Professional Insight, Personal Resolve Helped Dr. Marty Weiner Navigate Pancreatic Cancer
Contributing Writer
Julia Brabant
November 18, 2024
Diagnosed: October 2018
Current Status: Battling stage 3 pancreatic cancer
Martin (Marty) Weiner, M.D., a retired Lake Forest, Illinois physician, confronts pancreatic cancer with a blend of professional insight and personal resolve. While Marty built his career as an OB/GYN, he draws upon his knowledge of the medical field, the insurance system and the patient experience to navigate his own pancreatic cancer journey – and help others do the same.
Marty’s symptoms first became apparent during the fall of 2018, when he began dropping weight and experiencing abdominal pain. He was going to have an abdominal CAT scan, but a passing kidney stone sent him to the hospital first, with the stone ultimately passing as Marty arrived in the emergency room. Thinking the stone likely caused Marty’s abdominal pain, doctors planned to cancel the CAT scan, but Marty recommended they move forward with it anyway, urging them to take the scan “with contrast,” meaning it would rely on special dyes to make certain parts of the abdomen more visible.
After conducting the scan and reviewing the results, Marty’s doctor in the emergency room, then a colleague, offered up sobering news.
“He said, ‘I can’t sugar coat this; there’s something on your pancreas,’” Marty recalled. “As a colleague, he was pretty straight with it.”
A biopsy conducted two days later confirmed the presence of cancer, and things moved quickly after that. Marty met with a pancreatic surgeon and an oncologist that same evening. Marty’s care team wanted him to start chemotherapy using FOLFIRINOX, and he did so the following week. He was later switched to a combination of gemcitabine and Abraxane. While his tumor had responded well to the FOLFIRINOX, there were concerns about resistance, prompting the switch to the new regimen. These chemotherapies followed by radiation and then surgery are the more or less standard options when pancreatic cancer is considered operable. But if a cancer is operable, and if so, what operation to perform, is not always clear.
Local Chicago-area physicians recommended removing the distal part of the pancreas where the tumor was situated. This would have been less invasive than a complete removal of the pancreas and spared the portion of the pancreas that produces insulin. He knew that this alone would have left possible residual tumor on arteries next to the pancreas (celiac and hepatic arteries) that were surrounded or encased in cancer and increased his risk of the cancer coming back in his abdomen in a couple of years. The local doctors said they were unable to remove those vital arteries at that time.
As a physician, himself, Marty understood the value of a second opinion, and he sought one out, finding doctors at the Mayo Clinic that were able to perform his pancreatic surgery and remove the affected arteries at the same time. This involved taking an artery from his leg, attaching it to the aorta and using that to replace the blood supply to his stomach and liver. This surgery had increased risks, but a much better chance for a cure, or at least longer time to recurrence. This more advanced surgery was performed after chemotherapy and radiation. Marty attributes this to his still being here six years after his diagnosis of Stage 3 pancreatic cancer.
After the 2019 procedure, Marty had follow-up visits every three months. Eventually, he began having them every four months, and then every six months, until a scan revealed a small spot on his right lung. When the spot grew to be about 1 cm, Marty’s care team decided to remove it. During that process, doctors identified several additional spots in his lung, two of which turned out to be adenocarcinoma. Fortunately, there was no evidence of cancer in any other part of his body.
His team continues to monitor other spots in his right and left lungs, which may also be adenocarcinoma. For the time being, Marty is back on chemotherapy with gemcitabine and Abraxane. While he didn’t lose his hair during the first go-round, he did this time.
“I have a nice, shiny head,” he said. “I hope that’s my biggest problem.”
Marty admits his journey has been complicated, and multiple consults have given him multiple options, many of which did not exist even a few years ago. Thankfully, the doctors usually explained things in plain English so his wife (who is not a medical professional) could understand.
Marty states it is essential to go into each visit with a list of questions and always ask about options and new study medications or treatments. If, after the visit, questions remain answered, he says to use the portals to send a message. These are usually screened by the doctors’ mid-level assistants, so you will not bother the doctor with questions that they have been authorized to answer. The Nurse Practitioners (APN) and Physician Assistants (PA) have usually worked in this one area of medicine for a considerable time and can answer many questions that the physician routinely gets so you should not feel bad about bothering the doctor. If the question was not routine, they will immediately involve the doctor. Marty says the old saying is true – there is no such thing as a dumb question.
Marty’s life does look different than it did before his diagnosis – he has to take blood thinners due to the artery transplant and a stent, and he also takes CREON to help with digestion and several different medications daily for digestive discomfort. Digestive issues are a common problem for many people with pancreatic cancer, and Marty encourages those who have them to confer with their doctors about what they might do to manage it better. He also states that the neuropathy that chemotherapy causes affects his hands. This has prevented him from operating, but it does not significantly affect his normal daily activities.
“If it wasn’t for a great wife and family support system, this journey would have been nearly impossible. I’d have lost even more weight,” said Marty, who dropped to 118 pounds (from an initial weight of 182 pounds) at one point during his treatment. “It takes time to figure out what does and doesn’t work, food-wise, and a patient family that will push to keep you going when things are most difficult is important.”
He says the loss to 118 pounds came after he was hospitalized for sepsis about eight months after his pancreatic surgery. Marty said the sepsis could have easily killed him in his weakened state if he did not call his doctor at the very first sign of fever so antibiotics could be started immediately.
He’s also grateful for his care team at the Mayo Clinic, which he credits with saving his life, and for his own medical knowledge and how it helped him navigate this experience. And, now, he is grateful to organizations like PanCan and the Seena Magowitz Foundation that lead him to meet new physicians from around the country who came to the Seena Magowitz Foundation’s 2024 Power of Us fundraiser. This exposed him to other pancreatic cancer survivors who shared valuable insights and, more importantly, to specialists from around the country who attended and were willing to talk to us over the two days of the conference in a friendly, non-clinical environment. How often can patients share a meal with these leading experts and feel free to ask them for their opinions?
“I’m glad I didn’t accept the first couple of opinions I got on how to treat the tumor,” Marty said, when asked whether he considered his existing medical knowledge to be a blessing or a curse. “They wouldn’t have worked (the initial recommended treatments); I know that as a physician. You don’t have to just ‘accept’ the first opinion.”
He states the varied options he has had to consider for his treatment are too complicated for this piece. Marty went from having limited options to multiple options that can be confusing, even to a physician. Molecular treatments to mRNA vaccines to other promising vaccines, from doctors telling him they do not have good treatment options (in his opinion) to now, having much better, but difficult, good choices to make.
Marty and his family continue to research potential treatment options and explore every avenue available to treat his cancer. With a knowledgeable care team, a growing number of contacts in the pancreatic cancer community and the support of his loved ones, he remains vigilant and hopeful, knowing the right treatment may well be just around the corner. He also admits that the choices can be overwhelming, even for a retired physician.