Going the Distance
Marathoner-in-training takes on pancreatic cancer
- By Dagny Stuart | Image by Anne Weston, Wellcome Images
The day David Lipscomb was diagnosed with pancreatic cancer he had run two-and-a-half miles as part of his training for Nashville’s Country Music Marathon. At age 44, with a wife, Robi, and two college-age sons, Lipscomb was active and seemingly healthy. He and a partner were running Overflow Management, a Christian music artist management company based in Franklin, Tenn. He had no idea that his recent bouts of intense nausea were symptoms of a silent killer that would threaten this fast-paced life.
“On Christmas Eve we ate a big meal with our family, and that night I was violently ill,” Lipscomb remembered. The same thing happened after a big meal a week later on New Year’s Eve. His family physician thought the symptoms could be the flu. But a few days later when Lipscomb returned from that run, Robi looked at his eyes and realized they were yellow.
“I told him this is something serious,” Robi said. “I had seen some TV shows, and I knew that was a bad thing.”
Hours later in a local hospital emergency room – after an ultrasound, MRI and a CT scan – the ER doctor gave the couple the grim diagnosis. The tests had revealed a tumor in Lipscomb’s pancreas; it was almost certainly cancerous.
“When I was in the MRI, I was praying to be peaceful. I had this sense that God was preparing me for something bad,” Lipscomb said. He had no idea how difficult the coming journey would be.
Cancer of the pancreas is an especially lethal disease. According to the National Cancer Institute there were approximately 37,680 new cases in 2008 with 34,290 deaths, making cancer of the pancreas the fourth leading cause of cancer death in this country. Only 5 percent of patients are still alive after five years.
The pancreas is a thin, elongated gland about six inches long that lies behind the stomach. It produces juices to help digest food and hormones to help control blood sugar levels. In the early stages of pancreatic cancer, there may be no symptoms at all. Even when the disease advances, symptoms like abdominal discomfort, back pain or weight loss may be mistaken for other diseases. Many patients don’t suspect they are sick until they develop yellow skin or eyes, a symptom of jaundice. Because of these often subtle symptoms, most pancreatic cancer is diagnosed at an advanced stage when it is much more difficult to treat.
Until his bouts with severe nausea and jaundice, Lipscomb was unaware that he was sick, suffering from a form of cancer that had not yet gained wide recognition in the public consciousness.
Only recently has the spotlight begun to focus on pancreatic cancer – due in part to actor Patrick Swayze’s diagnosis and Carnegie Mellon University Professor Randy Pausch’s “The Last Lecture,” a primer for his children on living your dreams, that became an Internet phenomenon and sparked TV appearances and a book. Pausch died of the disease last year at age 47.
“There aren’t many celebrities talking about it or holding fundraising events on TV because they’re not around to do that,” Lipscomb said. “I want the public to understand this is a very
serious and terrifying disease, and it’s under the radar.”
After a biopsy, Lipscomb discovered he was one of the luckier patients; his tumor was blocking a bile duct at the head of the pancreas – the one place where tumors may be surgically removed.
After doing some research through the Pancreatic Cancer Action Network (PanCAN) and other organizations, Lipscomb decided to be treated at a comprehensive cancer center by a surgeon who performed a high volume of aggressive pancreatic cancer operations. He found Nipun Merchant, M.D., associate professor of Surgery at Vanderbilt-Ingram Cancer Center, who performs nearly sixty complex pancreatic cancer operations a year.
“Surgery is the primary treatment,” said Merchant. “Unfortunately only about 15 to 20 percent of patients are appropriate for surgery. If the tumor has already spread beyond the
confines of the pancreas – to the liver or the lining of the abdomen – taking out the tumor in the pancreas is not going to help the patient since all of the tumor will not be removed.”
The location of the tumor is also vitally important. The head of the pancreas wraps around two major blood vessels that supply blood to the liver and the intestines.
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