Harold Gerndt

When Harold Gerndt, M.D. — a retired surgeon from Manitowoc, Wisc. — sought a second opinion regarding treatment for his cancer, he and his wife, Marilyn, brought along input from a registered nurse and five physicians. These experts weren't Dr. Gerndt's private medical team; they're his children. A well-informed group who understood the seriousness of a pancreatic cancer diagnosis, the family wanted medical care from a place with a reputation for excellence and surgeons with a proven track-record. They decided on Mayo Clinic.

A place they could trust

Dr. Gerndt's path to Mayo began when he started experiencing pain in his abdomen. Results from a computed tomography (CT) scan didn't uncover anything. But, his daughter Kristin, a radiologist, wasn't satisfied.

"My daughter wanted to look at the images," says Dr. Gerndt. "I told her I was sure that wasn't necessary. She wanted to see them anyway. So, she looked at them, and she saw something right away."

Further evaluation revealed a lesion on Dr. Gerndt's pancreas. Physicians suspected it was cancer. But, its location near a critical artery and vein made surgery to remove it unlikely. They recommended other treatment options instead. That's when the Gerndts decided to travel to Mayo Clinic in Rochester, Minn., for another opinion.

Because his condition hadn't yet been confirmed as cancer, Dr. Gerndt wanted a medical center he could depend on to make a definitive diagnosis.
"As a retired surgeon, I knew Mayo had a good pathology department. They would be able to tell me if it was cancer or not," says Dr. Gerndt.
Armed with professional knowledge of their own, Kristin and her siblings — Julie, a psychiatrist; Elizabeth, a registered nurse transplant coordinator; Cynthia, an anesthesiologist; Steven, a cardiothoracic surgeon; and Brian, a vascular surgeon — agreed Mayo was the place to go.

"We chose Mayo Clinic because, with our family, we needed a neutral place we all would trust," says Steven. "The Mayo reputation and service we know as physicians made us comfortable. Many of us have friends or associates connected to Mayo who also contributed to the authenticity of its reputation."

An innovative approach

The Gerndt family also did their homework when choosing a surgeon. When he arrived in Rochester, Dr. Gerndt met with Michael Farnell, M.D., chair of Mayo Clinic's Division of Gastroenterologic and General Surgery.

"We searched for a surgeon who had a concentrated experience in pancreatic surgery, and Dr. Farnell fit the bill," says Steven.

After reviewing Dr. Gerndt's medical information and running several more tests, including a biopsy, Dr. Farnell and his colleagues diagnosed the lesion as pancreatic cancer. Dr. Farnell agreed the location of the tumor made removing it unwise at that time. But, surgery wasn't out of the question entirely.

"Surgery to remove the tumor is the best option for a patient with pancreatic cancer. But, Dr. Gerndt's cancer was locally advanced. It was up against other structures that couldn't be sacrificed. Therefore, at first glance, it looked to be inoperable," says Dr. Farnell. "By treating him with chemotherapy and radiation treatment first, we thought we could shrink the tumor enough to make an operation feasible."

Instead of surgery followed by other therapies, as is often the case in cancer care, Dr. Gerndt received his treatment the other way around. After five and a half weeks of radiation along with chemotherapy, tests showed the tumor had shrunk — if only slightly. Surgery was possible.

"Because the tumor remained stable with treatment, we were planning to take out the artery it was up against and reconstruct it, if we had to," said Dr. Farnell. "That's not usually done. We were going to push the envelope in his case. He was a good operative candidate, and his best hope was to get the tumor out. In the end, we were able to take the tumor without removing the artery, but we had a vascular surgeon ready in case it was necessary."

A way forward

Dr. Gerndt underwent an extended distal pancreatectomy, which involved removal of his spleen and approximately 70 percent of his pancreas. After overcoming several complications in the months following surgery, Dr. Gerndt began to gain weight and feel better. He continues to see an oncologist in his hometown for follow-up care.

Looking back, his family is pleased with what they encountered at Mayo. "We can be a bit demanding, as you might imagine," says Steven. "But, our family was treated with great patience and respect. We put our trust in Dr. Farnell's opinion, so we didn't have to bicker among ourselves. The experience was, overall, very good."

From his perspective, Dr. Farnell sees Dr. Gerndt's case as a good example of the high-quality care Mayo has to offer patients who have pancreatic cancer.

"Pancreatic cancer can be a tough diagnosis. Some people in the medical community are ready to just throw in the towel," he says. "At Mayo, we're aggressive with this disease. We're using innovative techniques to push the limits and remove tumors whenever feasible. We have not come up with a panacea for pancreatic cancer, by any means. But we are working hard to give these patients a good chance for a cure."