Two family accounts of case histories of family members with pancreatic cancer.
These are the case histories, as told by two families, of the struggle their loved ones had with pancreatic cancer - problems with diagnosis, pain control, etc. I have put these two stories on my web site, at family request, in the hope that they may be of help to some people. Diagnosis and treatment may well have changed in the intervening decade, but the disease is still often diagnosed at a late stage, when effective treatment becomes difficult.
James Briggs MB BS, DPath, FRCPath
DIARY OF AN ILLNESS - DAVID ATKINSON
1. 23 May 2001: Saw Dr H, complaining of stomach pains. Requested, and received, Metoclopramide as it had been effective on other occasions. Not effective this time.
2. 14 Jun 2001: Saw Dr F, with same problem but now more painful. He suggests endoscopy and refers me to Mr T.
3. 17 Jul 2001: Saw Mr T. He says endoscopy not indicated but arranges for Ba meal. Waiting time 10 weeks+.
4. 28 Sep 2001: Saw Dr L (Dr F not available) as pain growing and back pain also. She arranges blood test for?
5. 4 Oct 2001: Ba meal - shows nothing.
6. 5 Oct 2001: Blood test - results ?
7. 22 Oct 2001: Saw Dr L and ask for ultrasound scan. Receive pain killers (Tramadol)
8. 27 Oct 2001: Attend local hospital emergency centre with acute pain. Receive pain-killing injection. Blood taken for pancreatitis - nothing found. Receive alternative pain killers (Kapake).
9. 30 Oct 2001: Ultrasound scan - nothing very positive found.
10. 6 Nov 2001: Saw Mr T. He reviews ultrasound results and arranges endoscopy. Advises me to see GP for stronger painkillers.
11. 8 Nov 2001: Saw Dr? and receive morphine scrip.
12. 9 Nov 2001: Pharmacist queries morphine.
13.10 Nov 2001: Saw Drs H and P (together) and receive alternative morphine scrip (Temgesic).
14.13 Nov 2001: Have endoscopy by Dr F and told that duodenal ulcer found.
15.15 Nov 2001: Saw Dr F and given antibiotics and Lansoprazole.
16. 6 Dec 2001: Saw Dr F as no improvement. He doubles drug dose.
17. 17 Dec 2001: Saw Dr F as no improvement. He gives alternative drug (Losec) and says he will write to Mr T. Dr F mentions possibility of CT scan,
18. 31 Dec 2001: Review. Currently taking Losec and up to 3 Tramadol daily; and Temgesic to deal with very infrequent acute pain. Slow worsening of main symptoms including stomach pain, back pain, and distension.
19. 7 Jan 2002: second ultrasound; no diagnosis.
20. 8 Jan 2002: second endoscopy; no ulcer but symptoms persist.
21. 15 Jan 2002: CT scan.
22. 17 Jan 2002: CT results show swollen pancreas.
23. 18 Jan 2002: Saw Dr F. Possibility of cancer of the pancreas raised. Prescribed Dihydrocodeine.
24. 19 Jan 2002: Saw Dr C: prescribed sleeping tablets and morphine.
25. 24 Jan 2002. Needle biopsy of pancreas. Cancer confirmed with secondary spread to the liver.
26. 25 Apr 2002. Died.
QUESTIONS RAISED BY FAMILY.
1. Is persistent, unexplained, severe back pain typical of a duodenal ulcer? Do people with ulcers have so much pain that they require emergency pain killers?
2. Is excessive back pain typical of Ca pancreas?
3. In spite of increasing use of pain killing drugs there was seemingly endless prevarication. Why so slow to come to a diagnosis? Why no fast track to get to this diagnosis earlier?
THE STORY OF JOHN S's FIGHT WITH PANCREATIC CANCER
19 November 1942 - 31 July 1999
It is with infinite sadness I have to tell you that. after a truly heroic battle with cancer, John has finally said farewell to life.
