A few weeks after his 60th birthday, Miguel Pereira noticed that his urine was darker than usual. He made an appointment with his primary care physician, who ordered bloodwork. When the results showed very high levels of bilirubin – a normal byproduct of red blood cells – his doctor advised him to go straight to the Emergency Department.
For adults, elevated bilirubin levels can mean a problem in the liver or a blockage in the bile duct. The CentraState team performed specialized endoscopic procedures to unblock Miguel’s bile duct and check for any related issues. They discovered that a pancreatic tumor had been compressing his bile duct – and a biopsy confirmed pancreatic cancer. Alexander Itskovich, MD, hepatobiliary and advanced gastrointestinal (GI) surgeon and medical director of the Statesir Cancer Center at CentraState, met with Miguel in the hospital that evening.
“Dr. Itskovich explained his treatment recommendations, and I put my trust in him,” says Miguel, a Colts Neck resident. “I’m so thankful I went to the doctor when I did, because otherwise it might have been too late.”
“Miguel took everything in stride, which helped him do well,” says Dr. Itskovich. “A positive outlook can be beneficial, because mood can have a major impact on the immune system.”
Chemotherapy was the first step, as it can help determine whether a patient with pancreatic cancer is a good candidate for surgery while increasing the chances for a successful outcome. Miguel underwent 12 sessions of chemotherapy under the care of CentraState oncologist Aileen Chen, MD. Imaging results showed a slight decrease in tumor size – signifying that the cancer had not yet spread to other areas of the body – and Miguel was ready for surgery.
A Complex, Lifesaving Surgery
Working with an interdisciplinary team, Dr. Itskovich performed a highly complex surgical intervention called the Whipple procedure to remove Miguel’s pancreatic cancer and reroute his digestive system accordingly. This included removing his gallbladder, duodenum (first part of the small intestine), part of the stomach and 40% of his pancreas. He then reconnected Miguel’s bile duct, the remaining portion of his pancreas and the remaining portion of his stomach to the small intestine to enable food digestion. This meticulous procedure took about seven hours.
“I didn’t have any pain or major discomfort after the procedure,” says Miguel. “It was the first time I was ever in the hospital, and the care was amazing every step of the way.” Following six more chemotherapy sessions, Miguel’s CT scan showed no signs of cancer.
Setting Sights on What’s Important
For Miguel, this year has been “like a rebirth.” He went camping with high school friends and made more time for family. He even traveled to his birthplace in South America to experience a soccer game at Centenario Stadium, where the first World Cup was played, with three generations – including his son, Paul, and his father, Julio.
“We’re making the plans we used to just talk about,” says Miguel, who has Germany and England on his list of future soccer trips. “Watching my dad’s face light up when he sees me and my son means the world to me. This is what life is all about.”
CentraState’s High-Risk Pancreatic Cancer Screening Program
The Statesir Cancer Center at CentraState offers pancreatic cancer screenings for individuals whose family history puts them at a higher risk of developing pancreatic cancer. Pancreatic cancer screening holds great promise in diagnosing pancreatic cancer earlier, at a stage when the cancer is more treatable. Visit centrastate.com/pancreatic-screening to learn more about risk factors and find out if you are eligible for a screening.
