DCI Board of Advisors member Nancy Wright during a visit to Duke in August 2021. Photo by Les Todd.
Stronger by the Day
Published
From the Duke Cancer Institute archives. Content may be out of date.
In 1988, Nancy Wright successfully beat breast cancer. But at the time, she didn’t know any other cancer survivors. “Nobody talked about cancer back then. I realize just how uneducated I was about cancer in general,” she says.
Her mother-in-law, who was a member of a group that existed at the time called the Duke Cancer Institute (DCI) Citizens Advisory Council, arranged for a two-time breast cancer survivor to speak to a group near Wright’s home in Lexington, NC.
Shortly after that, in 1994, Wright joined the DCI Citizens Advisory Council, then later the DCI Board of Advisors. She found it exciting and educational to hear from other survivors and cancer researchers. “The council encouraged us to be advocates and to write letters to our legislators asking for increased funding for cancer research,” she says. “That was my first foray into political activism.”
Nancy began thinking of herself as someone who advocated for others with cancer. Patients should ask lots of questions about their care, and they should expect answers, she says. She advocated for her husband as he successfully fought lymphoma with Duke’s help, and she has advised countless friends and family.
She has always told her friends to go to Duke for cancer care because of the access to the latest evidence-based treatments and new therapies available through clinical trials. “If not Duke, go to one of the three National Cancer Institute-designated comprehensive cancer centers in North Carolina. We’re fortunate to have three. Some states don’t have any,” she says.
A Heart-Dropping Diagnosis
In February 2021, Nancy had to follow her own advice. One morning she woke up jaundiced. She felt fine, but consulted with her primary care doctor. Results of her blood tests were normal, but her liver values were elevated.
When subsequent tests showed her liver values had worsened, her doctor ordered a CT scan.
The scan showed a tumor in her pancreas. ”Well, my heart just went through the floor,” Nancy says. “I thought, besides glioblastoma, I can’t have anything worse.”
The cancer was stage 2. Duke surgeon Peter Allen, MD, performed surgery right away. Nancy needed the Whipple procedure, a complex operation to remove parts of the pancreas, the small intestine, gall bladder, and stomach, then reattach the remaining portions so they can function.
“Dr. Allen was so very positive, and he reassured me,” Nancy says. The surgery went well. She didn’t have a lot of pain, and the 10-day recovery was easier than she expected.
The treatment afterward was the challenging part for her. She could tolerate only four weeks of the planned eight-week chemotherapy regimen. She lost more than 50 pounds.
She hadn’t realized how weak she had become. “It was all I could do to leave the cancer center and walk to the parking deck,” she says. “When I was at my worst, Gordon had to help me up those three steps. I did not have the strength to get up the steps, and it really surprised me.”
Nancy has worked through it with the help of her husband of 52 years. She feels stronger now, able to climb the stairs leading to their beach home without stopping to rest. She is cooking and enjoying some of her favorite foods again, like fresh summer corn. Listening to the waves is its own form of therapy.
“Right now, I am in a holding pattern of recovering strength, gaining weight, and eating,” she says.
Once she is stronger, she hopes to work with her oncologist, James Abbruzzese, MD, to try a different treatment regimen tailored to her. “As anxious as I am about not being treated right now, because I know how aggressive pancreatic cancer is, I also know that my team has my best interests at heart,” she says.
Friends who have been treated elsewhere have told her that sometimes they felt their doctors weren’t listening to them. She has found the opposite at Duke. “Dr. Abbruzzese has been really good about answering my questions,” she says.
Nancy is optimistic about the future, including the hope of defeating all cancer if young researchers are supported. The Wrights’ granddaughter, Elyse, has an interest in science and cancer research, and she interned in the lab of Duke cancer researcher Jason Somarelli, PhD, during her junior year of high school. She is now a sophomore at UNC-Chapel Hill and is working in the lab of a cancer researcher there.
Elyse credits Somarelli with encouraging her passion for research. “Dr. Somarelli valued my thoughts and questions, and he was the first person to really challenge my thinking and push me to think more critically,” she says.
“You cannot foster an interest in research early enough,” Nancy says. “As my granddaughter says, ‘Why can’t I be the one to discover a cure for cancer?’ You have to love the passion and optimism of youth.”
