LINCOLN — A survivor of pancreatic cancer says hope, care at the University of Nebraska Medical Center and a strong support team saved his life five years after his diagnosis.

In early 2018, Kiim Bate of Lincoln developed a rash that was soon diagnosed as shingles. Later, his family doctor said Bate likely had cancer somewhere in his body. Multiple scans and biopsies were either negative or undetermined, until a call that September provided an answer.

“The biopsy was wrong, and it is cancer,” Bate recalls his doctor saying. “It’s pancreatic cancer, and it’s an aggressive one.”

Bate scheduled local robotic surgery for his pancreas, a six-inch gland in the abdomen that produces digestive enzymes and insulin. However, a push by family — particularly a nephew who is a doctor in Neligh, Nebraska — encouraged Bate to instead choose the University of Nebraska Medical Center.

“If you don’t go, I’m going to come and get you and take you,” he said his nephew told him.

‘New lease on life’

Dr. Luciano Vargas, Bate’s doctor at UNMC, affirmed his family’s concerns and said his patient needed eyeballs on the cancer, not a camera.

Within seven to 10 days, Bate said, he went through major surgery, which included removing a third of his pancreas along with 23 lymph nodes and his spleen. His cancer, at Stage 2B, had been caught early.

After the surgery, Bate underwent chemotherapy every two weeks for about six months.

“When you think about pancreatic cancer, we’re talking days, it changes. It’s quick,” Bate said. “And so every day is something that you just can’t waste.”

Dr. Kelsey Klute, a UNMC oncologist on Bate’s care team, said UNMC has kept an eye on Bate for five years.

“You can tell he just really feels like he has a new lease on life,” Klute said of Bate. “And to some degree, he actually does.”

‘Not playing by the rules’

Pancreatic cancer differs from other types of solid tumors, particularly because it doesn’t play by any rules or principles of solid tumors.

“Some of the basic, fundamental principles of cancer biology that we learn are not only not obeyed, they’re actually flipped upside down,” said Dr. Sunil Hingorani, director of UNMC’s Pancreatic Cancer Center of Excellence in the Fred & Pamela Buffett Cancer Center.

Pancreatic cancer is nearly impossible to detect early and is “incredibly insidious” in leading physicians away from diagnosis when symptoms are present, Hingorani said.

Pancreatic cancer also decreases the blood it takes in, rather than stimulating the growth of new blood vessels to grow its blood supply, as other cancers do.

“It isolates itself from the system and, in a way then, provides the first line of its defense against whatever we might introduce in the bloodstream,” Hingorani said.

Any toxins introduced in the bloodstream could impact other organs, Hingorani said, which is a resistance outsizing other solid tumors. In addition, the cancer violates a common vocabulary of cancer staging, from Stages 1 to 4, that surgeons use.

Generally, staging guides surgeons through “windows of opportunity” on when they should intervene, such as always cutting with Stage 1 or 2 cancer or never cutting at Stage 4. At Stage 3, “Think about it.” 

Yet, Hingorani said, a clinical Stage 1 pancreatic tumor may simultaneously be a microscopic Stage 4 cancer that has already spread to other parts of the body.

“That’s not playing by the rules,” Hingorani said.

Reason for optimism

The disease is highly lethal, Dr. Klute said, but added it is important to maintain hope.

“I always try to remind people you are not a statistic,” Klute said. “You are one person, and there are people who beat this, and there’s no reason you can’t be one of them.”

That optimism applies to the disease’s future, which Hingorani said will include further understanding of the differences he outlined, which could inform what drugs or delivery systems work best to target the KRAS oncogene that drives pancreatic cancer.

“Now, the ballgame is different,” Hingorani said, which will lead to a discovery of what “leads to catastrophe” for the cancer.

Family history

In 2017, the year before Bate’s diagnosis, his sister had been sick over the summer, yet doctors couldn’t figure out what was wrong. It wasn’t until that October that she was diagnosed with Stage 4 cancer and died about two weeks later.

Bate’s twin had also been suspected to have pancreatic cancer in 2018 and got a biopsy but died a couple of days later due to complications with the procedure.

Bate recalled hearing the word “cancer” when he was younger and soon after hearing “funeral.”

“There was no hope,” Bate said.

Bate, now 66, said he’ll spend his next minutes on gratefulness, something he learned through his life after leaving Kansas City slums and moving to Hastings in 1974. While some thought the move was for college, it was to follow a girl, his eventual wife of 47 years.

He graduated from Hastings College with a degree in human services but was self-employed for the better part of 40 years, including doing lawn work, small engine repair, working with wind and solar power and converting gasoline vehicles to all-electric.

“We did whatever we had to do to make a living,” Bate said.

Bate worked 70 to 80 hours a week and had never thought he’d quit working full time. But “the body’s forever changed” after his cancer treatment. During his recovery, he at one point got out a piece of paper for a “little pity party” and wrote down all the things he wasn’t going to be able to do.

