Unlocking Genetic Insights: My Journey Through a Revolutionary Clinical Trial
In June 2012, Steve Merlin, then 55 years old, faced a life-altering diagnosis: pancreatic cancer. His journey began with subtle symptoms, including fatigue and jaundice, which ultimately led him to seek medical help. Initially dismissed by his doctor, Steve’s condition rapidly escalated, culminating in a critical diagnosis after a series of tests. His experience underscores the importance of vigilance and proactive health management.
Understanding the Early Signs
Steve’s health issues emerged gradually. He first noticed fatigue, which he attributed to his demanding commute from the Jersey Shore to Manhattan. By late May, he experienced troubling symptoms, including dark urine and gastritis, indicating a deeper problem. A pivotal moment occurred when, during a routine visit to his physician, his symptoms became pronounced enough to warrant further examination.
- Initial Symptoms:
- Fatigue
- Dark urine
- Gastritis
- Jaundice
A Crucial Diagnosis
After a series of tests, including an ultrasound and an endoscopic retrograde cholangiopancreatography (ERCP), surgeons discovered a mass obstructing his bile duct. Dr. Daniel Cherqui, a hepatobiliary surgeon at Weill Cornell Medical Center, informed Steve that he was a candidate for Whipple surgery—a complex procedure necessary due to the tumor’s aggressive nature. The diagnosis of stage IIb pancreatic cancer came as a shock, especially given Steve’s healthy lifestyle.
Surgical Intervention and Chemotherapy
On June 18, 2012, Steve underwent the Whipple procedure, which lasted over nine hours due to unexpected complications. Following his recovery, he started chemotherapy with Gemzar. Unfortunately, after several sessions, scans revealed six small tumors in his liver, leading to a reclassification of his cancer to stage IV.
- Treatment Timeline:
- June 18: Whipple surgery
- Post-surgery: Started Gemzar chemotherapy
- Result: Tumors detected in the liver, reclassified to stage IV
Transition to FOLFIRINOX
Faced with the disappointing results from Gemzar, oncologist Dr. Manish Shah switched Steve to FOLFIRINOX, a more aggressive chemotherapy regimen. After twelve cycles, follow-up scans showed a remarkable reduction in tumor size, offering a glimmer of hope in his battle against cancer.
Genetic Insights and Clinical Trials
Exploring his family history of cancer, Steve underwent genetic testing and discovered he was positive for the BRCA-2 gene deletion. Understanding the implications of this finding, he consulted with Dr. Steven Lipkin, a geneticist who introduced him to PARP-1 inhibitors. This class of drugs has demonstrated effectiveness in patients with the BRCA mutation.
- Key Genetic Findings:
- Family history of breast and colon cancer
- Positive for BRCA-2 gene deletion
Enrolling in a Clinical Trial
Steve’s proactive approach led him to search for clinical trials involving PARP-1 inhibitors. With assistance from the Pancreatic Cancer Action Network, he connected with Dr. Susan Domchek at the Basser Center for BRCA. After meeting the criteria, Steve enrolled in the trial and began treatment with the PARP-1 inhibitor shortly after completing his chemotherapy, leading to a positive response.
A Journey of Hope and Advocacy
Now approaching the five-year mark since his Whipple surgery, Steve’s latest scans show a significant reduction in tumor size, and he remains stable without any signs of disease progression. His journey, marked by resilience and determination, has inspired him to mentor medical students and share his story with fellow cancer patients, emphasizing the importance of hope and proactive health management.
Steve continues to advocate for cancer awareness and research, sharing his story in the Survivors video “Plenty to Live For.” His experience serves as a powerful reminder of the potential for survival and the importance of early detection and innovative treatments in the fight against pancreatic cancer.
For more inspiring survivor stories, visit Plenty to Live For.
