Gary Stark’s lifestyle, with a history of smoking and eating high fat foods, put him at a higher risk for pancreatic cancer. In December 2012, Oregon Health & Science University’s Dr. Brett Sheppard and a team of seven began a sixteen–hour surgery on Stark’s stage three tumor. It involved meticulously separating the tumor from the inferior vena cava and aorta, dividing the stomach, isolating the portal venous system, dividing the pancreas, removing a portion of leg vein and replacing what was invaded by the tumor. We visited the 62 year old Idaho man at his OHSU hospital room where he had returned for treatment for an infection and malnutrition, a common challenge for many cancer patients.
Though gaunt and weak, Stark’s cornflower blue eyes lit up as he expressed his gratitude for Dr. Sheppard’s team, and second chances.
How did you find out you had pancreatic cancer?
In 2011, I was working as a facilities engineering supervisor at St. Alphonsus Hospital inBoise. I noticed a painless yellow jaundice on my skin. Tests confirmed a blockage in the bile duct, then pancreatic cancer. Panic struck. I thought, ‘what are we going to do?’ So we set up an appointment with a cancer care facility and they started me out on chemo and radiation therapy. The doctor told me it would take time for the chemo and radiation to work and to come see him in June. In September, we saw the surgeon and he said it was inoperable. More panic struck. I was talking to some friends in the hospital and one of the nurses recalled that someone had undergone a Whipple surgery performed by a Dr. Brett Sheppard and I thought, well, it doesn’t hurt to get a second opinion. Dr. Sheppard did a CT scan and told me, “We can operate on that.” Wow, that was awesome. We were just ecstatic.
Tell us more about your lifestyle prior to being diagnosed.
I had stopped, but years earlier had smoked for fifteen years, a pack a day. Diet was, well, I did my share of fast food. My wife is a wonderful cook, but I’d go to work and have French fries and a sandwich. Also, I had worked in construction maybe around asbestos and with trichloroethylene, cleaning processed piping, but I don’t know if that contributed.
Why do you think you survived?
Dr. Sheppard and his team saved my life. I had come to the conclusion that I needed to finish up any loose ends for my wife, and when Dr. Sheppard told us he could operate, I don’t think there’s an adjective that would describe the euphoria that we all experienced. Pancreatic cancer is a deadly disease and it’s a long shot, but if he could do something for me, oh my gosh, it felt like a new beginning. He’s like no surgeon I’ve ever dealt with. He is the most kind and compassionate person I’ve ever met my whole life. He’ll talk to any audience at a level where they can all understand what’s going on and you really feel like he cares, and that was a huge deal. He’s a treasure to this hospital and for pancreatic cancer patients all over this country. He and his team are dedicated to this cause.
Dr. Sheppard told us that motivation is huge in this battle and you agree. Where did you find your motivation?
Oh yeah, I wanted to live. But Dr. Sheppard motivated me to the level where I needed to be in order to survive. I was ready to toss it in. I was reading all the statistics online and going, man this is not good, not good. Dr. Sheppard is a skilled artisan, and by that he motivated me. Unlike some surgeons, Dr. Sheppard doesn’t have the ‘God syndrome’ affliction. He’s dedicated to his goal, and to me that’s what buoyed me and gave me hope. Also, I saw the way his team responds to him. They are looking for good outcomes. That’s huge for the patient. The morning of the eighteenth of December, they brought me in to pre-op, and Dr. Sheppard came in and introduced each and every one of his team members to me (anesthesiologist, anesthesia resident, chief surgery resident, two O.R. nurses, vascular surgeon and vascular fellow). That showed respect for them and for me. He obviously empowered them to bring their knowledge to the table. It was brilliant. It just made me feel great going into surgery. Finally, I also have a network of friends back in Meridian (Idaho), who I knew were taking care of my wife and were so kind. There again, it all comes back to how you treat people, and if you treat them with respect they will walk through fire for you if you ask them.
What do you want people to know about pancreatic cancer?
Go online to the Pancreatic Cancer Action Network (www.pancan.org), or look up Dr. Sheppard. People need to take their lives into their own hands and don’t just listen to the first person you talk to. You need to sprinkle that with a second, maybe third opinion because if you put on all your chips on one thing, your chances of getting a good outcome are dramatically reduced. Don’t panic. It doesn’t do anything but lead to chaos.
Relishing life as retirees in Bend, Ann Moore and her husband of forty-six years spent their days playing golf, bridge and keeping up with their toddler grandkids. “Life was good,” says Moore. “I had always been super healthy.” So it was with great shock that in the fall of 2003 Ann was not only diagnosed with the deadliest form of cancer, but that, according to multiple doctors, she had “zero” chance of survival. OHSU’s Dr. Brett Sheppard took her as a patient. He described her pancreatic cancer tumor as, “rock hard, no surgical planes separating tissue, with very little recognizable where we had to be.” Because Ann had taken care of herself, she withstood the rigorous operation and now, nine years later is officially cured—the rare five percent who survive. At age seventy-five, she’s back on the fairways, and, as we learned, is helping other pancreatic cancer patients fight for their lives.
