In 2011, Francesca knew something was wrong. Her stomach hurt and was upset after eating, and she just didn’t feel right. She had also lost a lot of weight, but thought that was normal, considering her life at the time. “I was working fulltime and had just stopped breastfeeding,” she explains. So when she went in for a checkup, she expected to hear it was a stomach problem.
But an ultrasound in November 2011 showed she had pancreatic cancer. “I was shaken. I was only 41 with an 18-month old daughter,” Francesca says. “My whole life was in front of me.”
Rallying quickly, she sought out long-term survivors of pancreatic cancer, which was “very helpful.” She also started learning about treatment options. “I didn’t focus on the bad numbers, I did research,” she says. That was a natural for her. Now on leave, Francesca has years of experience as a consumer market researcher for a Los Angeles movie studio.
Surgery was out because the tumor had wrapped around major arteries. “It was too risky and unlikely to get all of the tumor,” Francesca says. And interviews with oncologists across the country showed that there was no consensus on treatment. “I chose the most aggressive,” she says. “I wanted the max I could take because we could scale back if necessary.”
Francesca underwent 20 months of chemotherapy, typically three weeks on and one week off, and the tumor shrank under this intensive treatment. But afterwards it regrew. She tried radiation, which didn’t work, so then she did more research.
In September of 2013 Francesca opted to try a new procedure offered at the University of California, Los Angeles (UCLA), the nanoknife. “They use an electric current to blast the tumor,” she says. But when her surgeon opened her up, he found a second nodule, removed it, and then closed her back up without using the nanoknife.
The nodule was malignant so she went back on chemotherapy, but it was too much for her this time. “I was very weak after surgery,” Francesca says, adding that she didn’t know which path to take next.
Luckily, Marty Tenenbaum—Cancer Commons founder and metastatic melanoma survivor—had some suggestions. “It was an inspiration to hear Marty’s story,” Francesca says. “His will and determination, and his belief that you have to advocate for yourself and not just get what you’re given.” An option that appealed to her was an experimental immunotherapy that blocks PD-L1, a protein that lets tumor cells evade a person’s immune system.
Then a new phase I trial of a PD-L1 blocker opened in Los Angeles. And it was only 10 minutes from her house. Francesca began treatment in January 2014 and got the highest dose. “It was good for me,” she says. “The tumor stopped growing and some nodules disappeared.” But a strong autoimmune reaction may keep her from completing the one year trial.
If that happens, she will find another treatment to try. Says Francesca, “I have a four-year-old daughter and a wonderful husband. I need to fight for them.”
Update: We are deeply saddened to report that Francesca passed away on October 31, 2014. Her warmth, intelligence, and bravery will continue to inspire us. It is a privilege to share her story and keep her memory alive.