Karyn Wolschleger felt trapped in a bad dream. It began the moment she heard the words, “pancreatic cancer.”
She knew little about the disease, only that it could be deadly.
“I knew the prognosis with pancreatic cancer is not good,” she said.
Every case is so unique, you just got to run your own race.
A door cracked open in her bad dream, and Wolschleger began to see a way forward.
Four years later, she stood in a church dressed in a black lace, sequined gown as a processional song played. She took her daughter’s arm and, with her husband, escorted her down the aisle on her wedding day.
It was a tear-filled milestone, one of many she has celebrated since her diagnosis with pancreatic cancer. Wolschleger has cuddled her first grandchild, watched her sons graduate from college, designed a dream home and taken family trips to Italy and Costa Rica.
In between lay a host of small but meaningful moments―the everyday times with friends and family that seem ordinary until the fear of cancer puts them in jeopardy.
It’s been quite a journey, from terror to triumph.
“I truly had God watching over me,” she says. “To this day, I believe he must have a purpose for me―in order for me to survive something like this.”
Back pain and indigestion
In late August 2012, when she was 54 years old, Wolschleger made the unusual decision to go to an emergency room.
Her back hurt, and at first she thought she had lifted too much while building a deck on her cottage. But she had long bouts of indigestion, too. Her abdominal area in general “just didn’t feel right.”
Wolschleger felt a bit silly going in for vague back and stomach pain. She rarely went to the ER―for herself or for her kids. Looking back, she feels she received special guidance from a beloved grandmother who died young.
Her maternal grandmother, Lorraine Closs, often took care of her when she was little, and the two forged a close relationship. Closs died in her late 40s, when Wolschleger was in high school.
“I think she was there telling me, ‘Karyn, go check this out,’” she said. “It was almost that little nudge.”
First, she had a blood test, and it revealed nothing wrong. The nurse encouraged her to get a CT scan.
The treatment of cancer, and particularly of pancreatic cancer, has improved quite a bit.
“They came back and said, ‘We found something,’” Wolschleger said.
A tumor the size of a golf ball grew on her pancreas. A biopsy the next day confirmed the bad news: She had pancreatic cancer.
Wolschleger felt overwhelmed with shock and disbelief.
“You’re in constant denial,” she said. “It’s like a dream that you expect to wake up from.”
She immediately wanted to research her condition online, but her husband discouraged that.
“Generally, online is a bad place to get your advice,” he said. “The information that is there is often inaccurate of 10 years old. And a lot has happened in 10 years.”
That is a good point to keep in mind, says Marian Oleszkowicz, MD, her internal medicine specialist.
“Every case is so unique, you just got to run your own race,” she says. Because of medical advances, “the chances of surviving and going through treatment with better quality of life have gotten better.”
It’s true that the data available online is chilling. The American Cancer Society lists five-year survival rates for different forms of pancreatic cancer. For the type that Wolschleger had―exocrine, or adenocarcinoma―survival rates run between 1 and 14 percent, depending on the stage of the cancer.
“It’s the more common cancer. Generally it has a worse prognosis,” said Mathew Chung, MD, a surgical oncologist.
However, better surgical techniques have improved survival rates, he said.
“Thirty years ago, 25 percent died from the operation,” he said. “Now, at high-volume centers, it should be less than 5 percent. Our center has a mortality rate (during pancreatic cancer surgery) of less than 1 percent.”
Recent developments in chemotherapy also have helped. By the time they are detected, 85 percent of pancreatic cancers are too large to be removed surgically. However, doctors now often can use chemo to shrink the tumor enough to make it operable.
‘Young, healthy and strong’
As they reeled with news of her diagnosis, the Wolschlegers met with Dr. Campbell, a key member of the Spectrum Health Cancer Center team.
Dr. Campbell saw reason for hope.
“The treatment of cancer, and particularly of pancreatic cancer, has improved quite a bit,” he said. “We have developed at Spectrum Health a very sophisticated treatment team for upper-intestinal malignancies.”
Every Thursday morning, about 25 cancer specialists―including surgeons, geneticists, medical oncologists and radiation oncologists―meet to plot treatment plans for individual cases of stomach, liver and pancreatic cancers.
Wolschleger’s positive mental attitude and physical fitness also helped her odds.
“She was young, healthy and strong,” Dr. Campbell said. “She was in perfect physical condition, both physically and mentally.”
Wolschleger’s tumor, at stage 2 or 3, was contained to the pancreas but too large for surgery―at least initially, Dr. Chung said.
It came down to―if I’m going to get this second chance, I’m not going to mess it up. And I was given a chance.
The team decided to give her eight sessions of chemotherapy to shrink the tumor, followed by six weeks of radiation, and then surgery to remove the pancreas.
