Lifestyle
Dad diagnosed with pancreatic cancer at 42 recalls ‘difficult’ symptom that sent him to doctor
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Back in 2017, Nick Pifani noticed a change in his body: Eating a meal hurt. No matter the amount that he consumed, he felt discomfort.
“I had pain any time I ate … which basically made me not want to eat or eat very limited small amounts,” the 50-year-old from New Jersey tells TODAY.com. “I was starting to lose weight, and I was not trying.”
Pifani called his primary care physician for a referral to a gastroenterologist. Sadly, he needed to wait about five months to see the new doctor. As he waited, what was once uncomfortable became painful and exhausting.
While he felt worried when he was diagnosed with Stage 3 pancreatic cancer, Nick Pifani stayed strong for his family.
“I’m a big runner and triathlete,” Pifani says. “I went out one morning to take a run, and normally I might run 5, 6, 10 miles, and I couldn’t make it past the end of the street because I was beyond fatigued.”GI distress and increasing pain
Pifani’s pain slowly progressed.
“The pain definitely made things difficult,” he says. “I would say it got really bad over a weekend to the point where I wasn’t sleeping.”
Pifani wondered if work stress contributed to his symptoms. After the three days of “off-the-charts back pain,” he visited the emergency room.
“I have a stressful job,” he says. “Maybe I had a severe ulcer or something. I thought, I’ll go there, they’ll run some tests, they’ll give me some medication … I’ll get fast tracked to see a GI specialist and then I’ll be on my way.”
Doctors in the emergency room thought it could be a problem with his gallbladder or his appendix, and they performed a CT scan. It uncovered something worrisome.
“I had a mass on my pancreas,” he says. “The doctor there was not ready to tell me I had pancreatic cancer.”
The following day, he underwent an MRI, and by that evening, doctors had confirmed Pifani’s diagnosis of pancreatic cancer. He was 42 years old at the time.
“My reaction was I’ve got to find the best surgeon. I have to find the best doctors for me if I want a chance to make it,” he says. “I really didn’t give myself a chance to get too terribly upset.”
Pifani wanted to show a brave face to his family.
“If they saw me upset, they’re going to be upset. So, I couldn’t do that,” he says. “Cancer doesn’t just affect the person, it affects the family.”
Pifani visited several doctors and they agreed he had Stage 3, inoperable pancreatic cancer. The tumor encased part of the superior mesenteric artery, an important artery that supplies blood to the gut, and prying the tumor off the artery could be tricky. But doctors hoped if he started chemotherapy, they might be able to successfully perform surgery.
He underwent six rounds of chemotherapy, then targeted radiation for five and a half weeks combined with a low-grade chemotherapy weekly. He finished treatment at the end of August 2017, and by September, his scans looked promising.
“The tumor had shrunk enough,” he says. “(My doctor) could see that it was starting to retract and move away from the artery and veins.”
In October 2017, he underwent a Whipple procedure, a 10-hour-plus surgery where doctors remove “parts of the bowel, parts of the stomach, parts of the surrounding lymph nodes to try to catch everything,” Dr. Arif Kamal, chief patient officer for the American Cancer Society, who did not treat Pifani, explains.
“It was a huge success because when the pathology report came back, I had negative margins,” Pifani says. “No signs of cancer.”
Pancreatic cancer
While pancreatic cancer remains less common, it is the third most-common cause of cancer deaths in the country, making it “one of the deadliest cancers,” Kamal says.
“It’s unique because it’s one of the few cancers that despite the survival benefits that we’ve achieved over that past 30 years … we don’t see similar gains in pancreas cancer,” Kamal tells TODAY.com. “It’s one of the few where actually mortality might, in fact, be increasing.”
Nick Pifani underwent aggressive chemotherapy followed by radiation because his pancreatic tumor was inoperable. The chemotherapy and radiation worked and he was able to undergo surgery.
When Kamal started medical training about 15 years ago, life expectancy for someone diagnosed with pancreatic cancer hovered around six months, he says. It’s gradually increased to about 15-18 months “with some really intensive treatment.” Still, this mortality rate exceeds other cancers. That’s because there are fewer treatments for pancreatic cancer and a lack of screening options.
“There’s not a way to find it early,” Kamal says. “Most people who are at average risk for pancreas cancer really never find it or are aware of it until it’s pretty far along.”
Typically, people do not experience symptoms until the cancer has spread to other locations, such as the liver, stomach, lymph nodes, arteries of veins, he notes.
“Once it’s done, it’s pretty advanced,” Kamal says. “Five-year survival rates at that point where it’s spread, even locally like that, is under 10%, which is pretty unique.”
Symptoms can include:
Pain that increases with eating
No longer being able to eat fatty foods
Loose stool after eating fatty foods
People with pancreatic cancer might undergo chemotherapy, radiation and a Whipple procedure. But treatment depends on the stage of the cancer when it’s found.
“The surgical procedures — if they’re indicated — are pretty intense,” Kamal says. “If we do a surgical intervention, we want to get as much tissue as we can.”
Kamal believes a lack of awareness of pancreatic cancer means that it might not receive as much funding as is needed to develop better screenings and treatments for it.
“There is a bit of an awareness and visibility (problem) and I think that can affect the funding climate,” he says. “It’s trying to play catch up from a science perspective. … That’s going to require some investment.”
‘A second chance in life’
While recovering from his 11-hour surgery felt tough, Pifani notes he would take surgery “in a heartbeat over how awful the chemo was.” Two months after surgery, he returned to running.
“The hardest part outside of a little bit of the physical pain in the beginning, with the procedure, it’s almost like you have to learn how to eat again,” he says. “You have to eat small meals because you don’t have all the parts before you went into surgery. So if you eat too much, you get sick.”
Pifani found that meat hurt his stomach, so his diet now includes fruits, vegetables, seafood and eggs.
“Overall the diet has worked much better for me,” he says. “I feel like my old self, which is great.”
Nick Pifani wants to raise awareness of pancreatic cancer so more funding could be dedicated to researching treatments and screening tools for it.
This month marks eight years that Pifani has been cancer-free.
“When my first oncologist discharged me, I didn’t quite know how to feel,” he says. “I didn’t know if I was ever going to make it to that point. That was always the goal.”
Pifani has lost several family members to pancreatic cancer — including a cousin and uncle who both died in six months or less — so he feels “extremely fortunate.” The family has a genetic mutation that makes it more likely they’d have pancreatic cancer.
“I have a second chance in life, and I do my best to make the best of it,” he says. “I also carry around … I guess guilt is the right word.”
But he’s transformed that feeling into action.
“I want to make sure I try to do everything I can to make a difference — to improve early detection, to raise funds to drive better treatment options, to do all the things that are really required to get to a better survival rate,” Pifani says.
This article was originally published on TODAY.com
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