Stage 0: The Day After the Diagnosis

It’s precancerous, and it’s coming out.

It’s a major surgery. Like last time.

This morning in Pilates, a flashback hit me—the table full of surgical instruments, the two months of daily heparin shots. I remembered everything. But here’s the good news: the cyst has not turned to cancer yet.

Dr. Merchant said, “It could be stage 0. With stage 0 cancer, there’s no chemo.” I think I threw my hands up in the air.

The Scene at the Hospital

Picture this: me and Justin, in the regular chairs (not the white-paper exam chair), notebook in hand with 13 well thought out questions. Dr. Merchant walked in with a team of nine. Yep, nine. This is a teaching hospital, and I support that. I said to Justin, “Let them watch—this is who’s going to treat patients like me in the future.”

It felt a little strange, having all these kids/interns (about 4) giving me the weird “I’m so sorry” smile.

The two nurses, listening and nodding. The scribe typing everything he heard.

The doctor standing next to Dr. Merchant, nodding and agreeing with everything that I, Justin and the doctor said. (He must be second in command.)

The Surgery Plan: Modified Whipple

So, here we go. It’s the Whipple surgery—technically a modified version because I no longer have the body or tail of my pancreas, or my spleen – that was taken out back in 2020. What’s coming out:

The rest of my pancreas
My gallbladder
My duodenum (part of the small intestine)
My bile duct
My stomach will be attached to my stomach.

All the guts—gone.

The Fear, the Facts, the Family History

This part is hard.

My mother had the same surgery. It was early days back then, and they didn’t get clean margins. I associate that surgery with her death. But this is not her story. This is mine. And the context is different:

It’s not cancer (yet)
It’s contained
It’s stage “0”—pending final pathology
No spread to other organs

This cyst hasn’t decided to turn malignant—but I’m not waiting around for it to make that decision.

Dr. Merchant and My Medical Dream Team

Dr. Merchant has done thousands of these surgeries. He is on par with my beloved Dr. Diane Simeone, who treated me back in 2020. We sent her my latest report. She read it, called me at home, and confirmed the plan:

“Your pancreas is not compliant.”

God, I love her.

We also talked about her new study on high-risk families and genetic mutations. I said, “Take the whole thing and have fun with it.”

Advocacy, Full Circle

Years ago, I enrolled in PRECEDE, Dr. Simeone’s early detection study. It helped catch my stage 1 cancer in 2020. She once invited me to speak at her conference. I brought it up again, how I’d love to speak as a survivor now-patient again. She was interested, and said:

“Let’s do the surgery and you recover, and we’ll see how you feel then.”

Yes. Yes, yes, yes.

The Facts (For Those Skimming)

Diagnosis: High-grade dysplasia (pre-cancerous IPMN cyst in pancreatic duct)
Surgery: Modified Whipple (pancreas, duodenum, gallbladder removed)
Date: September 2, 2025
Recovery: 7–10 days in hospital, 1–2 months at home
Aftercare: Final pathology will determine if chemo is needed, but likely not

If you’ve read this far—thank you. I’ll share more as we move through it.

And if you’re going through something like this?

You are not alone.

Meredith's Musings