by Tom Wilemon
Maudean Armour of Clarksville, Tennessee, is grateful she’s the first patient in Tennessee to undergo intraoperative radiotherapy for pancreatic cancer — a new technology that targets any remaining cancer cells with electrons during surgery.
The IntraOp Mobetron IORT with electrons at Vanderbilt University Medical Center makes surgery possible for patients with pancreatic cancer who may have been told their tumors are inoperable because of involvement of major blood vessels.
“I was kind of surprised to be the first,” Armour said. “I know pancreatic cancer is not a big secret. I knew Alex Trebek (former host of Jeopardy) had died from it. I was surprised, but at the same time blessed, that I had a doctor who had the knowledge and confidence to do it.”
Armour’s journey to Vanderbilt occurred after a series of referrals that began when her primary care physician wondered why her glucose level had spiked. The wife of a retired veteran of the U.S. Army, she had undergone an annual physical at age 64 in December 2021 at Fort Campbell when her primary care physician noticed her glucose level was unusually high. Armour was physically active with a six-day-a-week gym routine, so her doctor suspected there may be a reason for the high glucose level other than diabetes. He ordered a CT (computed tomography) scan, noticed a suspicious mass, and then referred her to a Nashville hospital for another scan.
Doctors there referred her to Kamran Idrees, MD, MSCI, MMHC, chief of the Division of Surgical Oncology and Endocrine Surgery.
Pancreatic cancer remains one of the deadliest forms of cancer. The location of the pancreas with its proximity to major vessels, duodenum, stomach, small and large bowel, liver and kidneys, makes precision critical.
“With the precision of intraoperative radiation therapy, we can target any remaining cancer cells on or near blood vessels to vital organs to preserve them. With this technology, we can precisely give radiation to the area of concern during surgery while avoiding unnecessary radiation to other organs,” Idrees said.
Armour’s tumor was close to her aorta and involving the vessels supplying blood to her liver, which made her surgical case particularly challenging and initially inoperable/unresectable.
“Once we got the results back from the biopsy, we sat down and Dr. Idrees gave me the options of what we can do,” Armour said. “We would start with chemotherapy, and then maybe radiation if the vessels are still involved by the tumor, and then see how it would go from there.”
She underwent chemotherapy from March to June 2022 followed by radiation therapy that she completed in September. After observing that the tumor had decreased, the surgery was planned for November utilizing the new technology.
During the surgery, the pancreatic tumor was first removed by Idrees and then in partnership with radiation oncologist Natalie Lockney, MD, assistant professor of Radiation Oncology, intraoperative radiotherapy was administered to the aorta to kill/destroy any remaining cancer cells.
“I’m going to say I’m blessed,” Armour said. “If things had gone differently 12 months ago, I probably wouldn’t be here. I thank God for the doctor who sent me to get the CT scan. If it had not been for him, it probably would have been too late, and it would have spread. I’m also grateful for this new surgery technology.”
She said she looks forward to getting back into her exercise routine and spending more time with her grandchildren.
“I can tell you that cancer is no joke,” she said. “Chemotherapy and the pills and the radiation are no joke. It is hard, but you have got to have the faith to see it through if you want to be here. I wouldn’t wish cancer on my worst enemy, but I am grateful God gave me the strength to get through it and my doctors the knowledge to do the things that they did.”