John had many stomach problems from the summer of 1998 but it was extremely difficult to trace the cause as there were several red herrings along the way. After an ultrasound he was told on Christmas Eve that the diagnosis was 80% for pancreatitis and 20% for cancer of the pancreas. John was as strong as a lion, still doing the heaviest building work, and full of life and energy so it was utterly impossible for him, or anyone who knew him, to believe that he had actually contracted this most deadly and evil of cancers. After an agonising wait however a biopsy confirmed our worst fears on 22 January 1999.
John resolved there and then to "never go gentle into that good night" and all his enthusiasm for life, courage, resilience and determination came to the fore. He was totally focused on beating the cancer and remained utterly positive, dynamic and with a total lack of self pity at any time. It was immediately obvious that orthodox medicine could do nothing for John. His cancer was inoperable and the oncologist suggested chemo and radiotherapy while telling him nonchalantly that this would almost certainly produce the most painful side effects without making any real dent on the tumour. (What a nice chap - some bedside manner!!) John was momentarily flattened by this man's destructive approach but not for long and he determined to keep his dignity rather than embark on a course of treatment which would ravage his body and turn him into a physical wreck. Over the next few weeks we tried desperately to get him accepted for clinical trials at University College Hospital on a very new photo-dynamic laser therapy but he was ultimately turned down.
At this very low point there was suddenly some very good news.
Our dear friends Jan and Ivor attended a conference at Westminster Hall in London and listened In a lecture by Dr Patrick K. He has strings of orthodox letters after his name but has practised ecological medicine for over 20 years and earned an international reputation for curing a wide range of diseases by holistic methods. Jan and Ivor were so impressed that they paid for John's treatment, for which we shall always be in their debt. Dr Kingsley prescribed infusions of vitamins and minerals, injections of mistletoe, and a strict anti-cancer diet with no sugar, salt, caffeine, processed foods. yeast, alcohol, dairy products or red meat. The enzymes he gave allowed John to enjoy food once more and the pain he had endured after eating vanished completely. Indeed in a short time he was also able to dispense with all painkillers. We travelled to Leicestershire twice a week for the infusions and oxygenation of the blood and met many delightful patients who all swapped information and tips at every turn. It became like going to a very happy club!
We continued to look for a miracle and explored every possible avenue to this end. This included visits to a wonderful faith healer, psychic surgeon, homoeopathic doctor. Reiki practitioner, and hypnotherapist. From them we gained encouragement, relief and a great deal of hope so that John remained optimistic, full of enthusiasm and determined to succeed.
I loved and admired him more than I can express for the way he faced his illness. John fought with panache, and the greatest courage, never moaning about what fate had done to him: his sense of humour also remained undiminished - when telling someone about the benefits of coffee enemas John added "Mark you they'll never want to come to US for coffee again!" as he roared with laughter!
John continued working until the middle of June when we spent a four day theatre break in London. It was the happiest of times and I have a very clear and wholly unforgettable picture of John festooned with luggage striding away at a rate of knots towards the tube station with me plodding behind like a geriatric snail. The temperatures were in the 80sF and he was still amazingly strong and full of vitality!
Alas, shortly after this John became very seriously jaundiced as the tumour began to press on the bile duct causing bilirubin to flood through his system which weakened him terribly after a few weeks. The hospital tried twice to remedy this by inserting a stent (tube) to relieve pressure, but they were unsuccessful. We hoped they would try once more, but it became too dangerous to attempt, given the condition of his liver and kidneys and the last week of his life was a downward spiral as as he was unable to eat and slept a great deal of the time.
John had very little formal education but after taking a plumbing course set about learning all the other building skills to great effect. 1 shall always remember his original mind, amazing natural talent and that great tenacity which thrived on a challenge. John genuinely cared for people and always wanted to help. His talents seemed limitless - a dab hand with a sewing machine, artistic gifts, especially for fine pencil drawings, and absolutely the finest mince pie maker in the country - Mr Kipling never stood a chance!
The loving and compassionate support of those friends who knew of his battle helped us enormously and was a continual source of joy arid encouragement to John.
A bright and shining light has finally been extinguished but John's gallant and caring spirit will always be lovingly remembered by so many people.
Counter added 20 Jun 2012
Back to Author's Home Page