Roger Caplinger At The Finish Line

Roger Caplinger and Family

ROGER CAPLINGER

Milwaukee Brewers Medical Director Handled a Pancreatic Cancer Curveball

Written By Julia Brabant
November 2021

Date of Diagnosis: December 1, 2017

Current Status: No signs of active cancer

Covering the Bases: How The Milwaukee Brewers Medical Director Roger Caplinger Faced The Fight To Strike-Out Pancreatic Cancer

As Medical Director for Major League Baseball’s Milwaukee Brewers, Roger Caplinger performs his best work behind the scenes, rather than behind the plate – but a 2017 pancreatic cancer diagnosis made him an increasingly public face in the fight to strike out the deadly disease.

As a longtime medical professional, Roger wasn’t one to “wait and see” when he started noticing unusual changes in his health. When his symptoms ranged from increasingly severe stomach pain to dark, discolored urine, he sought prompt medical treatment.

Lab tests revealed that his bilirubin levels and liver function test results were off the charts, prompting doctors to conduct a CT scan. Thinking Roger’s symptoms might be the result of gallstones, his primary care physician, Dr. Mark Niedfeldt, moved forward with an MRI.

By December of 2017, Roger, his wife, Jackie, and their two boys, Kyle and Brett, found out that his doctors suspected pancreatic cancer. Roger soon learned that Dr. Douglas B. Evans, M.D., F.A.C.S., one of the world’s premier pancreatic cancer specialists and researchers at the nearby Medical College of Wisconsin in Milwaukee, would take his case.

In conjunction with Dr. Kulwinder Dua, M.D., D.M.S.c., F.A.C.P., F.R.C.P, F.A.S.G.E., Dr. Dua performed an endoscopic ultrasound with a biopsy to assess Roger’s condition and determine whether his primary care physician’s suspicions were correct. He also placed a stent in Roger’s bile duct to help relieve symptoms. Tests confirmed that Roger had a Stage 1 malignant tumor on the head of his pancreas. While the news was certainly sobering, Roger recognized that he was among the lucky few who catch the condition at such an early stage, and that this was good news as far as treatment, options and prognosis.

Dr. Evans and other members of Roger’s medical team, among them Dr. Susan T. Tsai, M.D., Dr. Beth A. Erickson, M.D., F.A.C.R., F.A.S.T.R.O, and Dr. Paul S. Rich, M.D., started Roger on an intense, six-week regimen that involved radiation five times weekly and chemotherapy once weekly. At first, his body adjusted and reacted well, but Dr. Erickson warned him that many patients hit roadblocks after week three.

“She was right on,” Roger acknowledged. His care team gave his body a six-week break at the conclusion of radiation and chemo before scheduling his next step: surgery.

Roger would undergo the Whipple Procedure, which involves removal of the head of the pancreas, the first part of the small intestine (duodenum), the entire gall bladder and the common bile duct. What was already an extremely invasive and complex surgery became even more so when doctors discovered that he had an abnormality. His hepatic artery, which supplies blood to the liver and gallbladder, ran through his pancreas. This resulted in Dr. Evans and his team having to meticulously reroute the surgery, adding several hours of length and an even higher degree of difficulty to the procedure.

“Dr. Evans is an unbelievable technical surgeon,” Roger said, noting that the Whipple may be the most invasive, intensive abdominal surgery performed in modern medicine. “I was 50 and relatively healthy before all of this – I don’t know how so many people go through it in their 70s.”

Recovery was rough, and he soon started experiencing low-grade back pain. He again sought treatment.

“What you don’t know, you can’t fix,” Roger said. “Dr. Evans knew he could count on me to come in and tell him everything I knew and was feeling.”

It turned out his pancreas had begun to leak. After several diagnostic tests, two drains were placed in the areas of the surgically repaired pancreas to allow healing to take place. Additional review by Roger’s care team had doctors recommending he consider what would be the first of several clinical trials aimed at both treating patients and advancing pancreatic cancer research.

The first clinical trial involved the use of an Elekta Unity MR-Linac, a device that Roger says looks “straight out of Star Wars.” It uses magnetic resonance imaging and radiotherapy together to help target cancer cells more directly while avoiding live tissue.

At first, Roger was resistant to enrolling in the clinical trial. At his wife’s urging, though, he moved forward.

“What if you don’t do the trial, and then the cancer comes back?” She’d asked. “We should also do this trial and help other pancreatic cancer patients.”

With that in mind, Roger also enrolled in an IIT-TSAI-META-KAROC-REV2 clinical trial that explored whether doxycycline, which works as an acne antibiotic in mice, would help stimulate cancer stem cells.

In addition to participating in clinical trials, Roger underwent testing to see if he had any chromosomes or genetic markers that predisposed him to pancreatic cancer, or cancer in general. He thought something might appear on the tests because he was an otherwise healthy man who had no known family history, wasn’t overweight and didn’t smoke or drink heavily. Yet, the tests showed no obvious predispositions.

He also dropped 50 pounds after his diagnosis and hired a nutritionist to help him figure out how to adjust to his new dietary needs. Roger could no longer tolerate much of the fat content in foods and needed to adjust how he fueled himself by adding protein to his diet.

He had to take Creon pills, which serve as pancreatic enzyme replacements, but he soon learned his body couldn’t break down the capsules the medicine came in. He broke the pills apart and emptied the contents into applesauce until a friend and local business owner/compounding pharmacist found a way to repackage the pills into vegetable-based capsules. Now, that friend does the same for other cancer patients facing similar struggles with Creon.

While Roger has reached a point in his battle where he might be able to return for follow-ups on an annual basis, he chooses to instead have them every four months. He recognizes how lucky he is to that his Major League Baseball health insurance helps make this feasible, and he also notes how grateful he is for the work of Dr. Evans, going so far as to secure the doctor an autographed jersey from his all-time favorite player, Carl Yastrzemski, a former leftfielder and first basemen for the Boston Red Sox.

He also noted how much one of his early interactions with Dr. Evans shaped his perspective moving forward. He recalled the day one of Dr. Evans’ nurses, Gabby, told him, “The boss wants to see you.”

Feeling like he was on his way to the principal’s office, Roger instead found a five-year pancreatic cancer survivor, Kelley, sitting alongside the doctor in his office; a woman whose pancreatic cancer was almost identical to Roger’s.

“This is you in five years,” Dr. Evans had said.

While Roger holds Dr. Evans and his entire care team in high regard, he also has immense gratitude for his employer, Milwaukee Brewers Owner Mark Attanasio, and the entire Milwaukee Brewers organization, which he says has been a huge source of support along the way. Among other efforts, the team helped orchestrate a 2019 “Purple Tie Guy” fundraiser for Dr. Evans’ We Care Fund, which raises funding for pancreatic cancer research and clinical trials. The fundraiser generated more than $50,000 for the cause.

Roger also calls his wife, Jackie, his biggest cheerleader, noting that caregivers deserve the same degree of support and applause as doctors. He said that, since his diagnosis, he and his wife have also become supporters of Kathy’s House, a nonprofit that provides housing to out-of-town cancer patients undergoing treatments in Milwaukee and their caregivers.

Roger also recalled how his wife and sons showed up during one of his treatments with brand-new tattoos bearing the phrase, “Battle Ready.” Supplied by their friend and colleague, Bryson, the family had begun to use it as a mantra during Roger’s treatments, and they now had it tattooed in Roger’s handwriting on the inside of their wrists. Originally resistant to tattoos, Roger’s left wrist now bears it, too.

L-R Roger Caplinger and Dr. Douglas Evans

Roger Caplinger and His Wife Jackie

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