Thanks to screening study, man has precancerous lesion on pancreas removed to prevent pancreatic cancer

Norwalk Hospital
Alan Sinise

Picture of Alan Sinise. Full Credit: Ned Gerard/Hearst Connecticut Media

Summary:

  • Alan Sinise enrolled in Nuvance Health’s pancreatic cancer screening study due to his family history of pancreatic cancer.
  • During his participation in the study, MRI results showed that Alan had a precancerous lesion on his pancreas.
  • Alan had the Whipple procedure, a major operation, to remove the precancerous lesion from his pancreas to prevent it from possibly turning into cancer.
  • Alan, whose mom and uncle died from pancreatic cancer, encourages other qualified individuals to participate in the study.

Alan Sinise and his four brothers gathered around their mom in her hospital room at Norwalk Hospital as she was treated for advanced-stage pancreatic cancer. Her brothers also had pancreatic cancer, and one brother died. With this family history of pancreatic cancer, Alan’s mom and her care team encouraged the five brothers to participate in Nuvance Health’s pancreatic cancer screening study to reduce their risk of developing the deadly disease too.

Alan’s mom died from pancreatic cancer. Grieving this loss, Alan, 65, of Monroe, Connecticut, found strength in the fact that he had decided to enroll in the pancreatic cancer screening study, which he did along with three of his brothers.

Pancreatic cancer screening study

Pancreatic cancer is one of the most lethal types of cancer with a low survival rate because it is hard to diagnose early. Patients are typically diagnosed with advanced-stage pancreatic cancer when they have more serious symptoms such as abdominal pain, weight loss, or jaundice.

The pancreatic cancer screening study is run by a team of clinicians and researchers led by Dr. Richard Frank, medical oncologist and director of clinical cancer research for Nuvance Health. The study is open to people age 50 or older who have recently been diagnosed with diabetes mellitus. People who have a family history of pancreatic cancer may also qualify.

Richard Frank, MD
Dr. Richard Frank

“I enrolled in the study because my mom’s doctors thought the pancreatic cancer in my family might be hereditary,” said Alan.

Study participants have blood work every six months to look for biomarkers that would indicate pancreatic cancer, and an annual MRI of the pancreas to look for abnormal growths. Imaging, blood tests, and other study-related costs are 100 percent covered by philanthropic donations.

“Alan’s MRI demonstrated a suspicious multicystic lesion in the pancreatic head,” said Dr. Ron Lee, a Norwalk Hospital fellowship-trained MRI radiologist who has been committed to the pancreatic cancer screening study since it launched three years ago. Study participants’ MRIs are reviewed extensively by radiologists and a team of pancreatic cancer experts.

Ronald P. Lee
Dr. Ron Lee

“Suspicious lesions are furthered examined by endoscopic ultrasound or EUS, which Alan had. Our team reviews EUS results thoroughly, and we may recommend surgery if a precancerous lesion or pancreatic cancer is identified,” said Dr. Naveen Anand, gastroenterologist and director of advanced endoscopy at Norwalk Hospital. “The results of Alan’s EUS showed a precancerous lesion on his pancreas.” Dr. Anand has also contributed to the study since its inception.

Anand Naveen 2016
Dr. Naveen Anand

The team recommended surgery for Alan and connected him with Dr. Margo Shoup, surgical oncologist and senior vice president and system chair of Nuvance Health cancer services.

Margo Shoup, MD
Dr. Margo Shoup

Dr. Shoup would perform a procedure to remove part of Alan’s pancreas, small intestine, stomach, and bile duct, as well as his entire gallbladder. The procedure is called a pancreaticoduodenectomy — known as the “Whipple.” A major operation, the Whipple requires extensive pre-surgical planning from a highly specialized surgical team.

Alan was already somewhat familiar with this surgery. Although one of Alan’s uncles died from pancreatic cancer, his other uncle had the Whipple procedure and is still living.

“This is the same procedure my uncle had, and I thought I could survive it,” said Alan. “I watched videos about how the Whipple procedure is done, and I was feeling okay because I was arming myself with information.”

“The Whipple procedure is usually done for cancer, but we recommended it for Alan due to his family history and the fact that it was a precancerous lesion,” said Dr. Shoup. “We wanted to prevent the lesion on his pancreas from possibly becoming cancer.”

A successful surgery

After completing pre-surgical testing, including COVID-19 screening, Alan came to Norwalk Hospital for his scheduled surgery.

Dr. Shoup has personally performed several hundred Whipple procedures throughout her career.

Some Whipple procedures can take up to eight hours, but due to the planning, expertise, and coordination of the surgical team, Alan’s surgery took only three and a half hours.

“We put together an outstanding surgical team at Norwalk Hospital, as well as inpatient and outpatient specialists such as nurses, nurse practitioners, dietitians, and patient navigators who help the patient to be as strong as possible before surgery,” said Dr. Shoup. “After surgery, our nurses are specially trained to care for Whipple patients.”

Alan spent five days in the hospital after surgery, which is standard after the Whipple procedure. During his stay, his inpatient care team watched out for complications, such as bleeding and infection. Some patients also worry about becoming diabetic after the Whipple procedure due to removing part of the pancreas, but Dr. Shoup said that is rare.

“Alan did not experience any complications. It is so important that our inpatient care team is trained to look for any problems during recovery after the Whipple procedure,” said Dr. Shoup.

“I remember waking up in the ICU,” said Alan. “I stayed one night in the ICU, and then I went to another unit where they got me walking and sitting in a chair.”

Alan said that at first it hurt when he coughed and sneezed, and walking was painful.

“Then all of a sudden, I started walking further and on my own just two days later,” said Alan. “I was able to eat solid food on the last day I was in the hospital — waffles and sausage.”

Recovering at home

Alan continued his recovery at home under the care of a visiting nurse.

“It takes about four to six weeks to recover from the Whipple procedure,” said Dr. Shoup.

Because the surgery involves reconnecting several organs to allow food to digest normally, Alan had to be sure to cut food into small bites and avoid greasy foods at first.

“The pipes had to be reworked,” said Alan.

Alan’s diet has returned to normal. He just takes an enzyme with his meals to help with digestion, which is not uncommon after having the Whipple procedure.

“When I felt better, I got a steak, cooked it medium-rare on my grill, and it didn’t bother me,” said Alan. “I’m eating, I’m gaining weight, and things are looking up!”

Alan has resumed his hobbies of walking and cycling on local trails.

Following in his mom’s footsteps, Alan now wants to tell others about the study that may have prevented him from developing pancreatic cancer.

“They likely wouldn’t have found the precancerous lesion if I wasn’t in the study,” said Alan. “Participating in the study is nothing to be afraid of. This is the only way you’ll find out if you have something going on with your pancreas — I did the study, and look at what they found.”

“This is why we established the pancreatic cancer screening study — so we can get to patients before they have cancer,” said Dr. Frank.

Nuvance Health’s pancreatic cancer screening study aims to develop a screening test to detect pancreatic cancer at an earlier, curable stage. If you or a loved one is interested in participating in the study, contact Tammy Lo, APRN, at (203) 855-3551. Learn more about the pancreatic cancer screening study.

The pancreatic cancer screening study is made possible by generous donations. Support cancer services at Norwalk Hospital.

Disclaimer: The experience for pancreatic cancer screening study participants, and the outcome for patients who have the Whipple procedure will vary from person to person. No individual results should be seen as typical.

CONTACT
Amy Forni, Manager, Public Relations
(203) 739-7478 | Amy.Forni@nuvancehealth.org