Sharing Mayo Clinic: Reaching out after pancreatic cancer

Cancer

Sharing Mayo Clinic: Reaching out after pancreatic cancer

By
Dana Sparks

January 1, 2017

In August 2014, Richard Carvajal, then 43, was in the best shape of his life. He was excited as he left his home in Bainbridge, Georgia, to compete in his first Olympic-distance triathlon. But as he drove across Alabama on his way to the race site, he started feeling sharp abdominal pain.

“It kept getting worse and worse, and I literally crawled into a Birmingham emergency room,” Richard says.

Although doctors initially thought Richard’s pain was caused by kidney stones, it turned out to be a symptom of a much more difficult problem. Testing eventually revealed Richard had pancreatic cancer.

Working with a care team at Mayo Clinic’s Florida campus, Richard underwent surgery and then chemotherapy to fight the disease. It worked. More than two years later, Richard is in remission. And it’s given him a new mission.

“I will never hesitate to recommend to someone who has been diagnosed with cancer to go Mayo Clinic,” Richard says. “I know they will do the absolute best job possible and the research they’re doing has the chance to help many more people to be as lucky and blessed as I have been.”

A shocking diagnosis

When he first arrived at the hospital in Birmingham in terrible pain, Richard was told by physicians there that he likely had kidney stones. They gave him pain medication and some medicine to help him pass the stones. The pain was so severe that at one point he passed out.

“When I woke up, I immediately felt the pain go down,” Richard says.

A nurse told him it appeared that he had passed the kidney stone. Richard then had a CT scan to confirm the diagnosis. But when the results came in, a doctor informed Richard he had acute pancreatitis and recommended further testing.

Back home in Georgia, Richard — who at the time was president of Bainbridge State College — went to multiple gastroenterology specialists find the cause of the pancreatitis. No one could explain why it happened. They suggested he get follow-up testing in a year. Richard’s primary care doctor, however, recommended he see one more specialist. Richard went to see Bashar Qumseya, M.D., who had moved to Georgia after completing a post-doctoral fellowship at Mayo Clinic.

“I will never hesitate to recommend to someone who has been diagnosed with cancer to go Mayo Clinic.” — Richard Carvajal

“I met with Dr. Qumseya, and he explained that there was one more test we could do. The test was an endoscopic ultrasound,” Richard says. “He had learned how to do this test at Mayo Clinic and was the only doctor in the region trained to do it.”

Dr. Qumseya used the test to assess Richard’s pancreas. On Sept. 8, 2014, as he recovered from the procedure, Dr. Qumseya delivered devastating results. Richard had pancreatic adenocarcinoma, the most common and lethal type of pancreatic cancer.

Dr. Qumseya immediately made a call to his friend and former colleague John Stauffer, M.D., a pancreatic specialist and surgeon at Mayo Clinic’s Florida campus. Two days later, Richard made the three-hour drive from Bainbridge to Jacksonville to meet with Dr. Stauffer.

In the right hands

More than 50,000 Americans are diagnosed with pancreatic cancer in the U.S. each year. The diagnosis often comes with a poor long-term outlook.

“If it’s detected early, the only chance for a cure for this type of cancer is through surgery such as the Whipple procedure,” Dr. Stauffer says. “Unfortunately, less than half of all patients diagnosed are operable, because it’s often detected at an advanced stage due to an absence of symptoms.”

An MRI showed that Richard’s tumor was contained within the pancreas and had not spread to his liver or lungs. Due to the location of the tumor in the head of the pancreas, Richard was a good candidate for the Whipple procedure, where the doctors would remove the head of the pancreas, duodenum and gallbladder, followed by a complex reconstruction. The surgery was scheduled for Sept. 18.

“We offer coordinated multidisciplinary care with a team of excellent radiologists, gastroenterologists, oncologists and surgeons. We have a very tight-knit pancreatic cancer focused team with excellent surgical outcomes.” — Dr. John Stauffer

“We are one of the highest volume centers in the southeast for the Whipple,” Dr. Stauffer says. “We offer coordinated multidisciplinary care with a team of excellent radiologists, gastroenterologists, oncologists and surgeons. We have a very tight-knit pancreatic cancer focused team with excellent surgical outcomes.”