“I got a couple, two, maybe three or four things on the list and I thought, ‘Kim, you dumbass, turn that page over and write down all the things you’re going to do,’” Bate said. “Never looked at the other side since. Not going to.”

‘Hope fuels recovery’

Instead, Bate has focused on the bright side and has allowed hope, family and faith to uplift him.

“Hope fuels recovery,” he said. “You don’t get better if you don’t hope, and you don’t get better if you don’t think there’s a chance.”

Bate’s wife, Nancy, described the recovery as “kind of a roller coaster,” though better than expected.

“It was one of those — you didn’t really have a choice, you just muddle through and do the best that we could,” she said.

While the Bates said it was difficult at the time to work with insurance — Kim Bate said this is a point where lawmakers can apply pressure for more early detection — they’re thankful for the outcome.

The couple’s son, Patrick, and daughter, Ella, also aided in the journey. Patrick said that through many ups and downs, Bate’s persistence and stubbornness paid off.

“He grew a lot,” Patrick Bate said of his father.

‘I will not live in fear’

Much of the hope came out of a sense of respect for those rooting for him. This includes some 100,000 people, Bate said, who raised his name in prayer on any given Sunday as part of a nationwide prayer list started out of a little church in Kansas City.

Bate is now a full-time student at Wartburg Theological Seminary, taking courses online and in person. Every Sunday, he serves in a small Lutheran church in Palmyra, Nebraska, about 20 miles from Lincoln, which he described as “another step” in his faith journey.

“If I don’t honor all that they did to help me, then I’m the one that’s dropping the ball,” Bate said.

He said one of his heroes is Robin Roberts, a “Good Morning America” anchor on ABC who is a survivor of breast cancer and myelodysplastic syndrome, a rare blood disorder that affects bone marrow. On days when he got really sick, Bate said, he’d watch GMA and see Roberts as a cancer thriver, not just a survivor.

“She may never know what she did for me in my life. But where did I get my hope?” Bate said. “That’s one of my places.”

Some people in remission worry about the cancer returning, Bate added, but not him. If he did, he said, the cancer would win again.

“I will not live in fear of this cancer coming back,” Bate said. “I won’t let it take a minute from me, not one moment. Can’t.”

‘Settling a score’

Hingorani, as the lead of UNMC’s pancreatic cancer division, said simply he didn’t choose pancreatic cancer as a specialty — it chose him.

In 1998, Hingorani said, he was studying the KRAS oncogene that drives pancreatic cancer, in the context of lung cancer, when his father was diagnosed with metastatic pancreatic cancer. At the time, there was “essentially nothing” to treat it, from a chemotherapeutic standpoint.

As one of his first patients as an attending physician, Hingorani said, his father lived about 10 or 11 months after his diagnosis — longer than Hingorani’s mentors thought he would. 

Hingorani said the fact he couldn’t save his father is “still the biggest failure of my life, frankly.”

“Everything that comes after that is about settling a score,” Hingorani said. “It’s about personal redemption and a vendetta, and I always put that out on the table up front.”

‘Hotline to a total embrace’

That experience also taught Hingorani how health care was set up for the convenience of the provider instead of for patients, who were expected to make individual appointments with a number of specialists. Now, with a vengeance, UNMC has changed the game.

Christina Hoy, clinical program director and a nurse practitioner, said whenever a prospective patient calls, she operates something of a five-alarm fire.

“Everything” is set in motion, including four medical oncologists who focus on pancreas cancer, five surgeons who specialize in operating on the pancreas and others at UNMC ranging from nutritionists and social workers to spiritual care, clinical research and financial counselors.

“Every week, there’s 40-plus people who come together to review cases, and we comb through — in detail — every scan on the big screen … and we go around the room, through each discipline, and challenge each other to come up with the best place of care for each individual patient,” Hoy said.

Tony Hollingsworth, a UNMC professor who has researched pancreatic cancer since 1985, said the team frequently rules things out and moves on quickly, with the patient in mind.

Hingorani said the center telephone number is 1-844-CUR-PANC, a “one-stop-shopping experience” and a “hotline to a total embrace of the patient.”

“This is a place I wish I could have brought my father to,” Hingorani said of UNMC. “This is the place you want to bring your loved one to if you want them to get the best shot at longevity. It’s as simple as that.”

‘The sound of hope’

Bate said more public awareness is needed about pancreatic cancer because neither his sister nor he thought or worried about the cancer before, and he didn’t even know the function of the pancreas. 

“It’s a story of hope,” Bate said.

After a patient’s last round of chemo, there is a bell that patients ring. Bate said that bell represents what is offered through his treatment.

“I cheat,” Bate said with a laugh. “Every time I get a clear bill of health, I smack that bell. I don’t just go and give it a little tap — it rings out. And when I hit that bell, I wait for it to echo down, and then I say loudly, ‘That is the sound of hope.’”