Jan’s Story: Surviving Late-Stage Pancreatic Cancer

In the summer of 2012, Jan Hilgeman went to her primary care physician for a routine visit to address her persistent indigestion. A sonogram found a cyst  on her pancreas and a series of tests revealed that Jan had inoperable pancreatic cancer. Filled with a mix of fear, worry, and shock, Jan was advised to begin treatment right away.

Pancreatic cancer is one of the most difficult cancers to treat and challenging to diagnose. Patient symptoms tend to be vague and unfortunately are not usually identified until the disease has already advanced. The prognosis for pancreatic cancer is bleak, with an estimated 11% five-year survival rate.

In recounting that dreadful day in 2012, Jan says, “My doctor, without pretty much skipping a beat, told me, ‘You’re going to see Dr. [John] Chabot at Columbia. You’re not going anywhere else but to Chabot,’ and that’s exactly what I did.”

“It’s a piece of advice that I will never regret.”

Beating the odds

Jan initially underwent chemotherapy to try to make her operable which was successful. She then underwent surgery to remove two-thirds of her pancreas, and completed a post-operative course of chemotherapy. In addition to Dr. Chabot, executive director of Columbia Pancreas Center, Jan’s care team comprised William Sherman, MD; Kyung Chu, NP; and Dr. Gulam Manji, director of medical oncology and translational research for the Pancreas Center. Dr. Manji has been her primary medical oncologist for the past five years.

Three weeks after a successful surgery in 2013, Jan returned to work, and just five weeks later, she was riding horses again, a lifelong passion dating back to childhood.

Unfortunately, Jan experienced a setback in 2015 when routine scans showed that the cancer had spread to her lungs. However, metastatic pancreatic cancer to the lungs is very different from metastases anywhere else in the body, therefore her team decided to recommend surgery. After another surgery, followed by chemotherapy and several rounds of radiotherapy, her routine scan in January 2022 resulted in “NED,” or no evidence of disease, and she has since remained disease-free.

“It’s unbelievable,” says Jan, 61. “I think back to when I was diagnosed. It was shocking. I was mainly worried for my family because I knew it was going to be harder for them than for me … But I had to have confidence that there’s a chance I would get through this. You can’t just roll over and accept your fate as a patient.”

Cure of pancreatic cancer is rare. If caught at a very early stage when surgical removal of the tumor is possible, the estimated 5-year survival rate is 42%. Only about 15% of people are diagnosed at this stage. Due to her unique case, Dr. Manji has begun molecular studies on Jan’s tumor tissue. The investigations could uncover new insights into the development of late-stage pancreatic cancer and treatment response.

“Jan is an incredible individual who has fought this battle with courage and an unbelievably positive outlook,” says Dr. Manji. “We hope to learn from her case and to understand the underpinnings of her tumor so that we can develop a potential treatment for the rest of the patients suffering this disease.”

Cause for celebration

At the start of her treatment in 2013, Jan, who loves to work in the yard, shopped with her husband for new flower bulbs. Her husband planted them in their front yard, and at the time, Jan remembers thinking to herself that she wouldn’t be around to see them bloom.

“I’m so happy and I’m just amazed,” she says. As her health improved steadily through the years, she began to plan for a party to celebrate the 10-year mark after her initial diagnosis. She didn’t mention this idea to anyone. It was something she vowed to do if she reached this milestone. And, in September of 2022, she did, catering a celebration for 60 guests—close friends and family—who have been a constant support.

“I’ve literally been planning this party for eight years, as soon as I started seeing that I was feeling better and responding so well to treatment,” says Jan. “It hasn’t just been 10 years. It’s been 10 years and I have a life … We’re planning for the 20th now.”