Battling pancreatic cancer in Duluth
November marks a shift in cancer awareness colors, from pink to purple in honor of Pancreatic Cancer Awareness Month. According to the American Cancer Society, pancreatic cancer has the lowest five-year survival rate of any major cancer, at only 8 percent. This disease is the third leading cause of cancer-related death in the United States.
Pancreatic cancer has made an impact on Duluthians. This week we will examine the impact it has made for one Duluth woman and a few of the medical impacts. Next week the story will continue by examining the effects of a rare form of the disease on a professor at St. Scholastica.
"We were in for a battle"
Janet Paavola met her husband, Martin "Marty" Paavola, 42 years ago in a karate class. They became fast friends and married five years later.
"We were both very physical people who loved to exercise," Janet said. "He was the love of my life."
Marty worked as a building official for Rice Lake Township and the city of Proctor. He was an avid hunter, fisher and cross country skier.
In 2011 Janet, a nurse, noticed Marty had a little bit of jaundice, or yellow discoloration. After a visit to the emergency room at Essentia Health, Marty was diagnosed with metastatic, or stage 4, pancreatic cancer.
"We knew that we were in for a battle with that cancer," Janet said. "We decided very early on that we were going to give this our best fight."
After undergoing the basic treatments for the disease, including an 8-hour whipple surgery, radiation and chemotherapy, Marty participated in an immunotherapy clinical study. Over the course of one year, he was given about 180 injections to stimulated his immune system. Although the study has closed, the results have not yet been posted.
"I keep looking for it. I want to know if they found anything," Janet said. "We figured that even if it doesn't help Marty, maybe it will help others. That was our goal from the beginning, to do everything we could to help him and to help others."
Nov. 15 marked the second anniversary of Marty's death. He lived three years and two months after his diagnosis.
"Which is just incredible. Some people only get months to live, we had three more years," Janet said. "He never really complained. He just kept on going. He didn't want to dwell on it. He was a good dad, a good person, and a great husband."
A combination of efforts
Essentia Health Oncologist Dr. Randall Millikan doesn't work exclusively with pancreatic cancer, but does read a lot of research on the disease in order to best help patients.
"I don't just see pancreas cancer, but I see a fair amount of it," Millikan said. "At the moment, it's an unsolved problem. I read an article last week that stated by 2030 in the United States, it's predicted to be the No. 1 cause of cancer deaths. Because all the other cancers are yielding slowly to better treatments, so far nothing very significant in pancreatic cancer."
That's not to say that things haven't improved in the area of pancreatic cancer research, Millikan said.
"On the fringe, we're starting to see some special cases and we're starting to learn a little bit about the various ways that this cancer can develop and can be treated in special subsets," Millikan said. "And in the last five years a combination of drugs have been shown to improve survival in patients that have an advanced disease. Once you have a medicine in hand that makes people live longer when their disease is far advanced, then you can take that treatment and apply it to people whose disease is only microscopic. Suddenly you really get some bang for the buck and convert people from being destined to have a relapse and die to people who don't have a relapse."
Still, Millikan said the major breakthrough, a treatment that reliably improves survival by a year or more for patients with metastatic disease, is yet to come.
One difficult problem for pancreatic cancer, according to Millikan, is that it doesn't have a screening process and it often doesn't present obvious symptoms until it reaches a late stage. Symptoms tend to be subtle and nonspecific, unless the cancer spreads and blocks the bile duct, leading to the jaundice that alerted Janet Paavola. Another symptom, if the tumor infiltrates a bundle of nerves called the celiac plexus, causes a sharp gnawing pain radiating from the right front to back between the shoulder blades. Other symptoms include inexplicable weight loss, loss of appetite, nausea, changes in stool and diabetes. Risk factors for developing pancreatic cancer include family history of the disease, age, chronic or hereditary pancreatitis, smoking, obesity and long-standing diabetes.
For more information on pancreatic cancer, visit pancan.org.
This article continues in the Nov. 27 issue.