The Half Decent Pharmaceutical Chemistry Blog

On March 31, Maria Rossi, my beloved grandmother, aged 82, was diagnosed with metastatic pancreatic cancer. Today, May 13, she passed away.

When I wrote this blog would have become much more personal towards its conclusion, I didn’t obviously think I would have ever written this post. At that time, everything was looking excellent: I had got the studentship I wanted, my thesis was going on nicely, my parents and grandma (who had always lived with us) were proud and happy, I was embarking on a new website and my head was literally full with ideas on future projects.
The news came as a massive blast. She had been suffering from abdominal pain and discomfort in the previous months and weight loss was going on since a couple of years (the picture above is from August 2005, when she was completely healthy): this phenomenon, however, had been associated by everyone with her (familial) problem with coping with dentures (and I still believe in it to be the main cause as she began to experience real issues eating certain types of food).

First, her doctor believed she was suffering from irritable bowel disease and gave her appropriate therapies to treat it. Given the lack of any improvement and because my mother insisted, she had a colonoscopy, which only proved no tumour was present there.
January arrived and she started to experience back pain too. Finally, ultrasonography and CT scan helped with a diagnosis: incurable, metastatic pancreatic cancer, the worst kind of pancreatic tumour.

Carcinoma of the pancreas is one of the most difficult to promptly diagnose, as it remains silent until it attacks other organs, liver in particular. Severe abdominal pain, jaundice and thrombophlebitis are widely thought to be the classic hallmarks of any pancreatic cancer. For what concerns the metastatic sub-type, the list of hallmarks features: pain, loss of weight, jaundice, nausea, anorexia, malaise, vomiting, back pain, diabetes mellitus, pancreatitis and ascites. Apart from jaundice, anorexia and diabetes mellitus (although glycemia was twice the normal towards her last days), she had all. Loss of weight, back pain and ascites are also the three signs of incurability.
According to the statistics, survival from the moment of the diagnosis is limited to 4 to 6 months.

I learned all these things a couple of days after the first exam, during an awful morning when I didn’t actually do anything in the lab, but spent my time searching for clear information about her disease (which had already been described to me as incurable). I was desperately looking for hope, any therapeutic protocol (even one under early investigation), or, at least, a date.
I instantly realised she couldn’t have undergone gemcitabine infusion or fluorouracil, as both cause unbearable side effects for an old woman.

Together with the doctors, we decided not to tell her about the incurable cancer and opted for a severe pancreatitis. Although I said she was suffering from many, dreadful symptoms, I recall she was, all things considered, relatively fine. She continued to cook for all and spent most of the days not in bed. However, even though she didn’t know the truth, things went downhill too quickly. She began to be given morphine to cope with her back pain and rapidly reached the point when she needed to stay in bed most of the time.

Nausea made impossible for her to swallow any kind of food or drink, last week, and we took her to a hospital last Friday, as renal failure was to appear on stage. For her last four days, we decided to take her to a private hospital, where she received all the support and comfort they could give her.
She died this morning, with my father and her daughter there. She had already lost awareness of the people around her on Sunday, although this might have happened even earlier but I prefer to think she was aware of me kissing and saying goodbye to her on Monday night, when I left her room.

By a large margin, she is the person I have loved the most in my life. I still can’t really realise that she won’t be there for my graduation or that I won’t talk to her about my life in London.
I thought I would have burst into tears the day she would have passed away. But I haven’t yet. Once we had arranged everything for the funeral, I went to the lab: I knew staying with other people and keeping my mind busy with some work was the right thing to do. In particular, I didn’t want to stay in the house we have lived together since I was born for too long as everything reminds me of her.

These events led me to the decision of dedicating my life and my research as a molecular biologist to cancer. Fortunately, my career will begin with a studentship offered by Leukaemia Research and a project aiming at increasing the amount of knowledge on pathways involved in the development of these tumours, in order to target them for therapy. I will obviously try to do something, in the future, about metastatic pancreatic cancer as it has killed a great part of heart.

I have also realised there are fantastic people among my relatives and friends: something I wasn’t that sure of recently.

So, I will now do what my grandma would certainly tell me to do: working and enjoying myself equally hard. I didn’t write a lot in these months as I wanted to look after her at my best. I never told her it, though, as she was also my first supporter as a blogger, although she never read this blog because she couldn’t speak English.

I am not a religious person and, thus, I find terribly hard to believe in life after death, but, nevertheless, I feel she will be supporting me: at least thinking about the happy moments with spent together makes me fell better and stronger, even if on the verge of tears, as I’ve just said. Even if I firmly believe that, if there is actually a life after death, dead people are completely detached from what happens to us, as this would be a source of trouble and distress to them.

Goodbye, granny: as you used to say, you’ll always be in my pocket to help me take the right decisions.