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Susan Stewart - Pancreatic cancer patient 

Susan Stewart

Susan Stewart and her dog. (Mike Wakefield/North Shore News)

How this pancreatic cancer patient found new hope thanks a TFRI-funded precision medicine initiative

When Susan Stewart felt nauseous during a weekend run in November 2016, she never would have guessed she was about to be diagnosed with Stage IV, terminal pancreatic cancer.

“I consider myself a really healthy person. I run, don’t drink much, and I’ve never smoked,” says the 58-year-old, who lives in North Vancouver, B.C. with her husband and has three adult children. “I thought I must be coming down with the flu, and rested for the rest of the weekend.”

The following Monday she returned to work, but after a trip to the washroom was stunned to see her urine was extremely dark. Panicked, she called her doctor.

“That was the first indication I had that I was sick. Literally I was fine, and then over a weekend I was not fine,” she says, noting she was officially diagnosed with metastatic pancreatic cancer on Jan. 4, 2017. “Even in hindsight I had none of the symptoms or risk factors. It shouldn’t have hit me. It was a real shock, and that was almost the hardest thing to deal with. It was unbelievable, really.”

Pancreatic cancer is the fourth most common cause of cancer-related death in Canada, affecting 5,500 people a year. The disease poses several major challenges for both patients and researchers: a lack of early detection tests as well as few known symptoms typically result in a late diagnosis. Unlike other cancers, there are currently no known biomarkers or subtypes of the disease, and there are few treatment options available.

Initially overwhelmed by the poor prognosis of her disease, Stewart decided to get into the most positive mind frame she could. Within a week of her diagnosis she was enrolled into the Enhanced Pancreatic Cancer Profiling for Individualized Care (EPPIC), a TFRI-funded precision medicine project that’s working to improve understanding of pancreatic cancer biology, individualize treatment strategies, and facilitate the development of new treatment options. 

Thanks to her enrolment in the program, Stewart was placed on a clinical trial and started on new experimental therapy. Although it is early days yet, her results are promising: after 1.5 years of treatment her pancreatic cancer tumour is no longer visible on CT scans, and the metastatic cancer on her liver has shrunk considerably.

“It’s been amazing. I’ve had some really, really good results,” Stewart says, noting treatment side effects have been minimal. “It’s really great they have this treatment where you can still function at a pretty high level with it, despite having Stage IV terminal cancer.”

While not all patients enrolled in EPPIC will have the same results as Stewart, researchers are hoping to look at her genetic makeup – and that of 399 patients in Quebec, Ontario, Alberta and British Columbia – to understand why some people respond so well to treatment while others don’t.

All this genomic and clinical data will be stored in a knowledge bank that will be shared by Canadian and international researchers seeking ways to improve treatment, providing a glimpse into how precision medicine has the potential to change the future of cancer care for patients around the world.

“With the clinical trials and all the money going into the disease now, there’s HOPE in capital letters,” says Stewart. “I think that’s a really great thing for people in my situation, and my push is to keep the support coming for the research. This is a disease that needs more hope.”

As she continues to undergo treatment, Stewart sets regular goals to stay motivated. She took up snowshoeing, skis with her family, hikes every week, and completed the 10-kilometre Vancouver Sun run last year with her husband. She is enjoying her life and contributing her tumour samples to help others.

“Those little glimmers of hope from the treatments mean so much,” she says. “I might not live for another 30 years but I’ll take what I can get. I’ve really learned to appreciate every month I’m here.”

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