Vaccine Offers Hope to Pancreatic Cancer Patients
When Teresa Thorn started getting nausea last February, she thought it was an ulcer, something she'd had years earlier. 
As the days went on, though, the nausea remained, and Thorn's color started changing, something her co-workers at Hanesbrands Inc. noticed. Finally one Sunday, she and her mother, Naomi Ivester, went to the Emergency Department at Wake Forest Baptist Medical Center, where a battery of tests began.
Her longtime physician at Wake Forest Baptist, Mary Lyles, MD, eventually broke the news-Thorn had pancreatic cancer. She was 53.
Although pancreatic cancer has the nation's highest mortality rate, with just 6 percent of patients surviving five years after diagnosis, the outlook dramatically improves when it is diagnosed early and surgery can remove the cancerous tumor. As Thorn soon learned from Perry Shen, MD, her cancer was operable, giving her a chance for cure.
Thorn was sent home to Rural Hall to prepare for the resection surgery, which would ultimately remove 30 percent of her pancreas, as well as 9 inches of her small intestine and her gallbladder.
"The whole time I was home it was like I was in somebody else's life,'' Thorn says. "I did not believe it; all I thought about was dying. Then I met Dr. Shen. He's just very caring. He explains things to where everybody can understand-procedures and what my odds were.''
Latest techniques
Shen leads weekly conferences at the medical center for Surgical Oncology in which a multidisciplinary team of experts discusses cancer cases. There, around a conference table and with a computer screen to study diagnostic images, oncologists, radiologists and surgeons devise the best strategies for their individual patients based on current medical evidence and research.
For those with pancreatic cancer, strategies can include the latest techniques in surgery, such as the robotic type in which Shen specializes. Wake Forest Baptist is one of just a few centers around the country using robotic surgery to remove pancreatic tumors.
The benefit of robotic surgery is that it allows surgeons more dexterity to sew in the abdomen even as it remains a minimally invasive procedure. As a result, Shen says, patients get out of the hospital more quickly, and their faster recovery time allows them to more quickly start the chemotherapy they need to try to kill remaining cancer cells once the tumor is removed.
Shen, who has been at Wake Forest Baptist since 2000, has pursued not only the latest techniques, but also clinical trials of drugs and therapies not yet on the market.
One of those trials could prove fruitful to Thorn.
Surgery, chemotherapy and more
The goal behind multiple therapies is to eradicate cancer. Surgery removes the actual tumor. Chemotherapy is aimed at destroying any cancer cells left in the body. Thorn is now part of a national clinical trial-Wake Forest Baptist is among several medical centers nationwide participating-and every two weeks along with her chemotherapy receives a dose trying another strategy-immunotherapy.
The vaccine being given to Thorn is intended, Shen says, to make any pancreatic cancer cells "seem like a foreign body, not part of the patient's own body. The body will consider any pancreatic cancer cells not its own tissue type and cause a rejection of those cancer cells.''
Because pancreatic cancer cells are aggressive and frequently return after surgery and even chemo, the vaccine holds promise as another tool to increase a patient's survival rate.
Thorn says she never hesitated when Shen asked her if she wanted to be part of the trial.
Although surgery was difficult ("Mom said when Dr. Shen came out after nine hours he looked like he had been through a war.''), and she continues to have bouts of nausea after eating, Thorn is positive how things have turned out. She has lost weight, has her color back and returned to her customer service position at Hanesbrands in early October.
"I really feel good. I haven't felt this good in a couple of years,'' she says.
Lyles says her longtime patient's lab results post-surgery, such as hemoglobin level, are "totally normal'' for an adult women.
"I think Perry Shen's idea that this was a lady whose body could respond to this treatment was right on,'' Lyles says.
Looking to the future
For Shen, patients such as Thorn make it worthwhile. He says part of what makes his job special is the ability to attack difficult cases with the multidisciplinary team.
"That really allows us to give these patients the most appropriate treatment plan up front,'' he says. "I like trying to determine the best combination of therapeutic interventions and then personalize it for that specific patient. It is quite gratifying when a patient undergoes successful intervention.''
When asked about the difficulties of his specialty field, with devastating illnesses such as pancreatic cancer, his answer brings to mind a Tom Hanks line from the baseball movie A League of Their Own.
"I enjoy the challenge,'' Shen says. "If it was easy, everyone would be doing it.''
Thorn, meanwhile, says she can't wait to getting back to things she does around the house she hasn't been able to do for most of 2012. Those include planting flowers, painting and doing things with her mother, as well as her son and daughter-in-law.
Being a recipient of the latest treatments has helped shape her own decisions.
"I am an organ donor,'' Thorn says. "I believe anything that can help our future, we need to do it.''