In addition to the team’s expertise and skill, Richard also appreciated Dr. Stauffer’s approachability.

“Dr. Stauffer is down to earth. He’s real. It’s like talking to a friend,” Richard says. “I trusted that I was getting straight answers from him. He and his whole team have been so supportive.”

Treatment success

When Dr. Stauffer and his team performed Richard’s surgery, they initially did an exploration to exclude the possibility that the cancer had spread. The cancer appeared to be contained within the head of the pancreas, so the surgical team removed the front half of the pancreas and duodenum as planned. They then connected the bowel back to the bile ducts, the remaining pancreas, and the stomach.

Richard spent five days in the hospital, and then went home to await the pathology results for the portion of the pancreas and 39 lymph nodes that had been removed for testing. He breathed a sigh of relief when he got the results. The entire tumor had been removed during the surgery, and there was no cancer in the lymph nodes.

Because pancreatic cancer is very aggressive, though, Richard still needed six months of chemotherapy to kill any cancer cells that might have remained in his body. Working with his team at Mayo Clinic, Richard opted to receive the treatment at a cancer center not far from his home.

“Dr. Stauffer is down to earth. He’s real. It’s like talking to a friend,” says Richard. “I trusted that I was getting straight answers from him. He and his whole team have been so supportive.” — Richard Carvajal

Richard recalls the local oncologist telling him, “Richard, you didn’t just get referred to any surgeon. You got referred to the best in the world for what you needed. And by the way, he did one hell of a job.”

From October 2014 to March 2015, Richard had 18 chemotherapy treatments.

“While it was exceptionally difficult, I was fortunate in that my body stayed strong enough to handle the treatments,” he says. “I got through chemo, and my oncologist told me I was cured. I lost 25 pounds, but I decided to start trying to recover in the best way I knew how. I started working out.”

A year to the day from that first trip through Alabama in 2014, Richard completed the Olympic triathlon he had set out to do before he received his cancer diagnosis.

“It felt good to cross that finish line and to know I had been blessed by what had happened,” he says.

A new perspective

Not surprisingly, going through cancer surgery and treatment has given Richard a new perspective on life.

“It’s crystallized what’s important to me. So, I try to make sure the time I have with my family counts,” he says. “In many ways my story is about meaningful change that manifests itself in subtle ways. The little things that matter — family dinner time, clothes shopping with my daughter. It’s those things we all do as parents, as spouses, as friends that we all know we can do better.”

Richard is also making every day matter at work. Eight months after completing chemotherapy, he was selected as the interim president of Darton State College in Albany, Georgia, to help lead the consolidation of that traditionally white college with a historically black university located nearby.

“We are creating something here that will change a region of our state for generations to come,” Richard says.

Sharing his story

Richard has been cancer-free since 2014. He returns to Mayo Clinic every six months for an MRI to make sure he is still in remission. This year, Dr. Stauffer asked Richard to time his scan with the PurpleStride race, which was established to fight pancreatic cancer.

“I was honored to participate because it’s a great way to raise money and increase awareness about pancreatic cancer, and hopefully inspire others who are going through this terrible disease,” he says.

Every time I see Dr. Stauffer I thank him for saving my life. I want to be his longest survivor. I want him to use my story to give hope to other survivors.” — Richard Carvajal

Richard shares his experience with everyone he can. He gives speeches to public groups. He also visits with people who have been newly diagnosed with pancreatic cancer. He’s always quick to praise Mayo Clinic.

“I sent a letter to the CEO of the Mayo Clinic [John Noseworthy, M.D.] after my surgery to say how incredibly impressed I was with every experience I had at Mayo, and to tell him and his staff that the level of customer service I received was extraordinary,” Richard says. “Every time I see Dr. Stauffer I thank him for saving my life. I want to be his longest survivor. I want him to use my story to give hope to other survivors.”

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