After Christine Earle had a hysterectomy in fall 2017, she never felt right. The mother of three sought care for her chronic stomach pain near her Eau Claire, Wisconsin, home. After two CT scans and a biopsy found a mass on her pancreas, Christine was diagnosed with pancreatic cancer in February 2018. Despite treatment with chemo and immunotherapy, the mass grew.
“They told me the chemotherapy medicine wasn’t working,” Christine said. “Then they tried immunotherapy, which didn’t work either. That is when I decided to seek a second opinion.”
Specialized Team Approach to a Second Opinion
With the help of her youngest son and a Google search, Christine decided her second opinion would come from the Froedtert & the Medical College of Wisconsin Clinical Cancer Center at Froedtert Hospital, which is home to an internationally recognized liver, pancreas and bile duct cancer treatment team. Christine made a September appointment with Paul Ritch, MD, a medical oncologist on the team, now retired. After examining Christine, reviewing her CT scan and learning about her nonresponse to prior chemo, he became suspicious of her cancer diagnosis.
Dr. Ritch referred Christine to his colleague John Charlson, MD, a medical oncologist who specializes in rare sarcomas in the abdomen. Dr. Charlson saw Christine and had similar suspicions. He then invited surgical oncologist Harveshp Mogal, MD, MS to see Christine. After examining Christine and ordering an additional CT scan and biopsy, the treatment team agreed that Christine didn’t have pancreatic cancer, but a rare cancer called retroperitoneal sarcoma, which develops in the space behind the lining that covers the abdominal organs.
“Dr. Ritch looked at me and said he didn’t think that I had pancreatic cancer,” Christine said. “It was such a turn of events for me. I went from basically trying to plan a funeral to planning to live in Milwaukee so I could get treatment.”
Christine’s team discussed her case extensively during their multidisciplinary tumor board meetings. Fortunately, since Christine’s tumor hadn’t spread to other organs like the liver or lungs, the doctors knew that curable treatments were still an option. First, Christine’s radiation oncologist, Meena Bedi, MD, planned a schedule of radiation therapy to try to shrink Christine’s tumor. Unfortunately, it did not shrink, but continued to grow.
At its largest, Christine’s tumor weighed 6 pounds, 9 ounces. It measured about 21 inches, or roughly the size of a small watermelon. At the same time, Christine barely weighed 80 pounds.
Because the tumor was still growing, Christine’s team recommended surgery to remove it. Given the tumor’s rarity and its proximity to the stomach, colon and critical blood vessels, Dr. Mogal knew it would be a challenging operation. He asked his colleague Kathleen Christians, MD, surgical oncologist, to join him during the December 2018 operation.
“Christine had a very large tumor,” Dr. Mogal said. “To remove it, we did an extensive operation where we had to take out her entire pancreas, spleen, gall bladder, part of her colon and part of her stomach before basically putting her back together. The surgery lasted from 7:30 in the morning to 6 in the evening.”
Road to Recovery
Christine spent a few weeks — including the holidays — at Froedtert Hospital recovering, which according to Dr. Mogal, is a short amount of time for someone who had such an extensive operation. Although Christine is now learning how to live with diabetes, a result of the removal of her pancreas, she is feeling good and getting better every day. She’s thankful for the care she received to treat her cancer and continues her follow-up care at Froedtert Hospital.
“I was totally impressed by the way all members of the sarcoma team explained things to me,” Christine said. “I was nervous, and yet I wasn’t because I really felt that they knew what they were doing. Everyone was so compassionate, too, and interested in me as a person, especially nurse practitioner Jenny Merrill. I felt such a connection, which was amazing to me.”
The Importance of a Second Opinion
The Froedtert & MCW academic health network is prepared to offer second opinions. The network features highly specialized physicians working together to find correct diagnoses and provide potentially lifesaving treatments that are backed by research. Christine’s case is a prime example, having been misdiagnosed with pancreatic cancer and given ineffective chemo before specialists at Froedtert Hospital were able to see her.
“If Christine delayed seeing us a bit more, I think she would have passed the surgical resection window,” Dr. Mogal said. “I doubt she would be alive today if we would have not been able to offer her surgical treatment. Our health network has dedicated teams that can get to the bottom of these extremely challenging diagnoses and offer patients the proper treatments.”