Pancreatic Cancer: Alvin’s story

Hepatobiliary surgeons John Matyas, MD, and Keith Nichols, MD, each have in their offices at Riverside Methodist Hospital a small bookshelf built by one of their patients — Alvin Immell. The shelves were Alvin’s way of heeding their advice to “keep moving” as he recovered from surgery for pancreatic cancer and thanking them for getting him through such a complicated surgery in the first place.

Alvin had undergone the Whipple procedure— or pancreaticoduodenectomy — at Riverside Methodist. The surgical procedure for cancer in the pancreatic head and the only chance for cure of the disease, the Whipple involves the removal of the gallbladder, common bile duct, a portion of the duodenum and the head of the pancreas.

It is a complex and extensive procedure that once had a mortality rate as high as 20 percent to 30 percent. At hospitals considered high-volume, such as Riverside Methodist, where specialized surgeons perform 10 or more procedures a year, the mortality is now 4 percent to 5 percent.

Richard Kennedy, MD, Alvin’s family doctor in Chillicothe, Ohio, sent the 71-year-old husband, father, grandfather and great-grandfather to Riverside Methodist to find out why he was more tired than usual and losing blood. Endoscopic ultrasound revealed Alvin had pancreatic cancer and that he was a candidate for surgery.

“Other than arthritis, I have felt well most of my life, so I was scared to death going into that surgery,” Alvin recalled. “But Dr. Matyas made me feel at ease. He used the paper on the examining table I was sitting on to draw exactly what he was going to do to me in surgery. He told me I’d be in the hospital for up to two weeks afterward... that I would probably need chemo and radiation... how sick I’d be at first... and that after six or eight months, I’d start to feel human again. And so far, he’s been right on the money.”

Alvin underwent the six-and-a-half-hour procedure six or seven days after learning he had pancreatic cancer — and was close to finishing daily rounds of radiation, plus a 24-hour-a-day regimen of chemotherapy.  “I’ve been carrying a bag around with me 24 hours a day,” he said.

He’s had no pain since the surgery, though he still feels a bit tired and worn out. “Dr. Matyas told me the more I move around, the better I’m going to feel, so I decided to build him and Dr. Nichols some bookshelves,” he said. He worked for a half hour at a time between hour-long breaks.

“There are not many doctors I know who call your wife twice a day while you’re in the hospital to tell her how you’re doing, but these two doctors did,” Alvin said, adding the entire team who cared for him gave him their very best. “Considering what they’re able to do, they’re not highfalutin or stand-offish. They’re like family to us.”

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