There are no early symptoms of pancreatic cancer, so it is often diagnosed in the late stages, when it is more difficult to treat. Symptoms of pancreatic cancer can include abdominal pain, jaundice (yellowing of the skin and eyes), weight loss, and back pain. This makes it especially difficult for patients like Alicia Avila, 49, of Martinsburg, to catch and treat early.
Avila went to her doctor in early 2021 because she had been having some high abdomen pain and yellowing of the skin. He ordered bloodwork and, after reading the results, called Avila and told her to go to the Emergency Department immediately. Her pancreas and liver were failing.
“I didn’t feel that bad, so I asked him if I could wait and go to his office the next day,” Avila said. “He said to trust him and go to the Emergency Room. I’d been seeing this doctor for years, so I trusted him.”
At the Emergency Department at WVU Medicine Berkeley Medical Center, doctors ran more tests and performed an ultrasound to try to determine the cause of Avila’s pancreas and liver failure.
A CT scan revealed a mass in her pancreas blocking the bile duct, but more specialized equipment was needed to determine the cause. She was transported by ambulance to WVU Medicine J.W. Ruby Memorial Hospital in Morgantown and was in the advanced endoscopy suite the next day with Shyam Thakkar, MD, WVU Medicine gastroenterologist, for a biopsy and placement of a stent to allow her pancreas to drain.
“Dr. Thakkar was in charge, and I believe he was meant to be the one to perform my procedure. He came to my room after he got the biopsy results and stood at the foot of the bed. I remember he looked me in the eye and was very kind and I felt I could trust him,” Avila said. “He said, ‘It is adenocarcinoma. It seems to be stage I and doesn’t look like it has spread. A surgeon will come talk to you about your options.’”
Brian Boone, MD, WVU Cancer Institute surgical oncologist, met with Alicia next and recommended a robot-assisted Whipple, also called a pancreaticoduodenectomy, to remove the head of the pancreas, a portion of the small intestine, the gallbladder, and the bile duct.
“Dr. Boone told me he had dedicated his life to the pancreas and pancreatic cancer, even though there aren’t many surgeons who specialize in the pancreas,” Avila said. “I saw his sense of urgency and knew he could help me. I knew he was my surgeon.”
The surgery revealed that Avila’s cancer was more advanced than the initial tests indicated. It had spread to her lymph nodes, putting her cancer at stage III. This meant she needed to undergo chemotherapy and radiation to kill the remaining cancer in her body.
She consulted with Joanna Kolodney, MD, WVU Cancer Institute medical oncologist, who recommended she undergo 12 rounds of chemotherapy followed by radiation therapy. “My body didn’t take the chemotherapy as well as we hoped it would, and I was only able to complete six rounds,” Avila said. “I had lost too much weight. I talked to Dr. Kolodney, and she recommended we take a break from the chemo and do radiation.”
Avila was able to complete her radiation treatments at Berkeley Medical Center, allowing her to stay close to home instead of at hotels and other accommodations in Morgantown. After completing radiation therapy, Avila was faced with a decision: go back to chemotherapy or go into surveillance.
“I had been working on how to balance my thoughts and reconcile what I’d been through. I learned different tools to help me be more in tune with my body,” she said. “I decided to go into surveillance.”
Avila had monitoring CT scans every three months to see if her cancer had returned and, at her last appointment with Kolodney, she learned that her cancer was officially in remission.
“It’s great news because I know there are not many success stories for stage III pancreatic cancer,” Avila said. “I think a lot of it was my connection with my doctors. I trusted them and saw the power of human connections. I was lucky to find all of them in the same place. I was also lucky to have my husband beside me through the process.”
Now, Avila lives her life differently, paying more attention to her experiences and taking more time with loved ones.
“I always thought of myself as a very strong person. I believed that once you set your mind to something, you could make it happen. I was always pushing the limits; I was a perfectionist. I would never stop to listen to my body. I realized I was breezing through life without really living,” she said.
“I remember that night in the Emergency Department, thinking about everything I was going to miss. I wasn’t going to miss not attending a meeting at work or getting another sale. I was going to miss spending time with my husband, giving a hug to my parents, walking my dog, all those little things we take for granted. The rest didn’t matter. Connection with other people is what matters.”
Avila shared her story at the 2023 WVU Cancer Institute’s Pancreatic Cancer Awareness luncheon. The day also included the 2023 Laurence S. and Jean J. DeLynn Lectureship featuring Vikas Dudeja, MD, the James P. Haynes, Jr., Endowed Professor in Gastrointestinal Cancer and director and professor of surgical oncology at the University of Alabama at Birmingham.
If you or a loved one are experiencing symptoms of pancreatic cancer, see a doctor right away. Early detection is key to successful treatment of pancreatic cancer. There are a variety of treatment options available for pancreatic cancer, including surgery, radiation therapy, and chemotherapy. The best treatment option for you will depend on the stage of your cancer and your overall health.