Against All Odds

Pancreatic cancer patient defies statistics, connects with others in fight for life

For Pamela Duda, diagnosed with pancreatic cancer in October 2007, the highlight of her treatment at the University of Chicago Medicine was talking with patients on the sixth floor while she waited to be called for chemotherapy.

Pamela Duda

“You’d see the same people, and you’d share a bond with them,” said Duda, a 53-year old Indiana resident. Then, when new patients came in, Duda would open up to them about the experience, too--the nausea, medications, and intimidating statistics: Pancreatic cancer often does its damage silently, and is the fourth leading cause of death among cancer patients.

“She’s eager to do everything she possibly could to improve her prognosis,” said Hedy Lee Kindler, MD, medical director of gastrointestinal oncology.

For Duda, part of improving her prognosis was connecting with others. “There were times when it was eye-opening, just to be able to talk to patients going through the same thing you were going through.”

Duda’s identical twin sister, Pat, also helped her through treatment. Sometimes the sisters made the 50-mile drive to the medical center together. Pat, who had been an oncology nurse for more than 30 years, took a month off of work when Duda went in for surgery and acted as her sister’s medical liaison.

“Sometimes you need to have somebody with you because you might be in a little bit of shock. You don’t always catch everything. There were times when the doctors would just stop and watch me to make sure I was getting it. They pay attention to that,” Duda said.

Hedy Kindler, MD Hedy Lee Kindler, MD

Diagnosed in 2007, Duda’s medical journey really began the year prior. In October 2006, she had her gallbladder removed after experiencing abdominal pain. Her doctor then diagnosed her with pancreatitis and in the process discovered that she had a birth defect called pancreas divisum. Sections of her pancreas had never joined together, so instead of one duct coming from her pancreas, Duda had two.

Doctors immediately checked her sister Pat for the defect, and found her pancreas was normal. “At the time they told me I could start having lots of pancreatitis problems, and I’d have to go to the University of Chicago,” Duda said. “That doctor knew that if it got worse he wouldn’t touch it. That saved my life.”

Because pancreatitis involves inflammation of the pancreas, the disease--if chronic--puts the person at greater risk for development of cancer. Inflammation leads to a change in cellular structure, and according to Kindler, “abnormal inflammation can sometimes lead to cancer development.”

Irving Waxman, MD Irving Waxman, MD

At the medical center, Duda first met with Irving Waxman, MD, professor of medicine and surgery. Waxman did not like what he saw in Duda’s scans, but hoped it was scar tissue from her gallbladder surgery.

After further monitoring, though, he realized he was looking at a stage II tumor, and called on Jeffrey Matthews, MD, chairman of the Department of Surgery, to conduct a Whipple surgery. » Learn more about the Whipple procedure

One of the most extensive surgeries, the Whipple procedure involves removing part of the pancreas and small intestine in order to save the rest of the digestive system from the tumor.

Jeffrey Matthews, MD Jeffrey Matthews, MD

“It’s a really challenging disease because there’s a lot of pain, weight loss, fatigue, and blockages. Being at a place that sees a lot of it and can do a multi-disciplinary approach is really what people want to do,” said Kindler, whose research includes the latest cancer treatments including many novel agents that are targeted to the biology of pancreatic cancer. “Standard drugs are not good enough as far as we’re concerned.”

Throughout her treatment, the entire team explained every step to Duda. “They didn’t sugarcoat it. I had a real understanding of what was happening to me.”

Duda recovered at home, in Hobart, Ind., and took a year hiatus from her job as a student supervisor at Hobart Middle School. She loved her work, but needed to give herself time to recover.

“I stayed home and had my chemo and went and saw my doctors,” Duda said. When they told her she would lose 10 percent of her body weight, she did--slipping from 106 to 94 lbs.

After surgery, Duda met with Kindler. And Kindler told her exactly what she was up against. “It was kind of a shock when she sat down and explained pancreatic cancer and the percentages, but I knew the battle that I had to do,” Duda said.

Discussing the disease with patients is a delicate balance, according to Kindler. “This is a really dismal disease with a dismal prognosis, but Pam has really outdone the odds and done really well.”

The average lifespan for patients who undergo pancreatic resection is approximately two years. But since that October four years ago when she had her gallbladder out, Duda has seen “an awful lot” of doctors, nurses, surgeons and technicians. Most of them consider her a “walking miracle,” surviving despite percentages that say otherwise.

She attributes her success to the care she has received at the medical center, as well as to her family and her faith. “This has been a journey for all of us. I do have a strong faith, but also a fantastic husband, wonderful family, and my healthcare advocate [Pat].”

May 2010