How white stools were a sign that I had terminal pancreatic cancer… at only 32

A Michigan man who was given a year to live after being diagnosed with terminal pancreatic cancer is still alive almost four later thanks to a ‘miracle’ drug combination.

Matthew Rosenblum was only 32 years old in January 2021 when he realized that he had lost weight and that his stool had turned a bone-white color.

‘At first I thought I was hungover. I had a few beers the night before, so I drank some Gatorade and lay in bed, but the urine didn’t lighten, Mr. Rosenblum said. The patient history.

The former PhD candidate was diagnosed with the common digestive disease Crohn’s disease at the age of 25, which causes inflammation of the colon.

Rosenblum assumed his symptoms were a result of the disease, as gastrointestinal distress was “par for the course for me”.

But within days his palms and the bottoms of his feet began to itch, which he described as ‘probably the worst’ symptom. “I’ve never felt anything like this before and these are hard places to scratch,” he said.

‘After a full night of itching, I put my hands and feet in the tub under warm water to soothe the sensation.’

He visited the hospital, where emergency physicians told Mr. Rosenblum that his blood was high in bilirubin — a byproduct of broken down red blood cells that affects the color of stool.

High levels may indicate a blockage in the bile duct – a tube-like structure that connects the liver to the small intestine.

Ultrasound revealed narrowing of this tube, which doctors tried to stretch using a stent.

Rosenblum said, “There was no sense of urgency … they didn’t think it was scary.”

Doctors removed the stent a few months later – only for Mr Rosenblum’s symptoms to return. His gastroenterologist said, ‘I don’t know what’s going on, but you definitely don’t have cancer.’

‘If you have cancer, I will roll over in my grave.’

But just two hours later, Mr Rosenblum’s results showed a tumor in a part of the stomach called the ampulla of Vater – a small opening where the pancreas and bile ducts connect.

Rosenblum had stage four pancreatic cancer, the third-deadliest form of the disease in the United States.

It has been called a ‘silent killer’ as patients rarely suffer symptoms until it has spread to other areas of the body where it is incurable.

In around 80 percent of cases, the disease is diagnosed at a late stage, when the chances of surviving more than five years drop to three percent.

Common symptoms include abdominal pain, loss of appetite, weight loss, jaundice, dark urine, light or liquid stools, fatigue and itching.

The NCI estimates that there were 64,000 cases of pancreatic cancer diagnosed last year, along with more than 50,000 deaths.

Most patients are over 65, and only 1.9 percent are Mr. Rosenblum’s age.

“The most popular narrative around pancreatic cancer is that it is not only very deadly, but also very difficult to diagnose,” Rosenblum said.

‘The pancreas is deep in the body. The earlier symptoms are very nuanced, can go unnoticed and can also be misdiagnosed as a number of other things.’

‘By the time you experience symptoms, the cancer has spread outside the pancreas. I wouldn’t say it’s too late, but that’s what the conventional wisdom is.’

Rosenblum had to undergo a Whipple procedure, also known as a pancreaticoduodenectomy. This involves removing the head of the pancreas, some of the small intestine, part of the bile duct, the gallbladder and some surrounding lymph nodes.

But his surgeon said that when they opened him up, they saw that the cancer had spread to other organs, rendering it inoperable.

Instead, he was prescribed a six-month course of potent concoction of chemotherapy drugs which were ‘terrible’ and ‘really, really abrasive’.

Rosenblum suffered debilitating nerve damage that left him unable to even get out of a chair on his own.

Worse, the medicine failed to shrink the tumor.

‘At this point I wasn’t sure I was going to be a special case or a miracle. I thought it was, Mr. Rosenblum said.

Doctors discovered that Mr. Rosenblum had a mutation of his BRCA2 gene, which is linked to several types of cancer, including breast and pancreatic. This led doctors to believe that targeted therapies might help.

The oncologist told him, ‘with treatment you might have one to three good years left – but that’s it.’

Rosenblum was put on a combination of the chemotherapy drugs gemcitabine, nab-paclitaxel and cisplatin (GAP). “My quality of life improved dramatically,” he said.

“By the time my first set of scans came around three months later, some of the spots on my liver had started to disappear.”

‘I didn’t lose my hair. I am six feet tall. I weighed 215 pounds when I was diagnosed and miraculously I’ve maintained a healthy weight, so I’m very grateful for that.’

“At this point, I thought I was still going to die sooner rather than later, so I tried to have fun, and that definitely made having fun a lot easier.”

As of March 2022, doctors could not identify any cancer outside of Rosenblum’s primary tumor. Almost a year to the day, they were able to perform a successful Whipple operation and remove the majority of the cancer.

Rosenblum will have scans to evaluate the remaining tumor every three months for the next six years.

However, he acknowledged that even if he has beaten the odds given to him by his doctors, “the chances of me living out the six years are astronomically small”.

‘Pancreatic cancer has a remarkably low five-year survival rate. I’m unlikely to see all that time, at least on paper.’

Rosenblum is still focused on raising awareness and making sure other patients don’t automatically see pancreatic cancer as a death sentence.

“It’s important to remember that you’re not a statistic,” he said. ‘I was diagnosed with something I shouldn’t have at my age. It was very unlikely. It was going to kill me and I didn’t die, so in a way I beat the odds not once but twice.’

‘Sometimes things get worse before they get better, and that’s no reason to lose heart.’

‘Have a drink, eat the cheeseburger and live your life to the fullest. That’s how I lived. Take your health seriously, but also meet yourself where you are.’