In 2009 Steve was diagnosed with pancreatic cancer. He had chemotherapy and radiotherapy to shrink the tumour, but the tumour remained too close to major blood vessels, so was inoperable. Steve feels quite well but knows he has a terminal illness.
In March 2009 Steve had a full medical examination and eye check before he went back Cyprus where he and his wife worked. The results were normal.
In April 2009 Steve and his wife went back to Cyprus. In mid-May Steve had some strange symptoms. His vision went a bit blurry and he started to get leg cramps at night. He also felt very thirsty. He went to see an ophthalmologist, who couldnt see anything wrong with his eyes.
In June a blood test showed that Steve’s blood sugar was very high and that he did have Type 2 diabetes. Steve started taking medicines for diabetes, but then he became jaundice, so he was referred to a gastroenterologist.
The gastroenterologist said that Steve should have an ultrasound. this didnt show anything so he had an MRI scan. This showed that Steve had a tumour at the head of his pancreas. It was pressing on the bile duct and so causing the jaundice and diabetes. The doctor also told Steve that he needed to return to the UK to get specialist help. By this time Steve felt very unwell and had an itchy skin. He and his wife had to pack up what they could in Cyprus before getting on a plane to return to the UK. They flew back inJuly.
Two days later Steve was admitted to a local hospital. There Steve was told that he had Type 1 diabetes so had to have regular injections of insulin. He also had a CT scan, which confirmed the tumour.
The surgeon decided to put in stent to keep Steve’s bile duct open. This was done during a procedure called an endoscopic retrograde cholangio pancreatography (ERCP). The doctor did a biopsy at the same time. The stent helped with the jaundice and quickly made Steve feel much better.
The surgeon told Steve that he had an adenocarcinoma, which would be hard to remove because it was wrapped round a major blood vessel. This was devastating news for Steve and all his family. After a few days in hospital, Steve went home.
The surgeon referred Steve to an oncologist. The plan was that Steve should have combined chemotherapy and radiotherapy in order to shrink the tumour. If the tumour shrank enough then a Whipple’s operation might be possible.
In August 2009 Steve started a five week course of chemotherapy. He had radiotherapy at the same time. Steve was given cisplatin from an IV and capecitabine by mouth. The side effects of the chemotherapy were not too bad. Steve had more discomfort from the radiotherapy. He felt very tired and after the radiotherapy finished he felt sick on a couple of occasions.
During this time Steve thought about having the Whipple’s operation. He was not convinced that he would have the surgery even if it were possible. He knew that it was a major operation, which needed a long period for recovery, and that the cancer was quite likely to return after surgery. However, Steve never had to make that decision. The chemotherapy and radiotherapy did not shrink the tumour enough to make the Whipple’s operation possible.
Steve had a CT scan about six weeks after the chemotherapy and radiotherapy finished and it showed that the tumour was still too close to major blood vessels to allow surgery. On 19th November 2009 the surgeon gave Steve and his wife the devastating news that his cancer was terminal. There was a Macmillan nurse in the room at the same time, who explained that support and pain relief would be available when the disease progressed.
At the moment Steve is feeling quite well and he is enjoying life. He takes insulin for his diabetes. He also takes Creon after meals to help with digestion. He eats whatever he wants to eat and he goes out, drives his car and his motor bike and has holidays. He feels a bit tired at times. He has had to retire from work due to his terminal illness. This was hard for him because he is only 47 years old. He does some voluntary work two days a week. Steve has had wonderful support from family, friends and his church.
Steve feels he has come to terms with his condition. Obviously he is sad that he has a terminal illness, but he has a strong Christian faith so says he does not fear death. He fears the process of dying but not death itself. He feels reassured partly because he has a very good GP and a Macmillan nurse who answers his questions honestly and who has reassured him that he will receive good palliative care.
Steve is not having any other treatment at the moment. He sees his oncologist about every three months. If he develops symptoms he may have some more chemotherapy or radiotherapy as part of palliative care. He knows that treatment will not cure his condition, and he thinks that he may only have months to live.
We spoke to Steve in 2010