William Ramshaw resides in the expansive Pacific Northwest. He is a six-year survivor of pancreatic cancer and has written a memoir Gut Punched! Facing Pancreatic Cancer.

William Ramshaw

With close to eight billion people on earth, as much as we would like to bundle cancer up into neat little packages, it's not that easy. Today we classify it by where it occurs, such as in a breast, the brain, or in my case, the pancreas. Rather than using this all too tidy classification system, I suspect everyone’s cancer is as night and day different as every person on the planet is different. Thus, everyone’s cancer should be classified to them by their name rather than by its location.

Having survived a type of cancer few do doesn’t make me the authority on all things cancer. At best I’m an expert on my cancer alone and no one else’s. Considering this, I am always hesitant to offer advice on anyone’s cancer treatment. I always leave that up to their doctors and them.

I avoid offering advice based on what worked for me or my Aunt Susie. It’s game time. They don’t need to be confused by my prattle (or yours) about how such and such worked or didn’t.

I avoid telling them about some exotic treatment somewhere. These things are endless and can be dangerous.

I avoid slogans and platitudes. Although these can help someone facing cancer feel better, they offer them little real help. But I must admit there is something about maintaining an upbeat perspective. Facing cancer is dark enough without succumbing to the terror of it.

I always offer them hope. I encourage them to get a second opinion and research their type of cancer on reputable websites to discover what’s new and possible trials they might want to explore with their doctor. In my view, an informed patient is a good patient. My doctors have told me as much. The better educated we are, the more likely we are to follow their sometimes-byzantine orders.

I talk to them about the process. Going to the clinic. Seeing people who are washed out and in trouble. Heart-wrenching doesn’t even begin to describe it. In particular, I let them know that their first visit to the chemo room will be an out-of-body experience. If their clinic offers chemo classes I tell them much like Nike says, “Just do it!” I offer ideas on how to deal with the tidal waves of information and what will seem like endless appointments with all types of specialists from A to Z.

I encourage them to see a counselor if they’re feeling overwhelmed by it all. Many clinics have staff counselors who are trained to deal with the hyper-anxiety cancer can cause. If their clinic doesn’t have a staff counselor, they may know who around town is good. I tell them there is no shame in talking things through with someone who is trained to help. Facing cancer is something few of us can do on our own. The same goes for our beyond courageous caregivers.

I tell them to take an active role in their treatment by asking a lot of questions rather than assuming that because their doctor said it, it must be correct. Our doctors are human too, they can and do make a mistake on occasion. Sometimes, what is plain language to them might be unintelligible to us.

I would say if their doctor does not want to have a give and take chat about their treatment plan, it may be time to look for another doctor or at least get a second opinion.

Fighting cancer is a team effort. Our doctors can do a lot, but they need us to do our part.

Although I am not a doctor, I read everything I can find about emerging cancer treatments. The news is promising. Big strides are being made. More and more genes are being profiled, unlocking their secrets long held in plain sight. Somewhat like an experienced mechanic who knows their stuff front to back who with the right tools can diagnose any engine problem, I envision a future where our doctors will have the tools to diagnose each cancer no matter how complex and offer an effective treatment regimen rather than pump us full of chemicals and hope it stops our cancer. Though I think this is still years away, we seem to be moving in that direction.

I hope for a future where our doctors will be able to tell us more about our individual cancers. While we are getting closer to this with genetic testing and tumor profiling, there is still so much we don’t know.

I envision a future where scientists will be able to profile our cancer down to the nit that caused it rather than classify it by its location alone. Hopefully, this will allow them to tailor a treatment to target the rogue gene that led to it.

I am ever hopeful that once science can classify a cancer to each of us by our name rather than by its location alone, we can offer real hope to those facing it. Everyone’s cancer is different, and it should be treated as such.

For more news on cancer updates, research and education, don’t forget to 

Articles

Where should you turn after receiving a cancer diagnosis? A cancer survivor offers advice on handling the difficulties of treatment.

Everyone’s Cancer Is Different

Back in 2013, my life seemed to be on track for once. I had a great job managing large projects, something I loved. My three daughters were off on their own and doing well. We had been able to set aside a little bit for the proverbial “rainy day.” Little did we know the clouds were about to burst.

