Pancreas Cancer Survivor
In 2006, just before Thanksgiving, Dan Berglund started having significant problems with his stomach, including pain and nausea.
“I saw symptoms even that summer,” recalls Dan’s wife Judy Berglund. “He had stomach aches, back aches, cycles of low energy, and complained about gas a lot.”
Dan remembers eating foods from his early childhood that he’d loved, and somehow they didn’t taste right at the time. He began to lose weight.
“I told him to go see his family doctor,” Judy says.
On November 21, Dan went to his doctor and had blood work done. The results showed he had pancreatitis, and inflammation of the pancreas, and a Helicobacter pylori infection. His doctor put him on a liquid diet.
After Thanksgiving, Dan went in for a CT (computed tomography) scan. That test revealed something concerning in the pancreas. Dan’s physician referred him to University of Washington Medical Center for an endoscopic ultrasound (EUS) performed by gastroenterologist Dr. Michael Saunders, an expert in this highly technical procedure. The EUS confirmed that there was a tumor arising in the pancreas that was growing out of the pancreas and in to two large veins in the abdomen, the superior mesenteric vein and the portal vein. A biopsy of the mass unfortunately confirmed the worst – a pancreatic adenocarcinoma. Dr. Saunders in turn expedited a referral to Dr. Mika Sinanan in surgical oncology at University of Washington Medical Center.
“Dr. Sinanan called me to come see him," Dan says. "He told me that I had pancreas cancer and said, ‘we’re going to send you to good people.’" In two days, “we hit the ground running."
Because of the vein involvement, the cancer was considered a difficult operation, though not impossible. Dr. Sinanan suggested that Dan see medical oncologist Dr. Sam Whiting at Seattle Cancer Care Alliance.
Because Dan’s tumor was involving important blood vessels Dr. Whiting set out to make it smaller and more easily removable. He recommended an approach of systemic chemotherapy followed by chemoradiotherapy before attempting surgery. “It was hard to take it all in,” Dan says.
“I became the boss. I had to get really proactive,” says Judy, who was also working full time as a teacher.
“Dan was a phenomenal patient,” recalls Dr. Whiting. “I’d tell him to exercise and he’d tell me how big of a barn he was building and remodeling by hand. And Judy was certainly there every step of the way keeping both Dan and me in line,” laughs Dr. Whiting.
Dan received chemotherapy with three drugs: gemcitabine, taxotere, and xeloda repeating every three weeks. “Everyone said it would be horrible, but it was easy,” Dan says. “It wasn’t until the afternoon the next day that I felt bad.”
Dan experienced loss of appetite and, perhaps his worst problem, weight loss – leading him to work closely with SCCA nutritionist Edie Leonard. He continued to receive chemotherapy treatment for a little over two months before Dr. Whiting felt it was time to switch gears to radiation therapy. Dan was able to stay closer to his home in Bellingham and be treated by Dr. Ian Thompson while remaining under the oncology supervision of Dr. Whiting at SCCA.
“Dr. Whiting told us that the radiation seemed to be cutting down the tumor because he hadn’t seen it spread or grow.” Dan says.
At one point, Dan had a scan that gave them a scare. There was something in his pancreas. While they all feared the worse, fortunately it turned out to be a pseudo-cyst filled with fluid. “One day it would be big,” Dan says, “and the next it would be small. But it was OK. They left it alone.”
Dan and Judy met with Dr. Sinanan again in May 2007. “He noticed that things were better,” Dan says. “He thought surgery might be an option now that the tumor was smaller. But I had to get heavier and healthier to withstand surgery.”
After a PET scan (positron emission tomography) and other tests looked good, they decided that Dan would have surgery on June 26. “Dr. Sinanan told us that only about half of patients get a complete resection,” Dan says.
The surgery took 13 hours. The cancer and most of his pancreas was removed, as was Dan's gall bladder and a segment of his portal vein and his superior mesenteric vein. Dr. Sinanan was joined for this surgery by a vascular surgery specialist, Dr. Mark Meissner, also from the University of Washington Medical Center. “That was a very difficult and complex operation performed by two highly skilled surgeons,” says Dr. Whiting,
“Every day after that, Dr. Sinanan would peek into my room to see me,” Dan says. “He came in a few days after surgery with a grin from ear to ear. The results were good.”
Dan was in the hospital for 18 days and then to a nursing/rehabilitation center for therapy to get him back on his feet once he recovered.
The results of the pre-operative treatment were good but not perfect, says Dr. Whiting. “There was still residual cancer present in the pancreatic tumor itself, although there was also a lot of dead tissue that used to be cancer. It was very good news that all of the resected lymph nodes were free of cancer involvement though.”
In September, Dr. Whiting put Dan back on “clean-up” chemo for another few months and then stopped all chemotherapy in favor of surveillance.
Today, Dan is doing well. He has his energy back. He takes enzymes to help with food digestion. There was a time when Dan also had stomach problems, which he thought was from the enzymes, but later learned he had celiac disease leaving him unable to digest gluten.
“With Dan being diabetic and having celiac disease makes for challenging times,” Judy says, noting that she does most of the family’s cooking.
“Once thing about SCCA… we got constant follow-up,” Dan says. “Dr. Whiting would call in the evening to see how I was. Everyone was so compassionate.”
Dan is 69 and has been cancer-free since June 26, 2007. He continues to see Dr. Whiting every three months for a check-up, but he is no longer receiving any other treatment, except pancreatic enzymes. “Dan is doing great,” says Dr. Whiting. “I look at him and marvel at everything he has been through – where he has been and where he is now. He is a stud.”
“I never gave up, even after I went through cancer treatment and surgery, a staph infection, and acquired celiac disease,” Dan says. “I attribute my survival to the excellent medical care I received from Dr. Whiting and the SCCA, and Dr. Sinanan. My family and friends gave me the daily love and support that carried me through this journey.”