11/13/2023
“I had this weird thought, ‘Now I know what I am going to die from.’ ” Cindy said.
The 82-year-old from Fairfield County, Connecticut, was overwhelmed when she was diagnosed with pancreatic cancer. Cindy also was overcome with gratitude to have been part of a study that found the cancer early, which is very uncommon when it comes to pancreatic cancer.
No symptoms of pancreatic cancer
Aside from well-controlled diabetes, Cindy had always been healthy until March 2023. She had eye surgery and oral surgery and she started having back problems. In addition to the physical toll, Cindy was also dealing with the emotional fallout from downsizing and moving from her home of 18 years.
“I just did not feel well. I thought I was exhausted from packing and the surgeries. But I decided to see my primary care doctor, Dr. Jill Denowitz,” Cindy said.
Cindy had routine bloodwork, including an A1C test that showed her blood sugar was dangerously high.
“Dr. Denowitz called me and said, ‘Pack a bag and call 9-1-1,’ ” Cindy said. “I could not believe the diabetes was so out of control.”
After Cindy stabilized at the hospital, Dr. Denowitz connected her with Dr. Charles Ma, an endocrinologist with Nuvance Health Medical Practice Endocrinology.
Pancreatic cancer screening study at Nuvance Health
“Dr. Ma thought I could be a candidate for a pancreatic cancer screening study at Nuvance Health,” Cindy said.
“We consider screening people for pancreatic cancer if they are newly diagnosed with diabetes after age 50, or if they have unexplained deteriorating diabetes or other red-flag symptoms such as weight loss — which Cindy had,” Dr. Ma said. “Nuvance Health researchers are studying whether new-onset diabetes is a risk factor for pancreatic cancer to detect it earlier. While pancreatic cancer is also known to cause diabetes, it is a rare cause of new-onset diabetes.”
The pancreatic cancer screening study is open to people aged 50 and older diagnosed with diabetes in the last 12 months. People with deteriorating diabetes, such as a sudden increase in A1C without changes in lifestyle or medications, may also be eligible for the study.
“I thought, ‘Why not participate,’ even though pancreatic cancer was not something I ever thought about. I have no family history,” Cindy said.
Cindy then met Tammy Lo, APRN, pancreatic cancer research nurse practitioner at Nuvance Health.
“Tammy explained that I would have imaging of my pancreas as part of the study,” Cindy said.
In August 2023, Cindy had an MRI and got a call that same night to schedule an endoscopic ultrasound within a few days.
“I had a gut feeling something was wrong,” Cindy said.
Pancreatic cancer can be a ‘scary’ diagnosis
Cindy’s gut was right. She had stage 1 pancreatic cancer, which meant it had not spread.
Cindy had “tons of emotions” and thoughts swirling inside her head.
“I went from disbelief and denial to frightened, depressed and numb,” Cindy said.
“My catastrophic self immediately thought about the worst outcome. Pancreatic cancer was unchartered waters other than what I saw Alex Trebek go through because I watched Jeopardy.”
Cindy’s care team at the Whittingham Cancer Center at Norwalk Hospital recommended she have surgery as quickly as possible. She would also need chemotherapy after surgery.
“Dr. Frank clearly explained my treatment plan and I knew what to expect,” Cindy said about Dr. Richard Frank, medical oncologist and chief of cancer research at Nuvance Health. Dr. Frank also leads the pancreatic cancer screening study.
“I felt confident because everyone on my care team was proactive and supportive. They scheduled my surgery for August 31, 2023,” Cindy said.
Surgery for pancreatic cancer
Dr. Daniel Labow was Cindy’s surgeon. He is a surgical oncologist and the system chair of surgical services at Nuvance Health.
“I appreciated Dr. Labow because he was honest with me. He explained all the possible scenarios that might happen during surgery,” Cindy said. “I felt like I was in the best possible hands.”
Cindy was impressed with the pre-surgery recommendations for nutrition and supplements.
“They helped me get in the best possible physical shape before surgery to help me recover after it,” Cindy said.
Dr. Labow performed laparoscopic surgery to remove the cancer so Cindy could start chemotherapy sooner. During a minimally invasive operation, surgeons operate through small incisions so people can recover faster and have less pain compared to an open procedure.
“Dr. Labow said my surgery was ‘extremely boring,’ which was a good thing!” Cindy said. “He also said he was able to remove all the visible cancer.”
Cindy recovered at Norwalk Hospital for about five days.
“Recovering from surgery was painful, but the care was extraordinary,” Cindy said. “Everyone was responsive and helped manage my pain very well.”
