Diagnosed in early 2015 at age 59, Durbin lost a significant amount of weight after her operation and now carries just 98 pounds on her 5-foot-7-inch frame — “I’m kind of a spear,” she quips. She remains an avid biker and walker despite the ups and downs of her recovery, continually adjusting her diet and her physical-activity level. Durbin also takes pancreatic-enzyme supplements and monitors her sugar intake to promote digestion and avoid diabetes. “It’s just a new, constantly changing normal,” says the Minnesota retiree. “It’s been quite a trial-and-error process to figure out what my body can tolerate.”
Why Is Recovering From a Whipple So Tough?
Whipple surgery for early-stage pancreatic cancer represents the best chance of a cure for this aggressive type of cancer, experts say. But recovering from the complex procedure — which typically involves removing the head of the pancreas, parts of the small intestine and bile duct, the gallbladder, and possibly part of the stomach — can be extremely challenging. Durbin is among the fewer than 20 percent of pancreatic cancer patients considered eligible for the Whipple, which is usually available only to those with early-stage disease that hasn’t spread to other organs or extensively to nearby blood vessels. Like Durbin, some patients proceed with the surgery after a course of chemotherapy or radiation that helps shrink tumors sufficiently. “It’s a major abdominal operation that requires rerouting several components of the digestive tract,” explains Kevin Roggin, MD, a professor of surgery and cancer research at University of Chicago Medicine. “So it takes the body a while to learn the new set of internal plumbing.” Named for the American surgeon Allen O. Whipple, MD, who’s credited with popularizing the complex procedure in the 1930s, the Whipple comes with a relatively high complication rate. But fewer than 3 percent of patients die during the operation, according to an article published in June 2016 in Future Oncology. After the lengthy surgery, patients usually spend about a week in the hospital, during which doctors aggressively manage pain and gradually reintroduce the digestive system to soft foods. Much of the recovery process centers on figuring out what foods “agree” with an individual patient, says Victoria Manax Rutson, MD, the chief medical officer of the Pancreatic Cancer Action Network (PanCAN). “It’s very normal to experience nausea, vomiting, or heartburn,” Dr. Rutson says. “A lot of it is due to a temporary paralysis of the stomach. In some cases, patients have to make permanent changes to their diet because of diarrhea or stomach pain, but sometimes they find they enjoy different types of food more than they did before the Whipple.”
The Road to Recovery: 5 Top Tips
What can patients and caregivers do to smooth the recovery process? Rutson and Dr. Roggin offer this advice: