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Matthew Rosenblum continues maintenance chemotherapy
Julia Brabant, January 2024Diagnosed with Stage 4 pancreatic cancer at age 32, Matthew Rosenblum continues maintenance chemotherapy
Matthew Rosenblum’s pancreatic cancer journey had more than a few twists and turns, but after some trial and error, the 35-year-old once told he had one to three so-called “good years” left to live is now planning a once-unthinkable return to professional life.
Diagnosed with Stage 4 adenocarcinoma in 2020 at just 32, Matthew, now of Hazel Park, Michigan, had recently relocated to Durham, North Carolina, when he developed a range of unusual symptoms. Dark urine, pale stool, nausea and vomiting, and itchiness were among them, with the itchiness worsening at night and primarily affecting his hands and feet.
“This was a particularly gruesome torture,” Matthew said.
She tried to put my mind at ease. She looked at me and said, ‘You definitely don’t have cancer.’
After back-to-back nights of intense nighttime itching, Matthew, on the advice of his then-girlfriend, went to a local urgent care. Because he was new to the area and the COVID-19 pandemic was ongoing, he hadn’t found a primary care physician yet.
At urgent care, blood tests showed elevated AST, alkaline phosphatase and bilirubin levels. These results were so troubling that, at first, the assumption was that Matthew had a severe drinking problem. After ruling that out, the urgent care doctor told Matthew to go to the emergency room for further testing. He did so that day, undergoing an ultrasound, an ERCP and a CT scan.
While awaiting test results, doctors determined Matthew had a stricture of the bile duct; a blockage preventing bile from moving from his liver to his small intestine. The resulting buildup was the cause of his symptoms. Doctors installed a stent to keep the bile duct open and obtained brushings for cytology tests, which determine whether cells are cancerous.
After reviewing Matthew’s tests, his team discovered he had atypical ductal cells. However, whether those cells were malignant was unclear. Additional tests suggested gallstones, so doctors performed surgery to remove his gallbladder. When his symptoms returned despite the surgery, he returned to the gastroenterologist, who ran tests confirming that Matthew once again showed elevated AST, ALT and bilirubin levels. The GI doctor ordered an additional endoscopy.
“She tried to put my mind at ease,” Matthew said. “She looked at me and said, ‘You definitely don’t have cancer.’”
It can help tremendously to have people to talk to who’ve been in similar positions. I didn’t get too involved with organizations while I was sick. But, now, I can do it, I enjoy doing it and I have a strong desire to use my own experience to help other people.
Standing more than 6’ tall and appearing well-nourished, Matthew was, by all obvious indications, a healthy, fit young man. At this point, none of the diagnostic tests suggested a very serious cause. He felt confident in his doctors and wasn’t worried.
Several hours later, Matthew received test results via text message: His biopsy was positive for adenocarcinoma, a type of cancer that develops when exocrine cells in the pancreas multiply rapidly. However, at the time, Matthew recalls that his doctors never used the words ‘pancreatic cancer.’ As a result, Matthew’s understanding was that he likely had ampullary cancer, a cancer of the ampulla of Vator.
This type of cancer is also rare but far less lethal than cancer of the pancreas. Despite this difference, the surgical response was the same.
Matthew’s medical team wanted him to have a Whipple procedure (also known as a pancreaticoduodenectomy), an extensive surgery often used to treat eligible pancreatic cancer patients. Upon starting, they realized his cancer had metastasized to several other areas, including his liver, lymphnodes, abdominal cavity and omentum. Because of the metastasis, the Whipple was no longer an option and doctors had to abort their efforts.
That was a tough pill to swallow upon waking.
I woke up and found out I wasn’t dying. It was like emotional whiplash.
“They told me they had to abort the surgery,” Matthew said. “I knew enough about pancreatic cancer to know what that meant. They were telling me I was going to die, and not in some distant future, but soon.”
His doctors concurred that Matthew’s prognosis was grim. However, because he was younger and stronger than the “average” pancreatic cancer patient, they thought that, through a combination of good luck and aggressive treatment, he might have a few years left.
With limited options, Matthew began chemotherapy with FOLFIRINOX, a standard front-line choice for patients with pancreatic cancer. His initial tests were positive, but follow-ups showed chemo wasn’t working anymore and that his tumor had grown and invaded his liver.
Returning to the drawing board, his care team decided to switch his chemotherapy regimen. Because Matthew was a BRCA2 mutation carrier, his team recommended a combination of three different drugs: gemcitabine, abraxane and cisplatin. The last one, cisplatin, was a platinum-based drug and a targeted treatment option for BRCA-2-positive people.
Matthew spent around six months taking the second chemo cocktail. This time, it resolved the lesions on his liver. His care team determined that he was now stable enough for another attempt at the Whipple.
This time, Matthew was able to have the full procedure. It was a tremendous and once-unimaginable success. After the surgery, Matthew showed no sign of metastatic disease.
“I woke up and found out I wasn’t dying,” he said. “It was like emotional whiplash.” Matthew spent several months recovering from the surgery and adjusting to the new dietary changes that come with a Whipple. He was never especially good at regulating his food intake, so doing so after surgery was difficult. But, he adds, “I made it work.”
Now, over a year and a half post-surgery, Matthew continues to show no sign of cancer. In the interest of maintaining his remission, Matthew takes a PARP inhibitor, a special kind of oral chemotherapy, to help prevent recurrence in patients, who, like him, are BRCA mutation carriers.
Matthew has follow-up tests and scans every three months, and he’ll do so for another five or so years. His last CT/MRI was on January 9th of this year and it continued to lack signs of recurrent metastatic disease. He is also in the process of switching oncologists so that he can see one in Detroit, rather than traveling back and forth to North Carolina like he and his partner, Natalie, have done for the past year.
While he’s happy to reduce the burden of out-of-state travel for follow-up visits, he does feel some trepidation about switching doctors.
As Matthew’s health improves, he also continues to become more active within pancreatic cancer advocacy and research circles.
“It can help tremendously to have people to talk to who’ve been in similar positions,” Matthew said. “I didn’t get too involved with organizations while I was sick. But, now, I can do it, I enjoy doing it and I have a strong desire to use my own experience to help other people.”
While Matthew is more than happy to candidly share his own experiences with people facing similar hardships, he’s cautious about doling out advice.
“Advice in this case can be very complicated – everyone’s situation is so different,” Matthew said. “Ultimately, what you have to do is find a way to make this livable for yourself. It doesn’t matter what it is or what you do, but you have to figure out what gets you through and gives you the confidence to persist.”
For Matthew, irreverence proved helpful.
“I’d make jokes,” he said. “I’d make fun of it and laugh about it. I didn’t feel a need to always behave like a model patient. If you happen to see me at a pancreatic cancer event, buy me a drink, and maybe I’ll tell you the good parts.”
Matthew also drew inspiration from the work of the English philosopher and cancer survivor Gillian Rose. In Love’s Work, (2011) Rose reminds readers that “comedy is homeopathic: it cures folly by folly.” (143). Matthew says laughter was his natural response to his diagnosis and one that carried him through treatment. It also powers his style of survivorship to this day. Still, he appreciates that every patient and survivor is different.
Beyond the jokester persona, Matthew knows how to get serious. For example, he believes there needs to be a much larger discussion about health equity and how pancreatic cancer impacts people from different backgrounds. With his academic experience in Jewish social science, Matthew is particularly passionate about promoting health literacy within the Jewish community and educating its members about the various genetic conditions that affect them.
“I speak from experience,” he says, pointing to the documented connection researchers have drawn between his BRCA-2 mutation, his diagnosis and his Jewish identity.
Matthew has concerns about the lack of awareness on these matters despite the robust efforts of Jewish medical advocates. Of course, Matthew notes, Jews are not alone in this. African Americans are also disproportionately affected by pancreatic cancer. Evidence suggests that many other groups also have a predisposition for pancreatic cancer.
On a related matter, Matthew firmly believes ageism is a significant impediment to the modern treatment of pancreatic cancer patients.
“We must break the influence of this ageist bias,” Matthew notes. “The widely held assumption that pancreatic cancer is a disease of the elderly is doubly problematic because the association to the elderly can be used to reinforce some hurtful and disempowering stereotypes about age and ability.”
Matthew also considers it problematic that there seem to be a growing, but still quantitatively small number of adolescent and young adult pancreatic cancer patients whose underlying conditions go misrecognized, making their survival less likely.
“This was very nearly my story,” Matthew said.
Matthew also feels that more attention to income equality is necessary and that patients need to know more about the financial challenges that accompany a diagnosis and what resources might be available to help them.
“There needs to be more supportive care for people in financially tenuous situations,” Matthew said. Matthew’s own professional background is in geography and social science. Now that he’s feeling strong enough to return to the workplace, he hopes to use his combination of personal experiences and professional skills to help people facing cancer.
Aside from the Seena Magowitz Foundation, Matthew’s involvement in the cancer community primarily revolves around his work with the Pancreatic Cancer Action Network (PanCAN) and its Michigan affiliate. A notable achievement was his interview with WXYZ Detroit, where Matthew shared his story and promoted PanCAN Michigan’s annual PurpleLight event to local and national television audiences.
“Speaking as a survivor at PurpleLight Michigan was an incredibly fulfilling experience,” said Matthew. In recognition of his contributions, Matthew had the honor of representing PanCAN Michigan this year on World Pancreatic Cancer Day in the group’s “Survivor Spotlight.”
Matthew also has plans to share his pancreatic cancer journey with Let’s Win Pancreatic Cancer and has several other collaborations in the works.
Most recently, Matthew has been a guest on several cancer podcasts.
First, he appeared on the Patient from Hell podcast produced by Manta Cares, a startup founded and run by two breast cancer survivors.
During the episodes, Matthew delves into his background in geography and academia, his experience with pancreatic cancer and the connection between cancer and Jewish identity. Shortly afterwards, he accepted an invitation to be on the Project Purple Podcast, hosted by the founder and CEO of Project Purple, Dino Verelli. This appearance had more of a singular focus on pancreatic cancer.
Matthew lives in metropolitan Detroit with his beloved partner, Natalie, and their 6-year-old pug, Monique. An avid basketball fan and a die-hard fan of the University of Kentucky Wildcats and the New York Knicks, he’s also passionate about the footfall team at Florida State, his undergraduate alma mater. Matthew’s hobbies include collecting rare coins and currency, a pursuit he began as a Cub Scout in elementary school.
Matthew has shown no sign of cancer since his Whipple surgery May 2, 2022.
