Joseph E. O’Neill Story – September 2006

Vital Statistics
Joseph O’Neill was diagnosed in March 2005, at the age of 52, with Stage 1-B (pT2, NO, MO) moderately differentiated adenocarcinoma of the head of the pancreas.
Medical History
Anxiety disorder, migraine headaches, hypothyroidism, elevated cholesterol, narcolepsy, acid reflux, Bell’s palsy, claustrophobia, hiatal hernia and chronic abdominal pain, Gilbert’s disease at one point, benign polyp removed colon September 2004.
Medical Journey
I was living in Texas and visiting loved ones on Christmas vacation. I arrived four days before Xmas and was staying in younger brother’s house in Petoskey, Michigan. The day after arrival I started feeling sick to the stomach area and in some pain. It was Christmas Eve, about 2:00 AM and I knocked on my brother’s door and explained that the pain was now too great to deal with and he needed to take me to the emergency room. My brother lived 9 miles outside of town and there was a snowstorm going on. I was admitted to Northern Michigan Hospital for four or so days, with CT-scans, ultra sound test, many other tests and given lots of morphine. They released me saying I had pancreatitis — they prescribed a liquid diet, and suggested a visit to a doctor when I got back to Texas. In January I returned to San Antonio and went back to teaching school. I was feeling constant pain at the bottom edge of my right ribs. I had pain for years in that area on-and-off but this was more severe and was constant. I went to Wilford Hall Medical Center on Lackland Air Force Base. My doctor ran all the tests over again, plus more. At the end he said I was okay and there was no medical problem found. I said that there is a problem somewhere and the pain is still as strong as ever. The Doctor explained that there was one other test he could run called an Esophageal Ultra-Sound (EUS). I decided on taking this exam, and the doctor contacted me with the results. Whipple procedure done in March 2005, Wilford Hall Medical Center. Pathologic review of specimen revealed a 3.5 cm ductal adenocarcinoma in the head of the pancreas. Six weeks of chemo 24 hrs a day for six weeks as well as six weeks of radiation – the max they could give me. Then four months of gemcitabine once a week.
How You Were Told / How You Told Loved Ones
I was given an appointment and he started the conversation by saying I’m sorry Sergeant, I was real sure the test would be negative. But your pancreas appears been ill for years and it has a tumor in the head of it. Also, that they had needed to remove a tissue sample, but that the biopsy equipment was missing a part. I was told not to worry – the tumor would be okay for a while, that the problem with the equipment would be fixed and I would be one of the first to get one of the procedures. It was over a month — and I finally was going to get the sample taken. When the test was completed the doctor stated the results were non-conclusive but his guess was that it was really NOT likely to be malignant. So, still no firm results. They scheduled me for Whipple procedure, and brought in a pathologist so as to get an immediate cancer diagnosis at the time of the procedure. But, when they got the results – the pathologist couldn’t say for sure – but indicated that the results of the procedure looked to be benign.
When/How You Learned “The Statistics”
A day later my doctor totally caught me off guard in my hospital room – he said that it was indeed malignant and that my life expectancy could not be really given. I soon found out the difficult statistics. I met with my family and told them everything, and no one knew how to react. It is still hard for them to this day.
Your Initial Response to Diagnosis and That of Your Family / Friends
My life was over and I was depressed. My girlfriend started to back off – though we still were planning a future as husband and wife. But the cancer killed that with my inability to support her and myself – due to loss of my ability to work, or care for her sickness. My immediate family and other relatives still can’t believe as healthy as I was that this cancer had attacked my body.
Dietary Experience
Eat just like rest of family, no alcohol, little soda pop, not much chocolate, smaller meals, limited intake. Walk once in a while.
Medical Team
Dr. Steven Bowers, surgeon; Dr. Barry Gardner; Dr. Pamela Tuli. Wilford Hall Medical Center, Lackland AFB. San Antonio Texas. My medical team was great. Primary Caregivers and Helpers: Girlfriend, brother, wife and Preacher People: Computer
Support Groups
Wilford Hall Medical Center Cancer Support Group
Online resources
I just look around
People who understand the loss of controlling ones own future, and the great pain of losing the ability to plan for events. What Your Doctor Would Say: My body told me there was a problem; I wouldn’t take the doctor’s word that I was fine; finding the tumor early; being of medium age and physically fit. What You Say: First, God must have more work for me on earth – something about protecting the future for my sons and grandsons. Importance of hope: hope for a pain-free future, one that includes love. Importance of Humor: I am very light hearted, and enjoy being with people having fun. If you can’t laugh at life, it will totally dry up your strength and life forces Importance of Spirituality: I believe God made me and will end my time some day. I hope that my life is pleasing to him. We are all children of God trying to share our existence each and every day.
To other patients: Follow your doctor’s orders, listen to what your body is telling you, surround yourself with good loving people. To primary caregivers: Don’t push things too hard about diet of patient, be there with a smile and the ability pick up on the needs of patients. To well-meaning others: Don’t be overly positive, because it can frustrate the patient.
Smile and face the morning Our Creator has Blessed us with, every second is a great gift. My prayers to the Families, Friends and Victims in their struggle to face each new morning.

Our science board is composed of:

James Abbruzzese, MD Chief, Medical Oncology Duke University

Markus Büchler, MD Chairman, Surgery Heidelberg University, Germany

Ralph Hruban, MD Director, GI / Liver Pathology Johns Hopkins University

Eileen O’Reilly, MD Associate Director for Clinical Research – Memorial Sloan-Kettering Cancer Center

Margaret Tempero, MD Chief, Medical Oncology University of California at San Francisco

Our Philosophy About Pancreatic Cancer

Pancreatic cancer is a serious disease. Taking an aggressive rational stance at the earliest possible time, supported by the best medical team, and treated in the most appropriate manner gives the best chance for survival.

We believe in strong patient-physician bonds, scientifically-based treatment, and that comfort can come from knowing that everything that reasonably can be done – is being done.

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PROPOSED: Every newly diagnosed person with pancreatic cancer (ductal adenocarcinoma of the pancreas) should receive genetic screening prior to beginning treatment – to test for germline genetic mutations in the homologous recombination DNA repair pathway, including genes such as BRCA1, BRCA2, PALB2, and others. These results, in from 12% to 17% of pancreatic cancer patients, suggest that treatment that includes DNA cross-linking agents such as platinum compounds or PARP inhibitors may be superior to standard best practices therapy.

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RATIONALE: The age of precision medicine in pancreatic cancer is approaching … [MORE]

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Pancreatic cancer is the 3rd leading cause of cancer-related death in the U.S. It is expected to become the 2nd leading cause of cancer-related death by the year 2020. Studies show that death rates for pancreatic cancer are increasing while for most other cancers they are declining.
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Pancreatic Cancer Blog

One of the observations that physicians often made when the standard of care treatment typically consisted of the chemotherapy drug agent of gemcitabine alone, was that many patients with pancreatic cancer (ductal adenocarcinoma of the pancreas) seemed to feel better after the initiation of treatment… More Here



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