Q: You had a healthy lifestyle, with none of the risk factors normally associated with the disease. What symptoms sent you to the doctor?
A: I had a little pain in my lower left abdomen. Because my husband had diverticulitis, I just self diagnosed. But then one morning, I woke up and just felt horrible all over. My doctor ordered a CT scan that very day, and I was told “there is something going on in your pancreas.” The diagnosis was adenocarcinoma encroaching upon the superior mesenteric artery and vein. That’s why the zero diagnosis because you can’t operate on the artery. We had just lost a friend to pancreatic cancer and were in the process of losing someone else, so I knew it was a quick and deadly disease. It was a huge deer in the headlights moment for us when I was diagnosed, complete shock. I actually did have diverticulitis—that was the pain. But the feeling bad all over was the cancer, so in a way it was accidental that it was discovered.
Q: So after you got this grim diagnosis, did you have any hope?
A: We consulted two excellent Bendsurgeons, who independently came up with the verdict of inoperable and zero chance for cure. My case was reviewed by the tumor board a tBend’s St. Charles Hospital, and they reiterated the same news. We opted for treatment and the first glimmer of hope we were given was by Dr. Commorford, a radiation oncologist, who drew a graph and said, “You have a five percent chance of survival.” Our daughter said I responded by saying, “I can do this!” I don’t remember saying that, but I remember feeling some sense of hope.
Q: That’s remarkable. Many people would be defeated by those odds.
A: I knew I wasn’t ready to go. I told them not to hold back, to do anything, even experimental. I thought, even if I don’t survive, maybe it will help the next patient.
Q: Did it instantly change the way you framed your life?
A: You look at things differently, like the squirrel dancing around the yard. You just know you may not have many days left. I kept looking at my little grandchildren at four and six years old, and I said, “I’m not ready to go yet. I want to see them grow up.”
Q: After the diagnosis, you begin chemotherapy and radiation to gain what you believe will be just six more months of life.
A: Yes, they gave me six months to live if I had treatment. So for six weeks, I had a twenty-four-hour drip of chemo and then radiation. In all, a year of various treatments. My only symptom was I was really tired. So I’m proceeding along and periodically getting CT scans and then about a year later, it appeared the cancer was pulling farther away from the artery.
Q: That’s when you meet Dr. Sheppard?
A: Yes, I was referred to Dr. Sheppard from my primary oncologist here inBend. I was Dr. Sheppard’s last patient of the day and he greeted me by saying, “I saved the best for last!” So from the beginning, I was comfortable and it just got better and better. What Dr. Sheppard did for me was a life-saving fourteen-hour surgery. Obviously his surgical skills saved my life, but as a super bonus, he is a delightful man, very pleasant and supportive.
Q: There was a pivotal moment during the surgery when Dr. Sheppard and his team discovered things were not what they hoped.
A: When they opened me up, there was some discussion about the fact the cancer had not pulled away as much as needed. They talked about whether to proceed. Someone said, “Well, what chance does she have if we stop?” I was told that’s when they just plunged right in and went for it.
Q: How is your health now, and your prognosis?
A: I was told I am cured of pancreatic cancer! If it was going to come back, it would have come back in two and a half years.
Q: How does it feel to be that rare five percent who survive?
A: The primary reason I survived is three exceptional doctors: my primary care physician ten years ago, Dr. Brenda Johnson, who got me a CT scan the very day I came to her office with abdominal pain; Dr. Robert F. Boone, who was in charge of all my treatment and who referred me to Dr. Brett Sheppard; and Dr. Sheppard, who performed life-saving surgery on me. Religion played into it, too. There were many wonderful prayers. I do bear some survivor’s guilt, but to help reduce that guilt, I work with the Pancreatic Cancer Action Network (pancan.org), and speak to people going through what I did.
Q: Now that you’ve been through this journey, what do you what people to know?
A: If you have symptoms or are diagnosed, don’t wait around. Find a doctor you trust and do everything he suggests. This is a fast-growing and deadly disease. I would also suggest people call the Pancreatic Cancer Action Network. It’s updated within thirty minutes when there’s new information. I found that, at that time, the American Cancer Society had very little info on pancreatic cancer. Personally, I have made few life changes as I never smoked, I tried to eat a healthy diet and exercise. We have reduced our intake of red meat, watch our alcohol consumption and just enjoy life.