Lia Wu

Lia, a mother of four from Tahoe City, California, was no stranger to lower back pain, having struggled with right-sided sciatica for several years. She’d also fallen during a run back in 2021 and injured the same area, but when the pain continued to worsen, she scheduled an appointment with her doctor. Lia had visited the same doctor about a year prior due to ongoing shoulder pain on the left side and an odd, involuntary breathing sensation she’d been experiencing. The doctor attributed her symptoms to depression, suggesting she consider taking antidepressants.

The problem was, Lia wasn’t depressed – she was in severe, worsening pain. The pain intensified to the point where Lia landed in the emergency room, and when she described her symptoms to a nurse practitioner there, he seemed to know something was wrong.

“I knew right away he was thinking cancer,” Lia said. “I could see it in his eyes.”

Medical professionals performed a series of scans on Lia, and the nurse practitioner than called Lia and delivered sobering news.

“You have metastatic cancer,” he’d told her, adding that the cancer in her abdomen had made its way to her liver and peritoneum. While he could tell the cancer originated from somewhere in the abdomen, he wasn’t yet sure exactly where it had started and urged Lia to see an oncologist right away.

“I was in complete shock,” Lia said, of hearing her official diagnosis. “Now I know, in retrospect, that chronic pain is not normal. If there’s chronic pain, there should be some answers – we shouldn’t be getting doors shut on us.”

Lia soon underwent several tests and biopsies, at which point doctors determined that her cancer had, in fact, originated from within her pancreas. They started her on FOLFIRINOX, a form of chemotherapy often used to treat advanced or metastatic pancreatic cancer.

Lia asked her oncologist about her prognosis and felt deflated by her response.

“It was very negative,” Lia said. “I get that they have to deal with facts, but I left this appointment with no hope; like I was already dead.”

She asked the oncologist if her outlook would change if Lia responded well to the chemo, but the doctor shook her head, again leaving Lia with little hope. At this point, she requested a new oncologist, finding the new one to be smart, factual and hopeful about her situation all at once.

Tests showed that the FOLFIRINOX was, in fact, working for Lia, clearing out the metastasis on imaging. However, Lia’s CA 19-9 numbers, which can sometimes indicate the presence of certain cancers, started rising, leading her care team to question if the effectiveness of the FOLFIRINOX was waning.

At this point, Lia switched from FOLFIRINOX to a combination of gemzar, Abraxane and cisplatin known as “The Triplet.” She’d also drafted that letter to her care team urging them to be as aggressive as possible with her treatment, prompting them to explore potential clinical trials.

Lia has several genetic mutations, including a KRAS G12-R mutation and an Mtap deletion. While both can raise the risk of cancer, they may also help people who have them qualify for certain treatments or trials they may not otherwise be able to access. Lia landed on the waitlist for several such trials, but has not yet been able to join one.

Lia did, however, visit a surgeon in Pennsylvania known for his expertise in Hyperthermic Intraperitoneal Chemotherapy, or HIPEC, at the suggestion of her oncologist. HIPEC is a specialized cancer treatment for certain types of cancer that have spread to the lining of the abdominal cavity. In layman’s terms, HIPEC involves a specific type of surgery called cytoreductive surgery, which removes visible tumors inside the abdomen, followed by heated chemotherapy treatments.

The hope is that, if Lia’s CA 19-9 numbers trend downward, she may become eligible for this type of treatment. In the meantime, though, she continues to undergo chemotherapy under the close watch of a care team that sees the potential for hope.

While her oncologist notes that a “cure” may be unlikely in Lia’s case, there is potential for what he referred to as “durable remission,” or a lengthy period where Lia would remain free from disease.

“The word ‘remission’ is fantastic,” Lia said. “It gives people a chance to live with cancer as something they can manage. That does give me more hope – I’m just going to keep putting one foot in front of the other.”

There is another drug currently awaiting approval by the U.S. Food & Drug Administration that may be of benefit to Lia due to her KRAS mutation. She also hopes that, one day, she may be also able to get onto a maintenance drug. In the interim, she’s continuing to follow doctors’ orders, and she’s also making a point to seek out positive, inspiring survivor stories.

“I Googled ‘Stories of hope – pancreatic cancer, Stage 4,’” Lia said, finding that these stories were not as hard to find as some think. She also joined a Seena Magowitz Foundation support group for people newly diagnosed with pancreatic cancer, finding it to be more positive and inspiring than another, local support group she’d tried in the past.

“I like the way Dr. Perry Francis leads the group,” she said. “He makes it feel like, while it’s OK to feel a little depressed, they’re there to pick you up, get you back on track and have you thinking positively.”

Through her survivor research and participation in the group, Lia became increasingly close with long-term pancreatic cancer survivor Steven Merlin. In addition to serving as source of strength and knowledge, Steven has also become a dear friend to Lia, accompanying her to an ERCP appointment and otherwise acting as a resource and sounding board throughout her cancer experience. Lia also joined Steven at this year’s Seena Magowitz Foundation “Power of Us” event in Milwaukee, Wisconsin, where the pair joined about 100 other pancreatic cancer survivors at various stages in their journeys.

Lia’s older sister, CPA and mother-of-two Natalie Holton, also joined Lia and Steven at the event, offering the same level of loyalty, support and compassion she’s shown Lia since day one.

“I didn’t know very much at all about pancreatic cancer prior to my diagnosis, but I do think the perception is that it’s a death sentence; that there’s not a lot of hope,” Lia said. “That really isn’t accurate, and many of the statistics out there are old and skewed. A lot of people are now surviving; we’re seeing so much hope on the horizon just within this past year that I’ve been treated – whereas 10, 15 years ago, that wasn’t the case.”

Lia has also started connecting with other people with Stage 4 pancreatic cancer, some of whom Steven Merlin sent her way for encouragement and support. When speaking with them, she makes a point to highlight the power of positive thinking.

“Some improvement comes from treatment, and some comes from state of mind,” Lia said. She also encourages people facing similar health hurdles to reach beyond their immediate families and social circles for support.

“Go ahead and use the support of a group like Seena Magowitz Foundation to meet others who can provide support and hope,” she said. “Find that support system outside of your family and friends, and be honest about what you need. Remind them that you’re still the same daughter, mother, friend, etc. Meeting with other survivors and patients…what a blessing.”

Lia continues to monitor her condition closely and explore potential existing and emerging treatment options.