It had been a grueling week. Getting a new project off the ground always is. A buddy from work and I had run out for a Friday lunch. We both had the special – chicken enchiladas in red sauce, with rice and beans. Over the weekend I felt off. I thought it was nothing more than an upset stomach. The next week I quizzed him if he had any issues with the food. He shot back, “No. Best Mexican food ever!”

The restaurant was a place I ate at often, and I had never had any issues with their food. Always hot. Plenty spicy. Just plain tasty. I knew something was amiss.

Concerned, I made an appointment to see my doctor of two decades – I’ll call him Dr. Ralph Stevens. Besides being our family doctor, over the years he and I struck up a bit of a friendship. Our daughters played volleyball together in a city league, so on occasion, I saw him at a game. Not thinking much of my queasy stomach, he ordered as he called them “routine tests” (I often wonder if our doctors use words like these to shelter us from knowing something far from “routine” might be going on).

The following weekend, things fell apart. Turmoil roiled my stomach. Feeling pukey, nothing sounded good. Nothing. Not knowing what else to do I called Ralph Sunday afternoon. He was blunt, telling me, “Either go to the ER or come in first thing on Monday.”

After Googling reasons to go to the ER, and not finding “feeling pukey” as one of the reasons, I waited to see him.

On arriving at his office on Monday, I found his waiting room packed with people who had had the foresight to make an appointment. I told his receptionist, “Dr. Stevens told me to come in.” She rolled her eyes and said, “Take a seat over there. We’ll get to you when we can.”

With waves of nausea rolling over me, I closed my eyes and hoped to be called soon. After some time, his nurse, Alice, took me back to an exam room where I continued to wait.

As she pulled the door closed behind her, she said as all good nurses say, “The doctor will be right in.”

A few minutes later, hearing a tap on the door, I opened my eyes as Ralph stepped in. Trying to look better than I felt, I forced a weak smile.

“Have you seen my test results?” I asked.

Scanning me up and down much like someone looks at a cheap T-shirt on a rack at Walmart, he said, “Dude! You’ve got other problems. You’re yellow.”

Two hours later, I had an emergency CT scan which showed my bile duct was blocked. A trip to the ER followed, where after nine hours I was admitted. All too soon I learned I had pancreatic cancer.

With few people with this diagnosis seeing two years and most not seeing five, I am amazed to be approaching eight. Thus, it’s not lost on me that I’m living on borrowed time. One only needs to scan the recent news to see this. With her pancreatic cancer found early, Supreme Court Justice Ruth Bader Ginsburg saw 11 years, whereas with his found too late, Alex Trebek of “Jeopardy” didn’t see two.

On learning I had pancreatic cancer and not being able to get much out of my tight-lipped surgeon who extracted my tumor as to what my survival chances were, I did what most would do. I put my affairs in order, updated my will and followed my doctor’s orders word for word. I asked a lot of questions but got only a handful of jumbled answers. Wondering if I would make it, life seemed to move in slow motion. After getting through my first and second then my 12th and 13th oncology follow-ups with clean labs and scans it dawned on me I might make it after all. There is life after hitting the wall (although it takes time to see it).

Part of the process for me has been accepting what is rather than wishing things were different. Once I accepted that I might very well die, I began to live again. Fear of death stops many of us from living. Accept what is (and start living again).

Some people work to live whereas others like me live to work. Although I wasn’t your classic workaholic who brought home stacks of work every night, I was on the edge. I took my job seriously, perhaps too much so. Like so many, I found meaning in my work. Facing the cruel reality that I might not make it forced me to realign my life and get my priorities straight. What mattered most to me? Someone once said, “If you look at a person’s calendar you can tell what matters most to them.” Looking at my calendar, it was all too apparent work was my priority. Restack your priorities (or cancer will do it for you).

Getting through the gauntlet of treatments, a grueling surgery followed by weeks in the hospital with complication after complication, six weeks of radiation and months of chemo changed me for the better. Although I’m not there yet, I work hard to be more patient and understanding. I am now more inclined to offer mercy rather than judgment. Hold your family close (because this is all any of us have).

