By Kay Quinn, St. Louis Post-Dispatch, February 26, 2007

A man from Okawville is living proof that there''s progress being made in the fight against pancreatic cancer.

Gary Hackstadt, 58, was diagnosed after noticing the whites of his eyes had turned yellow. He quickly recalled the date.

"January 20, 2003," Hackstadt stated in a matter-of-fact way. The average survival rate for someone with what doctors classify as his standard, "bad" type of pancreatic cancer is less than a year.

"I''m lucky, very lucky," Hackstadt said.

But two area pancreatic cancer specialists say luck is just part of the reason why Hackstadt has survived not only his pancreatic cancer, but also a return of his cancer twice, in the liver.

"Where we used to see 10 percent survival we''re now seeing 50 percent survival," said Dr. William Hawkins, referring to some types of pancreatic cancer. Hawkins is an assistant professor of surgery and a pancreatic cancer specialist at the Siteman Cancer Center.

The pancreas is a 6-inch organ near the stomach. It makes enzymes that help with digestion, as well as hormones, including insulin.

According to Hawkins and Dr. Steven Strasberg, who heads up liver and pancreas surgery at the center, improved survival can be traced to advances in surgical techniques and follow-up treatment for cancer of the pancreas.

The big surgical breakthrough is something called the Whipple Procedure, in which surgeons remove part of the pancreas, stomach and small intestine. Over the past 25 years, the operation has become safer, but it is still performed only in a minority of patients whose cancer hasn''t spread beyond the pancreas.

"With the Whipple Procedure, we''re very, very good at removing 99.9 percent of the cancer," Strasberg said. "The thing that defeats us is that little … cancer that''s left behind."

According to Strasberg, the development of a targeted form of cancer therapy, similar to ones used in breast cancer treatment, could push survival rates to as high as 75 percent from 15 to 25 percent.

After the Whipple Procedure, many patients are also candidates for a form of therapy called the Picozzi regimen. Surgery is followed by chemotherapy, radiation and a medicine called an immune modulator. Side effects and toxicity can be difficult to tolerate, but it offers hope for improved survival and quality of life.

"What we don''t know yet about this is, have we cured a lot of people or have we delayed the diagnosis coming back?" Hawkins said.

Hackstadt underwent the Whipple Procedure and the Picozzi regimen. He credits his medical care, support from family and friends and his positive attitude for his four-year survival.

He continues to work full-time as a truck driver, as he has for the past 30 years. And Hackstadt hopes to inspire others facing a diagnosis of pancreatic cancer.

"That''s the main thing," Hackstadt said. "There is hope out there."