Pancreatic cancer survivor shows the importance of routine health care

November 05, 2020
Janet Smith sits in her home
Janet Smith found herself on the receiving end of clinical care during her battle with pancreatic cancer after spending 15 years caring for others as a home health nurse. Photo by Kelsey Hudnall

After a decades-long career as a nurse, Janet Smith had switched her focus from caring for people to caring for animals in her retirement. She enjoyed volunteering at a local adoption clinic, where she has spent 13 and a half years feeding and socializing the cats.

What she didn’t count on for her retirement was a cancer diagnosis.

Now, she has one simple message to share in light of November being Pancreatic Cancer Awareness Month: “If you have a good primary care provider, it can save your life,” she said.

Last summer, a routine physical exam left Smith’s primary care doctor with concern after her bloodwork came back abnormal. She was referred to a gastrointestinal specialist in downtown Charleston, who ordered several scopes before sending Smith to MUSC Hollings Cancer Center to speak with Katherine Morgan, M.D., a gastrointestinal surgeon with MUSC Health.

“She said, ‘Well, it’s pancreatic cancer,’” Smith recalled. “Just out of the blue. Nobody in my family had had cancer.”

Because there was cancerous growth across multiple areas of her pancreas, the only way to treat it was to remove Smith’s entire pancreas. But because it had been caught early, her doctors were confident they’d be able to get it all.

“I don’t think I was quite absorbing it, so I said, ‘OK, let’s get it done,’” said Smith. “I had so much else to think about. Who was going to take care of my cat?”

In late 2019, Smith underwent a successful surgery. She spent three months in the hospital, where she worked to regain her ability to eat and retain her food. When she was finally released home in January of 2020, she was worried her beloved cat, Moe, wouldn’t remember her.

“I remember walking in the front door, and I saw his little head peek around the corner. All of the sudden, he came running to me, jumped into my arms and nuzzled into my hair,” said Smith, beaming at the memory. “For the next few days, he followed me into the bathroom and into every room in the house. He couldn’t get close enough.”

From provider to patient

Aside from spending her days traveling from one appointment to the next, Smith said the most challenging part of her diagnosis and treatment has been suddenly becoming a Type 1 diabetic. Since she no longer has a pancreas to create insulin, Smith has to monitor and control her own blood sugar with daily insulin injections. At 76 years old, the change has been an adjustment.

In her 15 years as a home health nurse, Smith spent a lot of time educating others on managing their diabetes, but she still didn’t feel prepared for the changes in lifestyle.

Janet Smith plays with her cat Moe 
After returning home from the hospital, Smith received a big dose of affection from her cat Moe. Photo by Kelsey Hudnall

“I’d done a lot of diabetic teaching, but it’s different when it happens to you,” Smith said. “A couple of times, my blood sugar bottomed out in the morning.”

She’s grateful she was discharged with a home health nurse who helped her find the correct dose of insulin to keep her blood sugar levels normal. The one-on-one time spent with her nurse reminded her of everything she loved about working in home health.

“Home health was my niche,” said Smith. “You were the doctors’ eyes and ears. It was just you and the patient — and maybe their family — and God. There was no hurry, no time constraints. When you needed to take extra time, you could.”

All these years later, she still remembers her patients by name. To her, they were family.

She recalled caring for a patient who was paraplegic and wheelchair-bound. When she went to visit him and his family every two weeks, she made it her mission to bring a silly joke because she knew he loved to laugh.

“We’d all laugh like it was really funny. And one day, he said, ‘Janet, do you realize how we laugh when you’re here? I mean, we laugh, but not like when you’re here,’” said Smith. “And every time I left, I’d lean down and kiss him on the head and tell him I loved him. He was like family to me. And when he died, I went to his funeral. They had his family go into a side room before the service, and someone came to me and said, ‘You’re wanted with the family.’ I was blown away.”

Another memorable patient was a woman who had been a nurse during World War II. Smith recalls having long conversations about whether she believed that medicine was too tough of a profession for women.

“That’s where she came from,” said Smith. “And I said, ‘No, I think women bring something special to medicine. It’s called compassion.’”

Even after she retired, Smith spent time keeping up with the families of patients she had cared for by sending Christmas cards and visiting. She feels that all the time she spent getting to know her patients helped her to connect with her own nurses at Hollings on a deeper level. She also recognizes good care when she sees it.

“I can’t say enough for the staff at Hollings. Anyone I came in contact with — the doctors, the nurses, the people behind the desk, the check-in and check-out people, everybody — they were all outstanding,” said Smith. “There was someone who worked the desk in the infusion clinic, and she would see me coming and say, ‘Hey, Ms. Smith!’ And I’d think, ‘How does she remember me? I’m only here once a week.’ But they do. They’re wonderful people. They know what they’re doing, and they do it well.”

She enjoyed getting to know her nurses on a personal level, bonding over things like a common love of gardening and cats. On her birthday, her radiation technicians printed out a big birthday card, wrote personal messages to her and laid it on the table where she was going to get her treatment.

The small, personal, everyday interactions gave her comfort in knowing she was right where she needed to be.

Returning to normalcy

Smith’s most recent scans show that she is cancer free. Her appointments are now being scheduled further and further apart, and she’s excited to be returning to some sense of normalcy — including continuing her volunteer work at the pet adoption clinic, where she was welcomed back with open arms.

“It was like homecoming,” said Smith. “Those people are so fine. I think that’s the biggest thing that has come out of this experience — how many wonderful people there are in this world. I just go to bed every night thanking God for this day and for all these people.”

“I think it’s really important to bring pancreatic cancer to the forefront. It can’t be a dirty word. Don’t put anything off, and don’t be in denial, because it can happen to anyone. Catch it early and trust the people who are working with you because they’re on your side.”
— Janet Smith

She said she’s grateful for the care she received at Hollings and from her oncologists Graham Warren, M.D., Ph.D., and Paul O’Brien, M.D., — especially for the fact that her cancer was caught before it had time to progress. She encourages others to take charge of their health by keeping up with their regular doctor’s appointments and by taking preventive measures, such as getting their annual flu shot.

“Pancreatic cancer just seems so prevalent. And I don’t know if people wait, but it’s usually caught late. I think it’s really important to bring pancreatic cancer to the forefront. It can’t be a dirty word,” said Smith. “Don’t put anything off, and don’t be in denial, because it can happen to anyone. Catch it early and trust the people who are working with you because they’re really on your side.”

For people who are already facing a diagnosis of cancer, her recommendation is simple: “My advice would be to go to Hollings. I think Hollings is just the place to be.”