Chemotherapy for pancreatic cancer
Cindy will have chemotherapy every other week for six months. She had her first treatment on November 8, 2023.
“Dr. Frank and nurse navigators Lauren Santa, Naakai Greene and Matilde Hinh prepared me for something I was terrified of,” Cindy said about having chemotherapy.
She took control of what she could and purchased a wig before she started treatments.
“The support I have received from my family and friends has been amazing,” Cindy said about her children, grandchildren, brother, sister-in-law, cousin and friends.
“I cannot imagine going through this without them,” said Cindy, who lost her husband in September 2023.
Interesting events leading to pancreatic cancer diagnosis and signs of hope
Since her diagnosis, some profound occurrences have helped Cindy find hope and meaning in her situation.
Connected, expert and compassionate care
Cindy is grateful for the fortunate events that took place to catch the pancreatic cancer early.
Pancreatic cancer is one of the most lethal types of cancer because it is difficult to diagnose early. Advanced-stage pancreatic cancer is difficult to treat and has a low survival rate. Currently, there is no screening widely available for pancreatic cancer — that is why researchers at Nuvance Health are passionately working to establish a reliable test.
A national study found only 3% to 5% of people are diagnosed with stage 1 pancreatic cancer, and it is usually by accident when they get a scan of their abdomen for something else. Most people find out they have pancreatic cancer when it is advanced and causes symptoms such as abdominal pain, weight loss or jaundice.
“I am glad I went to my primary care doctor rather than just attribute stress to how I was feeling. I am grateful she connected me with Dr. Ma and physician assistant Michelle Lee, who referred me to the pancreatic cancer screening study. Then, having screening imaging as part of the study was key to finding the mass in my pancreas early,” Cindy said.
“Remarkably, Cindy had early-stage pancreatic cancer detected. Dr. Ma was astute enough to refer her to the pancreatic cancer screening study, which I believe saved her life,” Dr. Frank said. “I am not aware of anywhere else that would refer her for pancreas screenings based on newly uncontrolled diabetes.”
Dr. Frank continued, “In most cases, we would have seen Cindy in about six to 12 months when she started having symptoms. At that point, she would have advanced-stage disease, which is notoriously difficult to treat.”
Cindy is quite knowledgeable about healthcare because her husband had health challenges over the years. As informed healthcare consumers, they believed it was kismet that Dr. Labow had recently started working at Nuvance Health.
“My husband and I were impressed with his background and experience,” Cindy said.
“My support system is in lower Fairfield County and my husband was very sick at the time. I did not want to travel anywhere farther than Norwalk Hospital for surgery,” Cindy said.
Dr. Labow was able to expand where he could operate from Danbury Hospital to Norwalk Hospital to keep Cindy in her community.
Positive signs
Cindy grows orchids. Today, all her orchids are blooming.
“That has never happened before,” Cindy said.
“I feel like the universe is saying, ‘Hang in there, you have a lot to live for.’ ” Cindy said.
And, she does.
Cindy is a caregiver through and through. She is a mom and grandma and enjoys spending time with family and friends.
At 82 years old, she still works and helps people as a clinical social worker.
She loves knitting, listening to music, playing mahjong, reading and the theater. She is also on the board of an organization that provides scholarships to students who have cancer.
“It was ironic to have cancer after years of working with students who have cancer. They inspire me because most of them overcome cancer and lead productive lives,” Cindy said.
Finding purpose after pancreatic cancer diagnosis
“I want to make some sense out of all this,” Cindy said. “It gives more meaning to what I am facing if I can help other people.”
Cindy is raising awareness about the pancreatic cancer screening study because she “has faith in Dr. Frank and the entire team.”
Norwalk Hospital is hosting an event to raise money for the pancreatic cancer screening study, which is 100% funded by philanthropy. Called Rocking for the Cure, Dr. Frank’s band, DNR is performing at the Westport Library on Saturday, November 18, 2023. Special guest James (Jim) Naughton will also perform.
Jim has a special connection with the Whittingham Cancer Center because Dr. Frank was the doctor for his wife, Pam, when she had pancreatic cancer.
Cindy is speaking at the event and recalled another interesting connection. Many years ago, Cindy was the business manager for a local YMCA. Jim and Pam Naughton were members and Pam participated in a fitness program Cindy managed.
“It is an absolute honor to carry on Pam’s legacy,” Cindy said.
*The patient’s name has been changed to protect her privacy.
Disclaimer: Outcomes from cancer vary from person to person. No individual results should be seen as typical.