A Family's Pancreatic Cancer Journey
Sometimes a medical decision is too bigfor a patient to make alone—especially whenpancreatic cancer isٳdiagnosis.
Joseph Chang, now 84, of Queens, was faced with asurpriseStage 1 diagnosisinJune 2019. His only symptomat the time, he recalls, was diarrhea.
“I found it by accident,” Joseph says. “I went to see my gastroenterologist for a colonoscopy, and toldherI had aproblem.She sent me to the lab for a blood test, and later that day, she called to say they found something unusual in my blood.”
The next stepwas a CT scan, reviewed byRohitChandwani, MD, PhD,acomplex general surgical oncologist at֭Ƶ (WCM).
Diagnosing his results
“Hehadthis unusual-looking area in the bottom part of the head of his pancreas,”Dr.Chandwaniexplains.“The biopsy originally said he had pancreatic fibrosis,but it gave me pause.”
Dr.Chandwani,assistant attending surgeon, NewYork-Presbyterian Hospital,andassistant professor of surgery, ֭Ƶ Medical College, Cornell University,continued to listen closely,andJoseph said he’d lost weight and been in pain. ThosedetailscausedDr.Chandwanitoquestion the biopsy results.
“Sometimes there’s a discordance between the biopsy and the imaging,” Dr.Chandwanisays.
He sent Joseph for a secondbiopsy, revealingpancreatic cancer, Stage 1. The treatment was clear, Dr.Chandwanisays—a Whipple procedure.Surgeons use ٳ,also called a pancreatoduodenectomy, in which they remove the head of the pancreas, a portion of the stomach, and other nearby tissues.
Dr.Chandwanitold Joseph he was a good surgical candidatebecause his cancer was in an early stage.Unsure,Joseph went for a second opinion.
Receiving a second opinion from his family
He consulted with an oncologist who was willing tousechemotherapyto shrink the tumor, saysJoseph’s son,Eric Chang,ofNew Jersey.
“Within a day, my father informed Dr.Chandwaniand his team that my father would pursue this alternative,” Eric says. “Dr.Chandwaninever told usnotto pursue the treatment, but did express deep concerns that treatment might not really do anything, potentially making my father less of a candidate for surgery.”
Joseph’s son, Tony, of San Diego, was gratefulthat Dr.Chandwaniallowed the whole family to participate in making the decision about Joseph’s surgery, and made himself available via phone and email when the family had questions.
“This decision was too big not to discuss as a family, especially since the treatment seemed daunting for a man of 83,”Tonysays.“We were concerned about my father handling such a big surgery at his age, but Dr.Chandwaniwas confident that he would recover.”
While Tony used New York City Subway analogies to describe the Whipple procedure to his father, Erictold his father that most pancreatic cancer patients arenotgood surgical candidates, and that the alternative approach may beineffective.
“My father did his own research as well, and Dr.Chandwanidrew us a diagram and used medical illustrations to help explain the surgical techniques and goals,” Tony adds.
Dr.Chandwaniwas comfortable having ٳChangfamily on board to help Joseph make his decision about the Whipple procedure.
“My role wasn’t convincing him to have an operation, but to weigh the risks and benefits in aggregate, and see that the benefits were greater than the risk,” Dr.Chandwanisays. “I told him I hadsuccessfullyoperated on patients his age and older. I felt I could safely get him through the operation.”
Moving forward with the Whipple procedure
After having weighed the non-surgical option, Joseph says,“Everybody in my family wanted me to have the surgery.With the surgerywe would have hope. No surgery--no hope.”
Joseph stayed in the hospital for about 15 days following his surgery in August 2019.
“Dr.Chandwaniand his team were so nice, and I am so grateful,” he says.
Eric agrees.
“The staff cared for my father as if he were their father,” headds. “Truly amazing and caring.”
Road to recovery
Although Joseph’s recovery has not been easy—Tony describes fatigue, and some initial difficulty swallowing—his energy is up and he is slowly regaining the weight he’d lost.
“Overall, his perspective has improved as his condition improved,” Tony says. “He knows it’s a journey and to take it one day at a time.”
More than a year out from his Whipple procedure, Dr.Chandwaniremains involved in Joseph’s care.
“Dr.Chandwanihas been very responsive to any and all concerns,”Tony adds. “My parents are happy with and thankful for the care my dad has received from Dr.Chandwaniand ֭Ƶ, and that outlook and trust are important to his physical and mental recovery.”
Joseph has undergone six rounds of chemotherapy since the surgeryandhopes to be able toexercise andgo for walks again soon.
“I’m going forwards, not backwards,” hesays.
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