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When she was struck with an attack of diverticulitis in January, Shiela McArthur went to the doctor expecting to receive a quick course of antibiotics to clear it up.
While the CAT scan confirmed diverticulitis, it also showed something unexpected: a tumor on her pancreas.
“I was so shocked,” she said. “I’ve never had a pain related to this cancer, so when we went in and they said it’s stage IV cancer, it was pretty mind-boggling.”
McArthur’s experience is not unusual for pancreatic cancer, often called a silent killer because its symptoms are usually not recognizable until it has advanced and spread outside the pancreas. As a result, it is often not diagnosed until it has reached advanced stages and is considered incurable. Pancreatic cancer has one of the highest mortality rates of all cancers, accounting for 2 percent of newly diagnosed cancers in the nation each year but 5 percent of all cancer deaths.
Indeed, when McArthur’s tumor was found, it had already spread to her liver, so she wasn’t a candidate for surgery. Her physician recommended she see Thomas D. Brown, MD, MBA, a medical oncologist specializing in gastrointestinal cancers and the Arizona Cancer Center’s chief operating officer. He recommended she consider participating in a new clinical trial about to open.
“It was a miracle that this trial came up just as I came to the Cancer Center to see Dr. Brown,” McArthur said. “It couldn’t have worked out any better.”
The advanced pancreatic cancer trial was studying the combination Gemzar, an approved and commonly used chemotherapy agent for advanced pancreatic cancer, and Abraxane, presently approved for the treatment of breast cancer and being tested for other cancers. In a Phase I trial of the combination, more than 70 percent of patients achieved stabilization or regression in cancer size lasting longer than four months.
“It was quite serious. I didn’t think at the time that we had even a year, so I just felt that I should take the best thing I could get,” McArthur said. “I figured this was the most recent up-to-date thing they’re working on. My philosophy was if there was anything I could do to contribute toward a cure for this cancer, I would feel very good about that.”
Beginning the first week of February, McArthur made weekly visits to the Cancer Center and was very pleased with the medical attention she received.
“I had to have a couple more CAT scans, and they did interviews each week when I came in for blood work,” she explained. “They would ask me how I felt and what was going wrong and what was going right. They kept very much on top of what was happening to me. I felt very good that they did that. If I was feeling bad, they would advise something to do. They were extremely helpful.”
Though patients in the trial were randomized to receive either standard of care therapy or the investigational treatment, McArthur did receive the new combination of drugs.
“I feel very fortunate that I did get the Abraxane,” she said. “In my mind, that was a good part of why it hit the cancer so hard and it looks so favorable in the reports.”
McArthur’s tumors have regressed to the point that they are no longer visible on CAT scans.
“The results have been wonderful,” she said. “It has shrunk the tumor to where they don’t see it, and they don’t see the cancer in the liver either. It’s just been a miracle.”
McArthur did have some side effects from the treatment. She felt numbness and tingling in her feet and fingers, a condition known as neuropathy, and the medication she took to control nausea made her tired and a little woozy. She stopped driving and couldn’t take the daily walks she and her husband, James, had enjoyed before her diagnosis.
She chose to end treatment on Sept. 9 and she’s back to walking and getting into her usual activities again. She even went on a trip to California in October – something she never imagined earlier this year she would do again.
“It’s nice to be feeling better and feeling like I’m doing things,” she said. “We try to go to the park at least three mornings a week and walk and I’m building that up.”
While her cancer appears to be in remission, she will continue to be monitored through monthly blood workups.
“It’s not showing up, but as the doctor said, it can be hiding in places you don’t know,” McArthur said. “They don’t see anything now, but those things are hard to beat, especially with pancreatic cancer. We’ll keep our eye on it. When it comes back, we’ll deal with it.”
While pragmatic about the future, McArthur is extremely pleased with her experience as a clinical trial participant and her returned good health.
“I definitely would recommend this to other patients,” she said. “I have no doubt about that.”
By Sarah Mauet