Medical Hero: Fitzhugh Dudley Staples
In the fall of 2010, after having lost a significant amount of weight inexplicably and responding to concerns from friends that he didn’t look well, Fitzhugh Dudley Staples went to the doctor. Shortly afterwards, he was diagnosed with Stage 3 pancreatic cancer. The oncologist at the community hospital where he went was not encouraging. “They basically sent me home to die,” said the 65-year-old retired partner of a prestigious law firm. But he wasn’t ready to give up that easily.
After receiving radiation and chemotherapy, Mr. Staples was told that he, after all, was stable enough to undergo modified whipple surgery. This procedure is used to treat pancreatic masses in an attempt to offer long-term control of disease and, in a small percentage of cases, a cure. He underwent the surgery without incident, but it didn’t result in a cure. Subsequently Mr. Staples received six months of chemotherapy. Thereafter, the cancer was stable for about seven months without treatment, which left Mr. Staples well enough to travel to New England and later to New Zealand and Australia. After he returned from Australia, however, he learned that his cancer had spread to his liver; he had progressed to Stage 4 pancreatic cancer. Even so, he remained open to new treatment options.
Around that time, Mr. Staples’ local oncologist suggested that he contact Johns Hopkins Kimmel Cancer Center to see if the Center was conducting a clinical trial that might be suitable for him. When he did so, he was told about a trial for patients with previously untreated metastatic adenocarcinoma of the pancreas. The trial would seek to evaluate whether adding a hedgehog inhibitor to a more conventional cytotoxic chemotherapy regimen (a combination of Gemcitabine and nab-paclitaxel) would increase progression-free survival for a significant time. Hedgehog inhibitors target Hedgehog signaling pathways, thought to play a role in regulating adult stem cells and to contribute to the development of certain cancers.
Mr. Staples met with a Hopkins oncologist to learn more about the trial and its possible side effects. Thereafter, a panel of Hopkins oncologists reviewed his medical records and determined that he met the criteria for the study. Mr. Staples agreed to enroll in the study.
He began the trial in June 2012 and has been on it ever since. “I’m told that I’m considered a star in the study because of the medical results I have experienced,” he says matter-of-factly. His cancer has remained stable, and he is tolerating the side effects—loss of hair, some loss of taste, and increasing fatigue—fairly well. He describes the side effects so far as “easily tolerated and essentially painless”.
Clearly, Mr. Staples’s stable condition is part of what makes him a stand-out trial subject: He’s outlasted the typical survival prognosis of patients with pancreatic cancer by two years. But his attitude also helps. “He is my star pupil. Whatever I ask him to do or not to do, he has no problem,” says Rosalind Walker, the Senior Clinical Research Nurse on the trial.
Mr. Staples describes his relationship with his medical team at Hopkins as one of mutual respect. “I listen to the doctors and nurses and I’ve asked a lot of questions. My doctor has taken the time to listen to me and fully answer my questions. I have never felt rushed or that my questions and concerns were not respected or fully addressed,” he says, adding, “The nursing and other staff members have been most considerate and positive, for which I am very grateful. Although the current treatment is not expected to be a cure, the doctors also say the longer I’m around, the greater the chance there might be a new development that might offer an even better prognosis.”