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Patrick Swayze Opens Up About Pancreatic Cancer

Actor Says He's 'Going Through Hell,' Took Experimental Medication

By Miranda Hitti
WebMD Health News

Jan. 7, 2009 -- Patrick Swayze has tried an experimental drug as part of his pancreatic cancer treatment, and he says he's not giving up despite grim odds.

Swayze, who starred in the films Dirty Dancing and Ghost and is filming a new TV show called The Beast, talks about his pancreatic cancer in an exclusive interview with ABC. Swayze tells Barbara Walters that he has stage IV pancreatic cancer that had already spread to his liver when it was diagnosed in March 2008.

"I'm going through hell, and I've only seen the beginning of it," Swayze says in interview excerpts posted by ABC.

Swayze, 56, also says that surviving five years is "wishful thinking," but that living two more years "seems likely, if you're going to believe the statistics." And he defines "winning" as "not giving up."

Swayze didn't have surgery for his pancreatic cancer because the cancer had already spread when it was diagnosed. His treatment included aggressive chemotherapy and an experimental drug called vatalanib.

Here are answers to questions about Swayze's pancreatic cancer.

What is stage IV pancreatic cancer?

In stage IV pancreatic cancer, the cancer has already spread beyond the pancreas, explains Gagandeep Singh, MD, FACS, director of the Liver and Pancreas Center at the John Wayne Cancer Institute in Santa Monica, Calif.

Singh is not treating Swayze.

What is the typical prognosis for stage 4 pancreatic cancer?

"Five-year survival is almost unheard of," Singh says. "But the flip side is that there are two to three percent [of patients] who do make five years.

"Each person should not treat themselves as a number -- that I have a 97% chance of dying from this disease because it's disseminated. Maybe I'm in the 2% or 3% that is going to survive five years," he says.

Singh notes that those five-year survival rates are based on data that dates back 20-30 years, and since then, new drugs have debuted.

"Now, the buzzword is targeted therapy," Singh says. He explains that in targeted therapy, drugs target a certain receptor or protein that is particularly abundant, or overexpressed, in a tumor.

Besides chemotherapy, Swayze took an experimental drug called vatalanib. What does that drug do?

Vatalanib inhibits tyrosine kinases, which are enzymes needed for cell growth, cell proliferation, and cell differentiation.

"What inhibition of this does is you're stunting the growth of the tumor," Singh says. "You're preventing it from getting more aggressive, with the hope that it ultimately dies and goes away."

He points out that vatalanib is still being tested and isn't available yet.

What else is in the pipeline for treatment?

"There are probably at least 100 to 150 new drugs that are in the pipeline," says Singh, adding that most experimental drugs are used with chemotherapy when other treatments fail.

"Stage IV therapy predominantly is chemotherapy-based, at the present time," he says.

"Cancer cells are very smart," Singh says. "The example that I use in a lot of talks is that they're going on a freeway ... if you're going by one main freeway and the freeway is blocked, you can take an alternative freeway to get there. And if the alternative freeway is blocked, then you can take multiple surface routes to get there."

It's the same thing with cancer cells, Singh says. "You think you can block one gene and hope that these cells are going to not grow any further? Well, they're smart enough to find an alternative route to get to the other end."

Singh predicts that in the next decade, cancer treatment will be a matter of using several therapies -- surgery, chemotherapy, radiation, and gene therapy or immunotherapy, if it's available.

"We don't have a magic bullet," Singh says.

Swayze has been working hard throughout all of this. How typical is his case?

"I don't know the extent of how much [cancer] was there in the liver" when Swayze was diagnosed," Singh says. "If he had no response to the chemotherapy, clearly he would have progressed. If Patrick has a good response to this, then he's in the fortunate group."

The odds aren't good, but Singh knows of patients who have lived longer than predicted. Singh says that several years ago he met a man who was a seven-year survivor of pancreatic cancer that had already spread when it was diagnosed. The man asked Singh to tell his story when he lectured on pancreatic cancer.

"I don't know whether he's still alive -- that was three years ago -- but it's a good success story," Singh says. "But in reality, most of these people are not around that long."

Swayze talks about the fragility of hope in the interview. How have you seen patients maintain hope in the face of pancreatic cancer?

"To give treatment to a patient who has pancreatic cancer, you have to give them hope before you start," Singh says. Without a little bit of hope or something to look forward to, "it's crushing not only them, you're crushing the entire family ... I think it is very, very important to give a positive message, even though we know this is a fatal disease."

Swayze says he's smoked for decades and has cut down but not quit because it won't change his prognosis. Is he right about that?

"Nobody is going to endorse that he should continue to smoke, because of all the health hazards associated with it," Singh says. "But I think realistically, if he cuts down smoking, is his survival going to improve? Nobody knows the answer to that, but I certainly wouldn't encourage it."

Singh points out that there is a "definite relationship" between tobacco use and pancreatic cancer risk. "The overall risk is approximately five times higher than the normal population if you use tobacco," he says.

SOURCES: Marsh, R. Archives of General Psychiatry, January 2009; vol 66: pp 51-63.

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