David developed symptoms just before Christmas 2003. He felt tired, his urine looked like the colour of tea, his eyes looked yellow, and he felt sick. His stools had changed colour and were greasy. He went to his GP, who sent him to the local hospital. Gradually he felt worse, and started to itch all over. He felt sick and was very worried. David had an ultrasound scan and on January 9th 2004 a doctor inserted a stent into David’s bile duct so that the bile could flow down the bile duct more easily. This was done through an endoscope. David had a sedative for this procedure.

David was told that he should go to a specialist hospital for more treatment, but he did not know the exact reason. A doctor had told him that he might have pancreatitis or possibly cancer. When he arrived at the specialist hospital he realised that he was in a hospital for cancer patients, which was rather a shock. He had a CT scan and was then told that he should have a Whipple’s operation. David felt extremely anxious.

The surgery took place on 24th January 2004. The surgery went well even though the surgeon had nicked the aorta and David had needed a lot of blood. David found that the intensive care ward was very noisy, and he had nightmares at times. He had drips, drains and a catheter. David was in the intensive care unit for a few days and then moved back to the ward. His pain was well controlled with an epidural. Later, when that was removed, he had a morphine pump. He developed an infection so had to have intravenous antibiotics. David felt that he had been well looked after in hospital, but he felt that there was a lack of continuity of care. He saw too many different doctors, who said different things and sometimes contradicted what others had said.

During the surgery the surgeon had taken a biopsy, and he was able to confirm that David did have pancreatic cancer. David stayed in hospital until the beginning of March. It was lovely to go home and get back to a normal life. The district nurse called frequently to dress his incision, which had been infected at one end.

In April 2004 he started adjuvant chemotherapy, just in case any cancer cells remained. He took part in a trial called the ESPAC-3 trial and he was given Adjuvant 5-FU as part of that trial. (ESPAC-3 is a multi-center, international, randomised, controlled phase III trial of adjuvant 5-fluorouracil/folinic acid (5-FU/FA) versus gemcitabine (GEM) in patients with resected pancreatic cancer). David had cycles of this chemotherapy for six months. At times he had nausea and did not feel well.

David was able to return to work in September 2004, soon after the last cycle of chemotherapy. His employer and work colleagues were all very supportive. For a couple of years he felt very well. He ate well and put on weight and enjoyed cycling and social life as well as his work. He saw the surgeon every three months for follow up.

In December 2006 David started to feel nauseous and unwell. He went back to the hospital for a check-up. However, the CT scan looked normal and the CA 19-9 tumour marker in his blood appeared to be normal too. David started to have diarrhoea and he lost a lot of weight. Eventually David had a private consultation with a gastro-enterologist at his local hospital. He had tests and was referred to the oncology department, where he was told that there had probably been a recurrence of his disease. The doctor assumed this after looking at a CT scan. David went back to the specialist hospital, where he had a PET scan. This confirmed that there had been a recurrence. David was relieved in some ways because at last there was a reason for his ill health.

In early 2008 David was offered the chance to go on a clinical trial which involved gemcitabine, capecitabine and erlotinib. David went on to this trial but suffered some side effects. He had some rectal bleeding and also vomited blood on one occasion. Now he has terrible memories of chemotherapy. It makes him feel sick just to think about it.

In January 2009 David started radiotherapy. He had 28 cycles of radiotherapy, Monday to Friday with weekends off. He did not experience any serious side effects from that. He just felt a bit tired at times, but he thought that that may have been partly due to all the travelling he had to do to get to the radiotherapy.

In September 2009 David started having some pain and discomfort. The CT scan did not show any real changes, but in February 2010 a blood test showed that the tumour markers had risen. Another CT scan showed that the cancer had spread to the pelvis.

David is now working with the Macmillan team. He controls the pain using hot water bottles, and morphine. He has also tried some breathing techniques, which help reduce the pain.

David has been told that he only has weeks or months to live, which is shocking news. He has been to the local hospice to discuss palliative care and the future management of his condition. He likes the hospice and has confidence in the staff but feels sad and weepy and very emotional at times because of what is happening. He has been given some anti-depressant tablets, which he has decided to try. David would like to stay at home as long as possible and then move to the hospice.

David has had tremendous support from his family, friends and colleagues. His employer has also given him great help and support at all times. He has had tremendous support from the Macmillan team and he has also found help via complementary therapies such as reflexology. He takes Creon to help him digest his food.

Doctors have suggested that David should have more chemotherapy, but he does not think that that is a good idea. He would rather enjoy the life that he has left, rather than suffer chemotherapy again for perhaps an extra couple of months.

David was interviewed in 2010.