In April 2008 Peter started to have problems with his bowels. He didn't have diarrhoea but he would need to rush to the loo to poo. Peter’s GP arranged blood tests, which were normal. However, he was worried when Peter told him that he had lost a stone and a half in two months. The GP arranged an urgent appointment with a specialist at the hospital.
Peter went to the local hospital and had various scans, endoscopies and a biopsy. In August 2008 he was told that he had inoperable pancreatic cancer. The surgeon told him that his tumour was in a place that was hard to reach, which made surgery impossible. This was distressing news, but Peter was glad to hear that he had not caused the cancer.
In September Peter started chemotherapy (an infusion of gemcitabine and tablets of capecitabine). Peter didn't have serious side effects, apart from changes in his blood. He sometimes had to miss treatment because his blood count was poor. In December he had another scan and the tumour had shrunk in size. This was good news.
Peter continued having chemotherapy until February 2009. He did the full six months of chemotherapy (thre weeks of treatment, one day per week, then a week off to rest every month). He had medicines to help with nausea. He did not have any pain apart from some indigestion at times.
Peter had heard about Cyberknife treatment, a highly targeted, very accurate type of radiotherapy. It allows clinicians to target certain cancers without affecting the surrounding tissue.
In April 2009 Peter went to a specialist who told him that if he wanted to be considered for Cyberknife treatment he must first have a PET scan to make sure that the cancer had not spread. Peter had a PET scan and heard that the result was good, so he would be suitable for Cyberknife treatment.
Peter went to a centre that specialises in Cyberknife treatment. At that time he had to pay to have it done privately. First of all Peter had another CT scan. Then he had a fiducial (a marker made of gold seeds) inserted by injection into the centre of his tumour. Fiducials are small gold markers that are implanted into soft tissues in or near the tumour to accurately guide the Cyberknife radiation beams. This was done with local anaesthetic.
Then Peter returned to the clinic for Cyberknife treatment on three consecutive days, 1st, 2nd, and 3rd of June 2009. Each treatment took about an hour and a half. During the treatment he had to lie very still. Peter think he had no side effects from this treatment. After this treatment the specialist at the Cyberknife centre told Peter that he hoped the cancer had all gone.
Peter went to his local hospital for check-ups. He had a CT scan in September 2009 and was told that the tumour had not spread. A CT scan in December did showed it still hadn't spread and Peter hoped that his tumour was ‘dead’. However, in March 2010 another CT scan found that the tumour was growing again and that the bile duct was almost blocked due to the enlarged tumour.
In May 2010 Peter developed jaundice, so on the 16th May he had to have a stent put in. The doctor tried to do this via an endoscopy but it didn't work, so Peter had the stent put in via keyhole surgery. This procedure was done with a local anaesthetic but was painful. It took about 15 minutes. Scans and tests confirmed that the tumour had ‘progressed’ and that it had spread to the liver.
In August 2010 Peter started chemotherapy again (this time just gemcitabine). He will have chemotherapy once a week for three weeks and then a week of rest, for at least three months, as long as his blood results are satisfactory. He will then have another CT scan and the situation will be reassessed.
Peter feels very positive and optimistic about the future. In spite of feeling tired and sick at times he works in his garden for hours at a time and still plays golf. His wife has been a tower of strength and has supported him at every stage.
We spoke to Peter in 2010