Pancreatic Cancer Affects Physicians Too

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At the age of 30, Dr. Mark Lewis found that he had tumors on his pancreas. His cancer wasn’t what people typically think of when they think of pancreatic cancer; his tumors, called Pancreatic Neuroendocrine Tumors or PNETs, grow slowly. Mark could monitor the tumors annually for almost eight years before having surgery. This year, scans of his pancreas showed that one of the tumors was growing aggressively so surgery would be required to prevent the tumor from becoming inoperable.

Most of the time this type of cancer is just bad luck. But, in Dr. Lewis’s case, he knew that it was hereditary. The same tumor syndrome had affected his father, a paternal uncle, and his grandfather. This type of hereditary cancer occurs due to a mutation on the MEN1 gene. His young son also carries this mutation. All tumors arise through mutation but in this rare syndrome it is Dr. Lewis’s own DNA that carried the code for his cancer. He was able to identify his personal risk by knowing his family history and getting tested through a genetic counselor. 

Although most patients with pancreatic cancer have not inherited tumor-causing genes they can still benefit from catching their disease when it is still operable. For Dr. Lewis that means working with primary care doctors, gastroenterologists, and endocrinologists to help them recognize two early warning signs of pancreatic cancer—weight loss and the development of diabetes in adults—and then focusing on those patients with screening efforts. Early detection may result in saving more lives from a disease that is often deadly once it spreads. Intermountain Healthcare will be participating in a national trial, run by the Alliance network, of focused screening for pancreatic cancer.

 

The Surgery

Pancreatic neuroendocrine tumors affect approximately 12,000 people each year according to cancer.net, and their surgical treatment is often the Whipple procedure, or a pancreaticoduodenectomy. During the Whipple Procedure, surgeons remove the head of the pancreas, the gallbladder, and some of the small intestine. For Mark the surgery lasted six and a half hours, but that was only the beginning of his cancer recovery. Many patients with the more typical form of pancreatic cancer go through months of chemotherapy to help shrink the tumor before it can be removed; Dr. Lewis’s tumor didn’t require that preparation for surgery.

The Recovery

“Recovery was difficult,” says Dr. Lewis, but throughout his journey, he learned a lot about being a doctor and a patient. In an interview he said, “Many people who have to undergo this surgery are twice my age. I realize that age is just a number, but typically the younger you are the more resilient your body is, making healing and recovery somewhat easier.” In two months, Dr. Lewis was barely back to normal, as the recovery from the surgery was taxing. Mark added that he “felt fortunate that he didn’t have to undergo chemotherapy before or after the surgery as many patients do.” 

Learn more about Dr. Lewis’s experience and future work here.