“Great Santini” Author Pat Conroy Diagnosed with Cancer

“I celebrated my 70th birthday in October and realized that I’ve spent my whole writing life trying to find out who I am and I don’t believe I’ve even come close. It was in Beaufort (S.C.) in sight of a river’s sinuous turn, and the movements of its dolphin-proud tides that I began to discover myself and where my life began at fifteen.”

These are the words of noted author Pat Conroy. Conroy’s novels, such as The Great Santini and The Prince of Tides, were often based loosely (and in some cases pretty closely) to his own life. And now that life has taken another “sinuous turn.”

Conroy’s publishing company, Doubleday, released a statement saying:

“Author Pat Conroy has recently been diagnosed with pancreatic cancer. Pat is currently undergoing treatment at M.D. Anderson (a cancer center affiliated with the University of Texas), where he is receiving excellent care and support from his doctors. The Conroy family asks for privacy at this time as Pat fights this challenging illness with the same spirit of courage that has forged his writing career.”

Conroy took to his Facebook page to confirm his diagnosis:

“I have recently been diagnosed with pancreatic cancer. With the help of the wonderful people at M.D. Anderson I intend to fight it hard…. I owe you a novel and intend to deliver it.”

This is not Conroy’s first brush with serious health problems. In 2012, he found himself in a hospital with complications from Type 2 diabetes, high blood pressure and a failing liver. Used to eating and drinking whatever he felt like, his doctor told him he needed to turn his lifestyle around. Conroy stopped drinking, began to exercise, and worked with a nutritionist to clean up his diet. He lost 25 pounds and even opened a fitness studio in Port Royal, S.C!

What is the Pancreas and What Does It Do?

The pancreas is a fish-shaped organ which lies behind the stomach. It is made up of two types of cells:

• ​ Exocrine cells: These cells produce a pancreatic juice that includes enzymes which aid in the digestion of food in the small intestine, breaking up proteins, carbohydrates and fats.
• Endocrine cells: These are clustered in small groups (called the islets of Langerhans) scattered throughout the pancreas. These cells produce important hormones such as insulin, glucagon, and somatostatin.

Two Types of Pancreatic Cancer

Pancreatic ductal adenocarcinoma (PDAC) is the most common and deadly type of pancreatic cancer, accounting for 95 percent of all cases, according to the National Cancer Institute (NCI). PDAC is a cancerous overgrowth of pancreatic cells arising in the exocrine ducts of the pancreas.

​The less common form of pancreatic cancer is pancreatic neuroendocrine tumor (often called pancreatic NET). Apple founder and CEO Steve Jobs died from pancreatic NET in 2011.

Pancreatic Cancer is the Fourth Leading Cause of Cancer Death for Both Men and Women

• ​In 2015, the NCI estimated that 49,000 Americans will be diagnosed with pancreatic cancer and about 40,560 will die from it.
• Pancreatic cancer is more treatable when caught early, but the vast majority of cases are not diagnosed until late stages of the disease.
• Five-year survival rates approach 40 percent if the cancers are surgically removed while they are still small and have not spread to the lymph nodes.

Pancreatic Cancer is Difficult to Diagnose

​There is no reliable screening test for the early detection of pancreatic cancer. What’s more, the symptoms are often vague and easily confused with other diseases. Symptoms include:

• ​​Dark urine and clay-colored stools
• Fatigue and weakness
• Jaundice (a yellow color in the skin, mucus membranes, or eyes)
• Loss of appetite and weight loss
• Nausea and vomiting
• Pain or discomfort in the upper part of the belly or abdomen
• Back pain
• Blood clots
• Diarrhea
• Indigestion

Who Has the Greatest Risk?

Inherited genetic disorders cause 5 percent to 10 percent of cases of pancreatic cancer and certain genes can increase the lifetime risk up to 80 percent, according to the NCI.

Those who are at higher risk include:

• ​Cigarette smokers
• People with two or more relatives who have had pancreatic cancer
• People of Ashkenazi Jewish descent
• People who have the BRCA2, STK11 gene mutation
• People with chronic pancreatitis (inflammation of the pancreas)
• People over the age of 50

How is Pancreatic Cancer Treated?

Because pancreatic cancer is often advanced when it is first found, very few tumors can be cured by surgery alone. The standard surgical procedure is called a pancreatico-duodenectomy.

When the tumor has not spread beyond the pancreas and cannot be removed entirely, radiation therapy and chemotherapy together may be recommended.

When the tumor has spread (metastasized) to other organs such as the liver, chemotherapy alone is usually used. The standard chemotherapy is a drug called gemcitabine. FOLFIRINOX is a drug combination that significantly improves overall survival compared with gemcitabine.

Managing pain and other symptoms is an important part of treating advanced pancreatic cancer. Palliative care teams and hospice can help with pain and symptom management, and provide psychological support for patients and their families during the illness.

New Breakthroughs on the Horizon

A relatively new class of drugs, called immune checkpoint inhibitors (or PD-1 blockers), has been effective for some GI cancers. Although these drugs (nivolumab and pembrolizumab) are not yet FDA-approved to treat pancreatic cancer, clinical research trials are currently recruiting patients with the disease.