Whether you are one year going on two, or in my case, seven years going on eight, know there is life after hitting the wall, accept what is, restack your priorities and hold your family close.

A survivor of pancreatic cancer looks back on the day he received his diagnosis, and shares advice for others in the same shoes.

7 Years Going on 8 – Life After Pancreatic Cancer

I am not sure, but I bet you find your oncology follow-up appointments a bit scary if not terrifying. Having survived pancreatic cancer for seven years, where many don’t see two and few see five, I have come to accept these things as part of my routine to hold my cancer at bay and perhaps see a few more years. And other than more grand-dogs, I hope to maybe see a grandkid or two.

Much like sitting in a courtroom waiting for the black-robed judge to arrive to pronounce my sentence, I have found sitting in one of those beige all-too-sterile exam rooms waiting for my oncologist beyond terrifying. Will she say, “Your scans look great!” Or a foreboding, “We saw something unusual and need to run some more tests.”

To help me deal with the dread of these follow-ups I do five things to get through them.

Back in my Navy days, we used to run a drill called “Brace for shock,” meaning the ship was about to take an incoming missile. It’s not anything any sailor wanted to think about, but it was part of our training. Waiting and waiting for them to come in and let you know if things are OK, or if you’ll be back in “active” treatment has become part of my life. While I’m an optimist by nature, I always know this could be the day. Hence, I brace for the worst and thus I am happy to hear the good news I remain cancer-free.

Let’s face it. Most of us look forward to seeing them about as much as we look forward to being leaned back in our dentist’s chair. It’s not something we relish but rather something we tolerate. I imagine they find no joy in telling someone they’re stage 4. Worse, this must wear on the human side of them. Hence, I always ask how they’re doing. Not to invade their privacy, but I ask them about their families too. Much as we face challenges, they have challenges too. If they see you as a friend rather than just another patient, I’m betting they’ll go the extra mile or perhaps run a marathon for you. Connect with your oncologist.

Rather than let them take charge of “your” appointment, take the time to write down what has happened since you last saw them and brief them on the high points rather than robotically responding to their series of questions. Much like a date where one person does all the talking, if we do not participate the outcome may be less than optimal. Besides improving the outcome, this shows we are involved in our care rather than expecting our doctor to carry us through the appointment. Your brief should be at max a 1-minute summary of key things that happened since you last saw them. I jot these down on a scrap of paper to make sure I don’t forget anything. Things like, “Did I visit another doctor about a health issue?” are helpful. “Have I noticed anything unusual?” “How am I dealing with my life?” The stress of cancer impacts every aspect of our lives, not just our health. Remember you live with yourself 24/7. Your doctor or their nurse practitioner sees you for perhaps a few minutes once or twice a year. Take charge of “your” appointment.

With minutes to talk to your overworked and often under-appreciated cancer specialist, I’ve found it helps for me to write my questions down ahead of time. Like most, I think I can remember everything, but when I don’t write my questions down, I almost always forget something. On my way out to my car, I hate it when I say under my breath, “Shoot, I forgot to ask…!” Write your questions down.

While this might seem obvious, it is not. Do they want to see you again in six months or a year? Is there anything they might recommend you do to improve your chances of holding your cancer at bay? Ask about the next steps.

Seeing our oncologists for a follow-up does not need to be something we tolerate but rather something we look forward to. As a key member of our health team, they have a wealth of knowledge about cancer and what we can do to stay cancer-free. To get the most out of your next appointment, brace for the worst, connect with them, take charge of “your” appointment, write down your questions and ask about the next steps.

A cancer survivor shares tips for getting through dreaded follow-up appointments that may lead to anxiety.

Five Things You Must Do at Your Next Oncology Follow-Up

Like so many, I’ve always been fascinated by the lore of Mount Everest. At 29,031.7 feet, nearly five and a half miles above sea level, the highest point on earth, people dream of summiting it and taking a couple of selfies before starting their perilous trek back down the mountain. What drives people to put their lives on hold, train for months, if not years, spend tens of thousands of dollars, all for the chance to conquer it with no guarantee whatsoever?

