Pancreatic cancer is the second-leading cause of adult cancer death for Wisconsinites, according to Dr. Doug Evans. He chair of surgery at the Medical College of Wisconsin and specializes in the research and treatment of pancreatic cancer. This is how he came to know retired vice president of medical health and safety for the Milwaukee Brewers, Roger Caplinger.
Caplinger was diagnosed with pancreatic cancer in December of 2017. After years of tailoring a holistic approach to health, sports psychology and athlete care for the Brewers — he utilized those tools for himself, along with his care team at MCW, to help him through cancer treatment.
Caplinger says the initial signs that prompted him to get medical help were low-grade stomach issues, dark colored urine and clay-like stool. Further investigation and scans revealed a malignant tumor at the head of his pancreas. Caplinger recalls that it came as a shock, he considered himself a healthy person with no family history of cancer.
"I feel that everything happens for a reason," says Caplinger. "And so we did our due diligence around the country, but right here at home at the Medical College of Wisconsin is the best pancreatic cancer program. So we teamed up with Dr. Evans and his entire team at the MCW to try to see where we were at [and] what the game plan was."
Evans has been interested in pancreatic cancer since he was a medical student. He notes it's currently the third cause of death behind lung cancer and colorectal cancer in the United States, but in Wisconsin, it's second — only behind lung cancer.
Evans explains that a tiny percentage of pancreatic cancer is referred to as the "Patrick Swayze phenotype": people who started smoking young. A second category is what Evans calls the "Luciano Pavarotti phenotype": patients with relatively poor diets their whole lives who tend to be significantly overweight. Then, a small fraction of patients are genetically predisposed.
"We know now what many of those genes are that increase risk slightly, but at least conservatively 85% of patients who unfortunately develop pancreatic cancer there's no predisposition and in general they're fairly healthy," explains Evans.
He says MCW has a whole army devoted to the disease within the MCW LaBahn Pancreatic Cancer Program. From laboratory scientists, clinicians, second opinion sourcing and the Pancreas School series, hosted by Evans, that helps break down topics relating to diagnosis and treatment.
Patients are also encouraged to think about participating in clinical trials — some of which are developed at MCW.
"A clinical trial, very simply, means that the doctors think it's the best treatment on the planet and they just haven't proven it yet," explains Evans. "This is the backbone for future discoveries. It's how we take innovation from the laboratory bench into the clinic and then eventually into the patient."
Caplinger was able to translate sports medicine background to his cancer journey, but he notes that not everyone going through cancer treatment have medical backgrounds — making the treatment plan overwhelming and intimidating at times.
"I told Dr. Evans that I'm in the health care business, but I'm going to try to separate myself from being a health care professional to a patient, which is very difficult," Caplinger recalls.
His treatment involved an intense, six-week regimen that involved radiation five times weekly and chemotherapy once weekly. This was followed by a Whipple Procedure, which turned into a more complicated surgery for Caplinger. Then, following recovery from surgery there was another six months of chemotherapy.
"It was a rocky road," he recalls. "It's not anything that's fun but it was an entire year and I think we learned a lot. I gave [Dr. Evans] constant feedback from my end. He and his team were able to change some protocols around, ... he's added nutritionists and he's added psychologists because this is not only a physical disease, it is also a mental disease. It's really hard and if you don't have a great team."
Today, Caplinger and Evans are teaming up and using their unique relationship as a tool to help others facing the disease and bring awareness to its impact through the Seena Magowitz Foundation.
Evans notes that while every patient's treatment plan is unique, there needs to be a solid foundation built on education, trust, and choosing the right care team.
"One of the biggest challenges that people have is trying to dodge what we call 'paralysis of analysis' where they just overthink everything. At some point you have to pick your team and then go with your team," Evans.
"If you feel confident in your team that puts your mind at ease, and when your mind is at ease, you can then focus on your own healing," adds Caplinger.
