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Looking back, the signs were there. "I can see I was sick," John Magee says. "Even though I might not have felt it, looking back at old pictures, I looked it."
By the time of his annual physical exam in January 2016, however, John had begun to feel it. "At the end of my physicals, my doctor always asks me the same two questions, 'John, do you feel sick in your body, or do you feel sick emotionally?'" he says. "For the first time in my life, I answered yes to both."
Those responses were a result of weeks of unexplained pain in John's lower back that had left him physically and emotionally worn down. After John admitted he was in pain, his primary care physician set about determining its cause. "We started doing tests to try to figure out what was going on," John says. "Initially, we thought I'd herniated a disk in my back again because I'd done that before."
Test results showed the problem wasn't in his back, and the true source of the pain remained a mystery. After weeks of being unable to pinpoint a cause or a solution, John began doing his own research. "One night, I read that the pain pattern I was experiencing is common with pancreatitis and pancreatic cancer," he says. "So I talked to my doctor about it."
Initially, John's doctor was skeptical. "We've been friends for 30 years, so that possibility was hard for him to accept at first," John says. When John's pain became so severe, however, that it forced him to go to his local emergency department, it was that longtime friend and primary care physician who urged his other care providers to focus on John's pancreas. "By him insisting they do that, they found the tumor," John says.
This wasn't the first time John had been given sobering news about his pancreas. Diagnosed with Type 1 diabetes 20 years ago, his pancreas hadn't worked properly for several decades. When he received the diabetes diagnosis, John took action by researching and implementing dietary and exercise changes in an effort to decrease the disease's impact on himself, his family and all those he served as minister of Light the Way Church in Cottage Grove, Minnesota.
As he listened to a radiologist confirm a diagnosis of adenocarcinoma, the most common form of pancreatic cancer, John once again decided he was going to become his own best advocate for what lie ahead. "I started chemotherapy immediately after my diagnosis," he says. "I didn't have a lot of confidence in the surgeon I was working with. My cancer was stage 3. The tumor had basically wrapped itself around an artery, so he said surgery was too risky. His medical assistant actually told my wife I'd be dead in 18 months based on what they saw."
"My mindset upon coming to Mayo Clinic was, 'I'm here because I want to live.' As soon as I met Dr. Truty, I realized he shared that mindset."John Magee
John refused to accept that prognosis. "My wife had a friend who'd been treated by Dr. Mark Truty at Mayo Clinic, so she sent an email to (Dr. Truty)," John says. "I kid you not, 20 minutes later, Dr. Truty emailed us back and asked if we had any flexibility to come to Rochester later that week. He said he'd like to meet me and talk to me about my treatment. That's how it all began."
For John, that brief email exchange with Dr. Truty was a seed of renewed hope. "Every cancer story is immediately a horror story. As soon as people started finding out my diagnosis, I felt like a ghost. I could see it in their eyes," he says. "But I have a wife, a family — children and grandchildren — and a congregation I love, so I said: 'Look, I'm in this to live. If there's any way at all to extend my life, to improve my quality of life, I'm in.' My mindset upon coming to Mayo Clinic was, 'I'm here because I want to live.' As soon as I met Dr. Truty, I realized he shared that mindset."
John says one of the most remarkable and memorable points in his treatment at Mayo Clinic came when Dr. Truty shared that mindset with John's oldest son, who'd accompanied him to Mayo Clinic in Rochester. "One of the first things Dr. Truty did was to take my son aside and share his own family's story of pancreatic cancer," John says. "In that observation room, with tears in both of their eyes, Dr. Truty told my son, 'This is why I do this, and I will do everything I can to help your father win this fight.' That was the beginning of a very meaningful doctor-patient relationship."
Already into his first round of chemotherapy upon arriving at Mayo, John says the first question Dr. Truty asked him was if he was ready for more. "I said, 'Yes I am,'" John says. "My care team described (chemotherapy) as weed killer and said there'd be no surgery until I went through more chemo and radiation to try and shrink the tumor as much as possible."
After eight rounds of chemotherapy, 25 rounds of radiation and another 25 rounds of oral chemo, Dr. Truty reassessed John's condition. "He made it clear my ability to have surgery was predicated on what they saw on my presurgery PET scan — whether my treatments had done what they were designed to do," John says. "After my scan, he looked at the results and said, 'Are you ready to go into surgery?'"
John was, and early the next morning, he did. While Dr. Truty understands why other surgeons had advised against surgery due to the location of John's tumor, he says it was something he and his surgical team were prepared for.
"We just have a different perspective on things here at Mayo Clinic, and we're willing to take on the more challenging cases that don't necessarily fit into nice, normal boxes."Mark Truty, M.D.
"His tumor was close to some arteries that are pretty critical," Dr. Truty says. "There are some criteria out there where people say, 'If they involve blood vessels, then we can't remove the tumors because we'd be leaving cancer behind.' We approach things a lot differently than other medical centers by saying: 'Why? If we need to, why can't we take out that blood vessel and reconstruct it?'"
That's exactly what Dr. Truty and his team did for John. "All it meant was that the operation was of greater magnitude and carried some increased risks," Dr. Truty says. "Because of that, we have to make sure patients like John are being treated adequately before surgery to justify those risks. We just have a different perspective on things here at Mayo Clinic, and we're willing to take on the more challenging cases that don't necessarily fit into nice, normal boxes."
Dr. Truty and his team also are willing to push the boundaries of treatment beyond the typical standard of care for a situation like John's. "If we approach everything as 'This is the standard of care,' well, then guess what you're going to get? You're going to get a standard outcome," Dr. Truty says. "The problem with pancreatic cancer is that the standard outcome is pretty poor. We're trying to do something that's beyond the standard of care for these patients at Mayo Clinic."
For John, going beyond the standard of care was the difference between a grim diagnosis and a bright future. "After I woke up from the procedure, Dr. Truty came in and said I was cured," John says. "Not in remission — cured. He said they were able to get all of the cancer out of me, which was mind-boggling."
Also defying expectations was how quickly John returned to his normal, active lifestyle. "I'm a minster, so I speak for a living," he says. "It's not like I'm lifting heavy equipment or doing physical labor, so I spent 10 days at Mayo after my surgery and then got back to work."
Six weeks later, John also was able to get back to swimming and lifting weights. Today, three years after Dr. Truty removed his tumor, John says he's officially back to full strength and full health.
"That's a little weird because I'd been dealing with the mortality of this every day while going through treatment," he says. "There's a weird reconciliation that happens within yourself when you're diagnosed with cancer. You're always looking at life and death. Cancer is always a part of you now, whether you're cured or not. But at the same time, I also have this wonderful new community of people around me now."
"Regardless of what you've been told, make that trip (to Mayo Clinic), and at least allow someone there to give you their take on what's happening with your health. You owe that to yourself."John Magee
It's a community that John is trying to grow even more through the pancreatic cancer awareness work he's done since his diagnosis. "I've done some work with the Pancreatic Cancer Action Network, and I've advocated in Washington, D.C. for more funding for pancreatic cancer research," he says. "My wife and I have also hosted the remembrance service that the Pancreatic Cancer Action Network does."
Asked what he'd like people to most take away from his personal story of pancreatic cancer, John says that it's to always get a second opinion. "No matter what you're told medically, get a second opinion at Mayo Clinic," he says. "Regardless of what you've been told, make that trip, and at least allow someone there to give you their take on what's happening with your health. You owe that to yourself."