Wolschleger liked having a plan laid out. As a mother of four, who kept home and family life humming along smoothly, she was a planner and a doer.
But being on the receiving end of the caregiving plans―that took some getting used to.
“She was always the Momma Bear,” her oldest daughter, Andrea, said. “She was always taking care of everyone else and putting everyone else first.”
Looking back, Wolschleger sees some “meant-to-be” moments that lined up to help her through her illness. For example, Andrea had just moved back home from Washington, D.C. four months earlier and was living with her parents as she started a new job.
Andrea and her dad created a caregiving tag-team. One of them attended every chemo treatment, scan and doctor’s visit.
And there were many pieces to coordinate―bloodwork, biopsy, immunizations, nutritional counseling, as well as appointments with oncology, surgical oncology and radiation oncology.
Juggling it all, Wolschleger impressed her care team with her positive outlook and determination.
“She’s one of those people who just loves life,” Dr. Oleszkowicz says.
“She never seemed angry or ‘Woe is me.’ She’s very gracious, very kind,” says Vicki Powell, a medical assistant who works with Dr. Oleszkowicz. “She’s amazing.”
Hoping for a long operation
Wolschleger took chemo every other week for three months that fall. The daylong sessions left her nauseated and weak. But in an unexpected and welcome development, she did not lose her hair.
In November, just before Thanksgiving, she began six weeks of radiation therapy.
At the same time, she prepared for life post-surgery. When her surgeon removed her pancreas, she would become diabetic in an instant.
As she prepared meals for Thanksgiving Day and the holidays, she practiced counting carbohydrates so she would be able to determine how much insulin she would need. Making Christmas cookies, she calculated the number of carbs down to the cookie.
“It came down to―if I’m going to get this second chance, I’m not going to mess it up,” she said. “And I was given a chance.”
Then came surgery on Feb. 26, 2013. All her anxiety hinged on that day.
“No one knew if it had spread to my liver,” she said. “If it had, they would be unable to continue the surgery.”
That morning, she prayed for a long surgery, because that would mean Dr. Chung was able to operate. When she awoke in the recovery room, the first thing she did was look at the clock.
“It was six o’clock at night,” she said.
Eight hours had passed, she noted with relief.
She asked over and over again, “Did they get it all?”
Dr. Chung removed the tumor, all of the pancreas, the spleen, the first section of the small intestine, the gallbladder, part of the bile duct and about a third of the stomach. Because the organs sit next to each other, it’s impossible to remove just the pancreas, he explained.
Wolschleger stayed in Spectrum Health Butterworth Hospital 16 days. She received all her food through a feeding tube, to give her stomach time to heal. With the help of diabetes education classes, she learned to calculate her insulin needs and to give herself injections with insulin pens.
Emerging from treatment significantly thinner than before, Wolschleger found most of her clothes no longer fit. But she hesitated to go shopping, and instead relied on yoga pants and sweatshirts.
Her daughter Erica went shopping for her.
“She made sure I moved forward and started living life again,” Wolschleger said.
Since Wolschleger ended treatment, no sign of recurrence has surfaced in four years of follow-up CT scans.
“We are feeling good,” her husband said. “Really optimistic.”
“It’s very gratifying,” Dr. Campbell said. “That is why you train, so to speak–for this win.”
Making the most of each day
Throughout Wolschleger’s cancer treatments, one goal loomed bright.
She wanted to see her twin sons, Matthew and Joel, graduate from college. That spring, she watched both graduation ceremonies―one on Mother’s Day and the other on Father’s Day.
In July, her husband arranged a family trip to Italy. She had long dreamed of going there, being a fan of pasta, wine and gelato. It became her new goal, and she worked hard to rebound from her surgery so she could handle full days of walking and sightseeing.
“I learned that if you walk in Italy, you can eat gelato every day,” she said. “As a diabetic, that was probably one of the best memories.”
And for her daughter Andrea, it would be hard to imagine a better victory than having her mom with her on her wedding day and for all the activities that surrounded it.
“To be there to find a wedding dress and to taste-test foods,” she said. “I would call her freaking out about something, and she was always the voice of reason.”
Looking at her mom with tears in her eyes, she added, “It’s just everything to have you there.”
Her mom smiled.
“I enjoyed it so much,” she said.
Wolschleger hopes her experience will give hope to others facing pancreatic cancer, or any tough cancer battle.
“Every day, there’s something new in medicine on the horizon,” she says. “There’s always something new coming out.”
And relishing her second chance at life, she urges others to make the most of their opportunities. If there’s a big dream, she says, go after it.
“Don’t put it off,” she says. “Do it. Don’t take anything for granted.”