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Beating the Odds: Whipple Procedure Helps UAB Patient Survive Pancreatic Cancer

More than 62,000 Americans will be diagnosed with pancreatic cancer this year. Treatment and recovery can be complex, often involving surgery and major lifestyle changes. The disease has a high fatality rate, but one success story is that of Doris Bowdoin, 78, who credits her survival to the advanced care she received at the O'Neal Comprehensive Cancer Center at UAB.

A resident of Panama City, Fla., Bowdoin was diagnosed with stage 3 pancreatic cancer in October 2014. It came as a complete surprise.

“Prior to diagnosis, I had no symptoms to speak of and certainly not anything that would make me think I had cancer,” Bowdoin says. “I had celebrated my 70th birthday that September. I may have been feeling some fatigue around that time, but I had been travelling, so I assumed that was the cause. A short time afterward, I woke up one morning and noticed that my eyes were yellow; I was jaundiced. After an evaluation by a gastroenterologist in Florida, I was diagnosed with pancreatic cancer. It surprised and scared me.”

Silent Killer

Bowdoin’s concern is understandable. Pancreatic cancer is a fast-growing type that starts just behind the stomach in the pancreas. The pancreas is a small organ that produces hormones and enzymes that help with digestion and control the amount of sugar in the blood. One of the deadliest cancers and with a five-year survival rate that averages 11%, pancreatic cancer is especially life-threatening because it often spreads silently. It’s difficult to detect because many symptoms don’t seem suspicious or are not obvious during the early stages, and examining the pancreas directly is difficult.

Knowing the seriousness of her condition and feeling weaker by the day, Bowdoin immediately began researching treatment options. “I knew that surgery for pancreatic cancer would be a long and complicated procedure, so I was seeking a doctor with plenty of experience in that,” Bowdoin says. “My research led me to the O'Neal Comprehensive Cancer Center at UAB (OCCC). I spoke to a doctor there who had treated my sister for ovarian cancer, and he recommended Dr. Reddy.”

The surgery Bowdoin needed was a pancreaticoduodenectomy, commonly called the Whipple procedure. Surgical oncologist Sushanth Reddy, MD, would perform the highly complex operation, which carries a risk of complications that can be life-threatening. It requires removing the “head” of the pancreas and sometimes the body of the pancreas, too. Portions of the small intestine, part of the bile duct, the gallbladder, lymph nodes near the pancreas, and sometimes part of the stomach also are removed. The remaining bile duct and pancreas are then connected to the small intestine, so that bile and digestive enzymes can still reach the small intestine.

“In terms of seriousness and complexity, on a 10-point scale, the Whipple procedure is a 10,” Dr. Reddy says. “Typically it is performed after a two- to three-month course of chemotherapy, followed by a month of recovery. With Doris, we did surgery first because of her condition. She was in an extremely weakened state.”

Bowdoin recalls how quickly her care proceeded once she arrived at UAB Medicine. “I was in rough shape, and Dr. Reddy knew I needed to get a certain about of nutrition and strength back before surgery was performed,” she says. “I was admitted on Oct. 21 and had the Whipple procedure on the 31st. There’s no question about whether that surgery saved my life.”

Recovery Journey

Recovering from the surgery involved several complications, including malnutrition, so the care team inserted a feeding tube that remained in place after Bowdoin was discharged in mid-November. Other problems emerged in February 2015, when Bowdoin began chemotherapy with her doctors in Florida. She found herself battling both dehydration and pneumonia.

“Dr. Reddy wanted me to come back to the OCCC so the team could address the serious issues I was having,” she says. “That’s exactly what I did, and once again they rescued me from a serious medical situation. Two weeks later, the feeding tube was removed, and I began a successful transition to other chemotherapy medications. That’s when I truly began to recover. Without the OCCC and Dr. Reddy and all the staff there who cared for me, I doubt I would be here today.”

Getting Her Life Back

Dr. Reddy says certain key factors often account for successful treatment and recovery from pancreatic cancer.

“If we define success as getting back to having a relatively normal life but with certain lifestyle and diet restrictions, the success is about 80%,” Dr. Reddy says. “But if we define success as patients being exactly who they were before this surgery, it’s much lower. It is extremely demanding on the body and can take quite a toll. Some people want to live exactly the life they had before, but this cancer almost never allows for that. It requires someone like Doris, who is willing to go through the procedure and recovery and afterward may have to make major lifestyle adjustments. Not everyone is able to do that.”

Bowdoin, however, believes that she did indeed get all of her life back. “I’m living a very active lifestyle,” she says. “I’ve been skydiving and ziplining, and I think that’s pretty good living at age 78. We aren’t supposed to use the ‘C’ word, for ‘cure’, but my latest scans show that I’m healthy. I’m now taking a single digestive medication, so actually the cancer robbed me of only one year of my life. I’m a pancreatic cancer survivor, and all the credit goes to UAB Medicine and Dr. Reddy’s meticulous, experienced approach to helping me survive.”

There is some poetry in the fact that Bowdoin’s survival began with a procedure performed on Halloween in 2014. She helped start a charitable organization in Panama City called the Witches of St. Andrews, and currently she serves as its treasurer. Members dress as witches and host a charity bicycle ride in late October to raise funds for the Nikki Mitchell Foundation, which supports research and financial assistance for people with pancreatic cancer.

Click here to learn more about pancreatic cancer and the advanced treatments available at the O'Neal Comprehensive Cancer Center at UAB.