After a Series of Setbacks, Pancreatic Cancer Patient Paul Sees Progress
Written By Julia Brabant
Diagnosed: May 2022
Diagnosed With Stage 3 Pancreatic Cancer in May, 2022, Paul’s Tumor Is Now Shrinking
In March of 2022, Paul Borys’ need for a blood pressure medication refill led to a diabetes diagnosis. In May, doctors told him he had Stage 3 pancreatic cancer. By December, Paul had gone through more ups and downs than most people experience in a lifetime – but with the help of his family, his medical team and other members of the pancreatic cancer medical community, Paul will start the New Year off with some much-deserved good news – and a strong desire to give back.
A resident of Gilbert, Arizona, Paul considered himself fairly healthy throughout most of his life. He did have high blood pressure and took medication for it. Doctors had also treated him for testicular cancer back in 1995, determining he was cancer-free after 10 years had passed with no reoccurrence.
When Paul went to fill his hypertension medication in March of 2022, tests showed that his blood sugar was sky-high, leading to a series of additional tests and a diagnosis of Type 2 diabetes, typically a major risk factor for pancreatic cancer. After a couple of weeks and additional lab work, Paul’s primary care provider changed his diagnosis from Type 2 diabetes to Type 1.
An endoscopy, colonoscopy and ultrasound followed, and Paul and his wife, Norine, suspecting cancer, prepared for the worst. It was a pleasant and welcome surprise when Paul’s doctor said the tests hadn’t turned up any masses – nor had his bloodwork indicated cancer, though they had yet to discover that Paul’s blood doesn’t show the cancer markers doctors typically use to measure cancer activity.
Feeling “out of the woods” for most of April and relatively happy to have just diabetes to deal with, Paul soon had a visit with a gastroenterologist, who, after reviewing Paul’s case, recommended an endoscopic ultrasound.
This time, tests revealed a medium-size mass on his pancreas. Doctors diagnosed Paul with Stage 3 pancreatic cancer May 10, 2022. But there was some positive news – it was possible he was a candidate for surgery.
Paul’s daughter-in-law is an emergency room doctor in a different state and pulled some strings to get Paul an appointment with one of the nation’s preeminent Whipple procedure surgeons. A complex operation often used to treat pancreatic cancer, the Whipple involves removing the head of the pancreas, part of the small intestine, the gallbladder and the bile duct.
Another Disappointment and Yet Another Setback
During that visit, Paul and his wife suffered yet another disappointment in what seemed to be a continuous series of blows. Because of the positioning of Paul’s tumor, which wrapped around major blood vessels, he was not a candidate for surgery after all. Moments later, and before they’d even left the room where the doctor delivered the bad news, Paul and his wife received a phone call confirming the birth of their third grandchild.
“It tore us apart,” Paul said, feeling joy and sorrow interwoven at the birth of their grandson and devastation at the fact that he now wasn’t sure how much time he’d have to spend with him. “We had done so much research and work to prepare for what we thought was a certainty – a Whipple procedure – and it all fell apart that day.”
With surgery off the table, doctors took other measures to treat Paul, installing a port in his body to deliver medication and a biliary stent to aid with digestion. That’s when the major complications began. Doctors had installed the port improperly, and it hadn’t been tested and had a kink in the tube. Then, just days later, the stent that doctors installed collapsed, leading to a bowel perforation and a major infection.
Paul spent 10 days in the hospital as a result of the infection, experiencing ongoing pain in his stomach that migrated through to his back. While he sat in a hospital bed, Norine spent hours researching doctors, pancreatic cancer programs and potential treatment methods.
A Friend Referred Him To Dr. Erkut Borazanci
Dr. Erkut Borazanci, M.D. is an oncologist and clinical investigator at the Virginia G. Piper Cancer Center at HonorHealth Research Institute in Scottsdale, Arizona. The friend’s husband had hoped to see Dr. Borazanci, or “Dr. B.,” for his own pancreatic cancer treatment but unfortunately passed away from complications related to the cancer before he had the chance.
Dr. B recommended Paul start chemotherapy using Gemcitabine, Cisplatin and Abraxane. He began treatment, but by mid-July, he started experiencing violent, convulsing hiccups that went on for almost four days straight. It turned out the hiccups were the result of an abscess and an infection in his gallbladder.
Paul spent three days in the intensive care unit before returning home and, eventually, traveling to Canada to see family. His hiccupping and vomiting resumed, causing him to return to the emergency room soon after they returned home to Arizona.
There, doctors determined his gallbladder had burst and that infectious fluids were now filling his abdominal cavity. The liquid was pushing on his diaphragm, causing the hiccups.
After developing sepsis, a serious, life-threatening complication, Paul spent three days in the intensive care unit and another week in the hospital before returning home for a brief weekend respite with family. He then started vomiting again, causing him to return to the emergency room three days later.
This time, doctors determined his tumor was obstructing his stomach and the opening to the intestines. To rectify the issue, doctors had to put a tube through his nose to drain the stomach and then place a stent directly from the stomach to intestines, bypassing all the digestive organs between.
The experience was as miserable as it sounds, but, thankfully, his condition improved. After another week in the hospital, Paul returned to Dr. B., who took the previous month’s events as an indication that the cancer was not responding to the first chemotherapy regimen. He decided to switch Paul’s current chemotherapy regimen to one known as “5FU,” a combination of drugs often used to treat pancreatic cancer. Continuous cycles of chemo over the next four months with FOLFIRINOX followed.
In October, Paul had a CT scan, and in November, an MRI, to monitor progress. The fluid still remaining in his abdomen made it difficult to compare the results of both tests. In early December, he had another CT and MRI.
Believing more traditional chemotherapy might do more harm than good, Dr. B. advised Paul to begin radiation in early 2023 while taking oral chemotherapy.
Paul is also starting to feel more like himself – albeit gradually. After losing about 85 pounds, his appetite is making a slow return. Because of physical changes to his digestive anatomy, he’s had to follow a virtually liquid-only diet until recently.
Dr. B. and his team continued to review and research Paul’s case, looking for potential reasons Paul may have developed pancreatic cancer. Paul underwent genetic testing, among other avenues of research. While tests showed a gene abnormality, it wasn’t something geneticists thought contributed to his cancer.
Paul also, at his wife’s suggestion, started communicating with other pancreatic cancer patients and survivors, meeting several of them in person over dinner in Arizona.
As his condition improved, Paul reached out to the Seena Magowitz Foundation and is launching a fundraising campaign with the help of the pancreatic cancer research nonprofit. He knows his immediate and extended family will continue to support his efforts and progress, just as they have since day one.
“I have a loving, caring family – everyone has done everything they can to help,” Paul said. He’s quick to credit Norine for her tireless help, support and ‘round-the-clock care.
“Some would say that’s expected in a 40+-year marriage,” Paul said. “But her diligence and devotion are extraordinary and a huge factor in my survival!”
With his wife in mind, Paul also offered up some advice for other families facing serious medical diagnoses. “Be very conscious of your primary caregiver,” he said. “They are on virtually the same journey, experiencing very much the same as the one with the condition.”
He has some words of wisdom for the patient, too.
“Don’t even think about going to Google,” he said. “Even something posted yesterday – it’s already old news. Believe a cure is coming.”
Paul Borys: Pancreatic Cancer Patient Story