Retired police officer’s death of rare cancer helping to shape care at UHNM
Richard Kelsall receiving treatment for rare form of pancreatic cancer, with wife Margaret Kelsall at his side
A retired Staffordshire police officer who became the world’s longest survivor of a rare form of cancer is helping to change the future of medicine.
54-year-old Richard Kelsall, of Gnosall, Stafford, was diagnosed with Pancreatic Acinar Cell Carcinoma (ACC), a type of pancreatic cancer, and was cared for at County Hospital in Stafford. He was initially given just four months to live - but actually survived for four years, thanks to the pioneering work of a University Hospitals of North Midlands’ doctor.
Fewer than 10 people are reported to have been diagnosed with Pancreatic Acinar Cell Carcinoma, making it one of the rarest forms of cancer. In Mr Kelsall’s case, Dr Apurna Jegannathen, clinical oncologist, persevered with chemotherapy treatment for 42 months, well beyond the standard timeframe.
Sadly Mr Kelsall has now passed away, but his case - where prolonged chemotherapy was administered - has served to highlight the unique benefits of personalised medicine.
Today Dr Jegannathen said: “Because of its rarity, there was no agreed consensus on the treatment plan for this type of cancer. We opted for chemotherapy, although resistance to this can often develop. Usually patients only receive chemotherapy for a short while, but in Mr Kelsall’s case we were able to give it for 42 months. This experience has therefore demonstrated that a generalised approach to treatment plans is not the way forward and that we have to look at every patient as an individual. Cancer care at UHNM will continue to be directed towards individualised medicine.
‘’Richard was able to spend an extra four years with his family because we absolutely refused to give up on treatment. This shows that we can’t live ‘by the one-size-fits-all’ approach, sometimes we have to go with gut instinct. It’s true that chemotherapy is a standard treatment, but the difference here is that we did not give up – and look what a difference it has made. Richard not only survived, he was able to really live. He had a good quality of life and was able to enjoy his family life for years more.”
Dr Jegannathen and Dr Shalid Gilani, oncology specialty doctor, have published their findings in the ACTA Scientific Cancer Biology journal, a high profile clinical publication with an international audience. Their article ‘A Sustained Response of Maintenance Therapy in Pancreatic Acinar Cell Carcinoma (PACC): A Case Report and Literature Review’ has been awarded the title of ‘Best Article’ and will help to shape the future of cancer care.
Dr Apurna Jegannathen, clinical oncologist, and Dr Shalid Gilani, oncology specialty doctor
Dr Gilani said: “We are incredibly grateful to Mr Kelsall’s family for allowing us to share their experience. Being awarded ‘Best Article’ means that our work will be shared with clinicians across the world and therefore go on to make a great difference to a number of patients.
“We are now entering into a new era of personalised medicine, where we use molecular profiling and genetics to tailor treatment to people on an individual basis. Medicine has been moving that way for a while, but Mr Kelsall’s case has really helped bring it home to us. This is the future direction and the way forward for cancer care. If we had approached Mr Kelsall’s treatment in the usual way, we wouldn’t have understood the disease pattern properly. We have to see patients for the individuals they are.”
UHNM is part of the ‘100,000 genome project’, a UK Government project which sequences whole genomes from NHS patients. The project focuses on rare diseases, some common types of cancer, and infectious diseases, in an effort to create a new genomic medicine service for the NHS – transforming the way people are cared for and bringing advanced diagnosis and personalised treatments to people nationwide.
Mr Kelsall had recently retired as a police officer in Cannock, where he had worked for Staffordshire Police for 17 years and was an active member of the community.
Richard in his early days at Staffordshire Police
We spoke to his wife Margaret Kelsall, about the immeasurable difference the extra four years made to their lives.
Margaret, 60, of Shrewsbury Road, Stafford, said: “When Richard retired we had just started to enjoy life. He was very active, he loved fishing, cycling and going out on his motorbike. But after a while he started to notice that he just didn’t feel right. He was very fit and would often cycle more than 50 miles a day, but he was struggling to recover as he would have been able to before.
“After various investigations, Richard had surgery to remove a very large tumour and he also had his spleen removed. Of course, we knew the outlook wasn’t likely to be good and we told the doctors that we wanted an honest answer as to what his chances were. They told us he had just months to live, it was awful.
“Richard and I were married for 33 years. We’ve been together since we were 17 and I couldn’t imagine my life without him. I loved him to bits and even now, it’s hard for me to get my head around the fact that he is gone.
“Thanks to the extra time we were given, Richard was able to spend more time with family, and in particular our two granddaughters, who he just adored. One of them was born in July 2014, just a few months before Richard died in October. We’re just so glad that he was able to have that time, he loved them and lived for them.
“Richard never gave up, he was a marvel. Every day he would wake up and say “I’m still here!” He was just glad to be alive and had a positive attitude. Towards the end he was so poorly, but he would still get up early every day, shower, have breakfast and be ready to start the day. Sometimes he would even do the housework for me while I was at work. He loved gardening and walking our rescue dog, Stanley – in fact, we used to say that those two looked after each other. Stanley always seemed to know when Richard wasn’t feeling so good.
“Dr Jegannathen’s mantra was ‘‘P’ for plentiful’, which always made us laugh and became our mantra too. Basically, she meant that she would keep going and would try anything and everything she possibly could to help us. We are incredibly grateful for her care and for the work of all the team at County Hospital, they really did look after us both. ”