In reading Jon Krakauer’s New York Times bestseller “Into Thin Air: A Personal Account of the Mount Everest Disaster” about the ill-fated 1996 expedition where 12 people died descending the mountain during a blizzard, I was struck by the many parallels between the ends people go to climb Everest and what it takes to beat cancer. Both have the goal of conquering it, and both are focused on surviving.

Pushing through brutal cancer treatments is much like climbing Everest – it taxes a person beyond their breaking point, but the real work comes in getting back down the mountain alive, much like staying alive after our treatments are over.

Quoting Rob Hall, one of the expedition’s head guides who perished on the mountain on May 11, 1996, Krakauer wrote, “‘With enough determination, any bloody idiot can get up this hill,’ Hall observed. ‘The trick is to get back down alive.’”

Anytime we are thrust into a volatile situation whether it be by our choice or some freak accident, we are forced to prove ourselves. Do we have what it takes? In proving ourselves, we also learn about who we are and what makes us tick.

Thomas Hornbein, who summited in 1963 via West Ridge, which was then thought to be unclimbable, wrote in “Everest: The West Ridge,” “But at times I wondered if I had not come a long way only to find that what I really sought was something I had left behind.” Much like Everest, cancer pulls out of us and our courageous caregivers something we had left behind, things we had always sought but didn’t know we were seeking. What is the essence of our lives? What matters most to us when our veneer is cut away, the pretenses we live by?

Above the famed “Death Zone”, at 26,000 feet, where oxygen is about a third of normal levels and frostbite can occur in minutes, climbers in trouble are often left to fend for themselves.

Months of treatment for pancreatic cancer, starting with surgery then radiation and chemotherapy, thinking I would not make it, tested me to my limits. On my own, with only a handful of those with this diagnosis seeing five years, I fought to survive against the odds. It made me wonder if I had not come a long way only to find that what I really sought was something I had left behind. Amid this, I learned so much about myself. For instance, I learned:

Perhaps the question most ask when we are placed in a horrendous situation is “Do I have what it takes?” Whether we are asked this explicitly or implicitly, we must answer. While it’s true we often don’t know, “I don’t know” is not an adequate answer. It’s often in climbing the last few feet towards the summit we can answer, “I have what it takes.”

My treatments taxed me far beyond what I thought I could do. Complication upon complication obstructed my path. I would like to say I had some inner strength, but that doesn’t get at the heart of it. I think it was more so that failure was not an option, so I was forced to put one foot in front of the other and keep moving. We can do more than we think.

I suppose the difference between “doing” and “facing” is that facing is much like a foreboding storm where one doesn’t know if it will blow by or create a white-out, putting an end to our ascent. Cancer is much like this. Early in the process, our doctor says things like, “We’ll ‘try’ this treatment and hope for the best.” We hope they’re right, but we both know it’s a medical guess, the best they can do for us right then. Only after the treatment works do we let out the breath we had held for months. We can face more than we think.

My life is interlocked and interwoven with others.

Much like being up on Everest, our fate is tied to others both physically and mentally. Dealing with cancer is not a private slog, but rather a public one – starting with our near family and a few close friends, rippling out from there to others who we will never know. Like it or not, our lives are interlocked and interwoven with others.

Perhaps one of the hardest things for me to face has been what will happen to my family if my cancer wins. Not only my immediate family, my spouse, and three daughters – what about my yet unborn grandkids and their kids? Everyone faces this question of their mortality in that we all face a certain end. But for us cancer survivors, especially those in active treatment, we face it today and live with it on an ongoing basis. Family matters.

I wish I could say all this has been easy, but it has not been. Much like summiting Everest, surviving cancer is at best an iffy proposition marked by hellish weather, sub-zero temperatures, rockslides, avalanches and little oxygen to sustain us in our climb. But for as long as we can, we need to keep climbing, putting one foot in front of the other, not looking down, pressing upwards towards the top. And once we’ve conquered our Everest of cancer, we must survive the trek down and stay alive.

A pancreatic cancer survivor describes the ways in which undergoing cancer treatment is comparable to summiting Mount Everest.

William Ramshaw

Everyone’s Cancer Is Different

7 Years Going on 8 – Life After Pancreatic Cancer

Five Things You Must Do at Your Next Oncology Follow-Up

Conquering Our Everest of Cancer

Latest News