A team at the Duke Cancer Institute (DCI) is launching a first-of-its-kind study that could bring new hope to patients living with advanced colorectal cancer.Led by medical student Cheryl Chang and DCI medical oncologist Nicholas DeVito, MD, the project explores why some colorectal cancers that spread to the liver respond well to chemotherapy while others do not. The team recently presented this research at the American Association for Cancer Research (AACR) Immuno-Oncology (IO) Conference.This type of cancer can be especially challenging to treat. Patients often face fewer effective options, and outcomes can vary widely. By taking a closer look at what’s happening inside the tumor before and after treatment, the Duke team hopes to uncover clues that could one day guide more personalized and more effective care.When colorectal cancer spreads to the liver at the time of diagnosis, it often means a tougher road ahead. Doctors know that these patients typically do not respond to chemotherapy the same way others do, but the reasons behind that difference remain unclear.“If we can understand why some patients don’t respond well, we may be able to adjust treatment earlier, or develop new options altogether,” Chang said.To do this, the team is studying tissue samples taken from patients before treatment, when the cancer is first discovered, and after about six months of chemotherapy, when surgeons remove part of the liver or colon.Looking at these pairs of samples gives researchers a rare opportunity to see how cancer and the immune system around it changes during treatment.This is the first known study to compare liver metastasis samples before and after chemotherapy in this specific patient group. Despite decades of using chemotherapy to treat colorectal cancer, surprisingly little is known about how treatment affects the immune environment inside these tumors.“This is an area that’s been largely unexplored,” DeVito said. “We’re excited to contribute something new that has the potential to change how we approach treatment.”A big focus of the study is the tumor microenvironment, the community of immune cells, cancer cells, and other structures within and around each tumor. Using two advanced technologies, the team examines the tumor at both the protein and RNA levels.Working with John Hickey, PhD, assistant professor of biomedical engineering at the Pratt School of Engineering, the team employed the Codex assay in the study. By using special antibodies to highlight different cell types, the assay lets researchers map where various immune cells are and how close they are to the tumor.The team also partnered with Erika Crosby, PhD, assistant professor in the Duke Department of Surgery, to use the Xenium assay, which analyzes the RNA within cells. This helps confirm the protein‑level findings while revealing additional details that might not show up at the protein stage.Early results show meaningful differences between patients who respond to chemotherapy and those who don’t. Some immune cells appear in higher numbers in people who respond well, suggesting these may serve as early indicators of how effective chemotherapy might be.“Without this collaboration between surgery and biomedical engineering, locating and reviewing patient records and samples would have been far more time‑consuming,” DeVito said. “Everything came together at the right time: the technology, the expertise, and access to the right samples. That’s what makes a project like this possible.”A major boost for this work also came from CRUSH Colorectal Cancer, which supports early‑stage ideas that need initial funding before they can compete for larger grants.“CRUSH provided the seed funding that allowed us to get started,” DeVito said. “An added benefit is that any data generated becomes a shared resource for the entire GI oncology team at Duke.”Looking ahead, the team plans to expand their research into mouse models in collaboration with Jatin Roper, MD, that mimic how colorectal cancer spreads to the liver. This could help them test the biomarkers they discover and explore new treatment strategies in the lab.“Ultimately, everything we’re doing comes back to the patient,” Chang said. “We want to find better ways to treat this cancer, especially for patients who don’t have many options today.”The annual CRUSH Colorectal Cancer 5K will be held on March 14. Learn more about the event.
A team at the Duke Cancer Institute (DCI) is launching a first-of-its-kind study that could bring new hope to patients living with advanced colorectal cancer.Led by medical student Cheryl Chang and DCI medical oncologist Nicholas DeVito, MD, the project explores why some colorectal cancers that spread to the liver respond well to chemotherapy while others do not. The team recently presented this research at the American Association for Cancer Research (AACR) Immuno-Oncology (IO) Conference.This type of cancer can be especially challenging to treat. Patients often face fewer effective options, and outcomes can vary widely. By taking a closer look at what’s happening inside the tumor before and after treatment, the Duke team hopes to uncover clues that could one day guide more personalized and more effective care.When colorectal cancer spreads to the liver at the time of diagnosis, it often means a tougher road ahead. Doctors know that these patients typically do not respond to chemotherapy the same way others do, but the reasons behind that difference remain unclear.“If we can understand why some patients don’t respond well, we may be able to adjust treatment earlier, or develop new options altogether,” Chang said.To do this, the team is studying tissue samples taken from patients before treatment, when the cancer is first discovered, and after about six months of chemotherapy, when surgeons remove part of the liver or colon.Looking at these pairs of samples gives researchers a rare opportunity to see how cancer and the immune system around it changes during treatment.This is the first known study to compare liver metastasis samples before and after chemotherapy in this specific patient group. Despite decades of using chemotherapy to treat colorectal cancer, surprisingly little is known about how treatment affects the immune environment inside these tumors.“This is an area that’s been largely unexplored,” DeVito said. “We’re excited to contribute something new that has the potential to change how we approach treatment.”A big focus of the study is the tumor microenvironment, the community of immune cells, cancer cells, and other structures within and around each tumor. Using two advanced technologies, the team examines the tumor at both the protein and RNA levels.Working with John Hickey, PhD, assistant professor of biomedical engineering at the Pratt School of Engineering, the team employed the Codex assay in the study. By using special antibodies to highlight different cell types, the assay lets researchers map where various immune cells are and how close they are to the tumor.The team also partnered with Erika Crosby, PhD, assistant professor in the Duke Department of Surgery, to use the Xenium assay, which analyzes the RNA within cells. This helps confirm the protein‑level findings while revealing additional details that might not show up at the protein stage.Early results show meaningful differences between patients who respond to chemotherapy and those who don’t. Some immune cells appear in higher numbers in people who respond well, suggesting these may serve as early indicators of how effective chemotherapy might be.“Without this collaboration between surgery and biomedical engineering, locating and reviewing patient records and samples would have been far more time‑consuming,” DeVito said. “Everything came together at the right time: the technology, the expertise, and access to the right samples. That’s what makes a project like this possible.”A major boost for this work also came from CRUSH Colorectal Cancer, which supports early‑stage ideas that need initial funding before they can compete for larger grants.“CRUSH provided the seed funding that allowed us to get started,” DeVito said. “An added benefit is that any data generated becomes a shared resource for the entire GI oncology team at Duke.”Looking ahead, the team plans to expand their research into mouse models in collaboration with Jatin Roper, MD, that mimic how colorectal cancer spreads to the liver. This could help them test the biomarkers they discover and explore new treatment strategies in the lab.“Ultimately, everything we’re doing comes back to the patient,” Chang said. “We want to find better ways to treat this cancer, especially for patients who don’t have many options today.”The annual CRUSH Colorectal Cancer 5K will be held on March 14. Learn more about the event.
