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“Nothing to Lose, but Everything to Gain:” 2-Year Pancreatic Cancer Survivor Richard Hsu’s Story

Written By: Julia Brabant
March 2023

Date of Diagnosis: March 2021
Current Status: In treatment (chemotherapy)

When Cupertino, California’s Richard Hsu first sought treatment at urgent care in early 2021, he did so because of an unexplained cough and ongoing abdominal discomfort. A chest X-ray didn’t reveal any obvious concerns, so doctors thought he had acid reflux. His primary care provider agreed and prescribed an acid reducer, which didn’t help.

Richard soon started experiencing distorted vision, prompting another trip to urgent care. There, the doctor suspected his symptoms might be consistent with those of a stroke and sent Richard to the emergency room. ER doctors administered tests and conducted a brain scan, which revealed a blood clot in his brain and an even larger clot in his heart.

Richard has patent foramen ovale, or PFO, meaning he has a hole between the upper chambers of his heart. Doctors thought this might have triggered a transient ischemic attack, or a “mini stroke” of sorts that can cause vision, speech and balance issues.

Richard’s medical team performed an MRI to get a better idea of what might have caused the clot in his heart. The test revealed lesions on his pancreas and liver, leading to a Stage 4 pancreatic cancer diagnosis.

Richard’s doctor installed a port to administer chemotherapy, and he began 12 rounds of chemo using FOLFIRINOX in March of 2021. After a brief break, he had another 12 rounds, and then another 12 more.

At that point, his body was ready for a break from the drug, which can have unpleasant side effects. Tests indicated his condition was stable, and his doctor was compassionate in accommodating his wishes. Yet, by December, his disease had shown signs of progression.

When the disease progressed, it was a wake-up call for me,” Richard said. “That’s when I started contacting survivors and learning about clinical trials and how critical they can be to a patient’s success.

After giving Richard a chance to build back strength, his doctors advised him to resume chemo using Folfiri. He hopes to join a clinical trial sometime soon and is actively looking for one that might meet his needs.

“For me, I want to try different treatments while I’m healthy enough to travel,” he said, noting that virtual appointments are not always possible in California, so he travels frequently so see specialists in different areas. “I want to be proactive while I’m still in good shape.”

Part of that proactiveness involves reaching out to pancreatic cancer survivors for insight, advice and support. He said Camille Moses and Steve Merlin, both of whom are 11-year survivors and advocates, were especially helpful in answering his questions and raising his spirits.

“Steve told me that when it came to treatment, he approached it as having ‘nothing to lose and everything to gain,’” he said. “That really struck me.”

He said meeting long-term survivors also shifted his mindset about the future.

My mind had been programmed to accept that I was going to die,” Richard said. “For the past two years, I’ve just been living day by day. After talking to Steve, Camille and other survivors, I learned there is hope for long-term survival. 

While chemotherapy and his search for a clinical trial continue, Richard makes an effort to keep his spirits up, believing that when the mindset improves, the body follows. He also hopes to help educate others about how important it is to get a second opinion and feel comfortable with one’s care team.

“There are doctors that try to enhance your quality of life, and there are doctors who think outside the box,” he said. “There are also new studies and clinical trials going on every day to help identify new treatment methods to try on top of today’s standard of care.”

While Richard’s adopted “Nothing to lose and everything to gain” mentality has helped him navigate the two years since his Stage 4 diagnosis, he’s also learned to ignore prognoses.

“A prognosis is just a prediction,” Richard said, noting that he’d already lived well past the “timeline” one doctor had given him. “It’s far from an exact science.”

As of March 2023, Richard is continuing chemotherapy, and his search for a clinical trial is ongoing.

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