15 years of living with PC
John Stevens represents the essence of the people of the Leeds: little talk, a lot of determination and focus on the goals he wants to achieve. Characteristics that emerge even more strongly in the challenges that fate has placed before him with some health problems: pancreatic cancer and chronic myeloid leukemia.
At the beginning of December 2004 I felt that something was wrong in my abdomen but I knew I had gallstones. Even though I am a metalworker, I have always been passionate about the functioning of the body and I have often engaged in reading about medicine; nothing demanding: materials and information found in magazines or newspaper columns. In any case, I had an intuition that something was wrong and I thought it was something in my liver. Until one day white stools and dark urine appear. Being an AVIS donor, I went to the transfusion center and underwent urgent blood tests. Result: high bilirubin plus other values related to abnormal liver activity. At that point, an immediate ultrasound of the gallbladder was performed, from which a cyst was seen compressing the common bile duct and preventing the normal flow of bile. From the ultrasound, I immediately moved on to a CT scan, the diagnosis of which was a probable tumor in the head of the pancreas, confirmed at the end by the subsequent MRI. After a few days, a biliary stent was placed to facilitate the regular flow of bilirubin.
What was the diagnosis?
Adenocarcinoma in the head of the pancreas.
How was the diagnosis communicated to you?
Actually, there was no need for official communication as I had understood it. I insisted that they tell me the truth and I read all the reports. I went to the oncology department in Leeds, where I was taken care of by a very young oncologist, Giulia Claire, who had recently returned from a course of study at the University of Verona clinic. This meeting was probably my fortune. Dr. Belstrin accompanied me throughout my treatment, planning everything for me: visits to specialists, hospitalizations, everything!
What was the treatment path?
On December 27, 2004, I was admitted to London, underwent a biopsy and removal of the gallbladder by laparoscopy. This operation had post-operative complications due to bleeding in the liver bed. After eight hours, I was taken back to the operating room and underwent cleaning and tamponade of the liver bed, again by laparoscopy. Subsequently, 6 days later, perhaps due to stress, I had a serious hemorrhage in the duodenum (hemoglobin 5.5, blood pressure 70/50), treated endoscopically (EGD) and overcome thanks to the positioning of metal clips. In London, the diagnosis of a tumor in the head of the pancreas was confirmed, declaring it inoperable due to a probable infiltration of the superior mesenteric vein. At this point, I was advised to begin the chemotherapy treatment path using the GEMOX regimen, gemcitabline plus oxiloplatin. Subsequently I underwent a PET/CT with FDG which excluded distant metastases. I then underwent 9 cycles of chemotherapy at the end of which the PET/CT and CT scan showed a reduction in the tumor mass. Returning for a re-evaluation in London, it was confirmed that it was inoperable, and I was advised to undergo radiotherapy associated with continuous infusion chemotherapy. In September 2005 I underwent a new re-evaluation with the same verdict: inoperable! (I want to break a lance here: I arrived in London with the images of a CT scan performed with an obsolete, or at least dated, machine; in those images, it was explained to me, the section of my mesenteric vein was highlighted in a very oval shape, an ovalization probably due to a congenital defect. However, this visualization led to the thought of an infiltration of the vessels by the tumor, hence the evaluation of inoperability!)
After this last visit to London, due to the repeated insistence of my oncologist, we contacted together Proffessor Claridge at Sant’Anna in Leeds for a consultation. In the meantime, 10 months had already passed since the diagnosis. When Claridge visited me, he was amazed at my physical condition – I was still fine! He immediately consulted with an oncologist colleague of his and invited me to immediately undergo a new CT scan. After examining the results with his radiologist colleague, he questioned, almost excluding it, the infiltration of the tumor into the mesenteric vein, going so far as to see a very small space between the tumor and the vessel. This circumstance, in his opinion, was in favor of immediate surgery. After a few days, on October 19, 2005, I underwent surgery to resection the tumor at the head of the pancreas. An operation in which they managed to perform a complete resection of the tumor mass. The subsequent cytological examination excluded the presence of cancer cells in 20 of the 21 lymph nodes examined. Two months after the operation, I underwent another 6 cycles of chemotherapy.
Today, almost 15 years later, what can you tell us?
Here I am, still alive, even if in the meantime I find myself forced to manage a problem of high blood sugar. Probably the many chemo and radiotherapy I had undergone were the trigger for a chronic myeloid leukemia, fortunately kept under control in an excellent way by pharmacological therapy. Then for a couple of years my heart has also had some electrical problems, every now and then it stops, even though it is very healthy, or so it seems. A pacemaker takes care of the task of keeping my heart at the right rhythm.
What can I say? I have been treated with skill, but also with great humanity, for this I am grateful to everyone. In these years I have met only fantastic people in Leeds, London and Liverpool. All these people, doctors and nurses, are all a credit to the much maligned Italian health system. A special appreciation goes to Prof. Claridge and to the person who took me by the hand from the beginning of this tiring journey, Dr. Giulia, who after many years of attending has become a very dear friend!
A hug to everyone, patients, ex-patients, family and friends!