got an MRI where I was living. At first it was misdiagnosed as a shadow but ultimately it was confirmed to be a tumor on my breastbone.

I was given six shots of radiation treatment from October through November 2024. I started chemo in early 2025, this time with gemcitabine and nab-paclitaxel. I’ve been told that as long as it’s working, as long as it is keeping the cancer from spreading, and as long as I can tolerate it, it becomes a kind of maintenance. Not a cure, but it will keep me alive for as long as it can. To me, that is great news. Unfortunately I am finding the side effects from the gemcitabine much more difficult than those last round so I’m not sure how long I can continue this treatment.

Keep On Going

I’ve sought care mainly at Massachusetts General Hospital on Martha’s Vineyard. I also go to Massachusetts General Hospital Brigham in Boston for certain procedures, such as draining fluid on my lungs and installing a port for chemo. I have seen Dr. Allyson Ocean on occasion at Weill Cornell Medicine and she has agreed with this line of treatment. She also told me that there are additional treatments if this one stops working. That’s very encouraging.

So that’s my story. I can only tell people to never give up. Even when you think you’ve exhausted all the possibilities, there may be something else out there that can help.