Douglas Janousek said 25 years in the newspaper industry can make someone serious, maybe even a bit cynical.
The longtime journalist turned personal chef could be serious or cynical about his upcoming surgery. But he's made a conscious decision to create some humor through the process.
Janousek, 56, will undergo a full pancreatectomy June 7, a surgery which will remove his pancreas, and all or parts of several other organs. It's a preemptive effort, he said, to avoid the family pancreatic cancer "curse."
"The way I look at it, if I'm laughing, I don't have the breath to be crying," said Janousek, who worked for the Enterprise from 1985 to 1986.
Janousek keeps his sanguine wit on display with a hat he wears in and out of his home near Pensacola, Fla. Six smiling, internal organ-shaped pins stick in the hat, pins which he calls his "replacement organs."
Also to wit, he calls the full pancreatectomy, which removes the pancreas, bile duct, spleen, gall bladder and parts of his small intestine and stomach, the "Angelina Jolie solution," a reference to the actress' decision to have both of her breasts removed to avoid cancer.
"It's the same kind of thinking," Janousek said. "You take out the playground of the cancer."
Though his humor keeps him upbeat, the gravity of the upcoming surgery is known, and the decision to have it wasn't taken lightly.
A family 'curse'
Janousek's family has a history of pancreatic cancer. His father died from the disease 20 years ago at age 69 — two days after Father's Day. He said it was a painful experience for all involved.
The experience became more distressing a year later when Janousek's brother died of the same disease at age 42, just before Janousek's birthday.
"I told myself I'm not going that way," Janousek said. "All the chemo does is make you feel bad a little longer … You have to decide if you want quality of life or quantity. There's no wrong answer."
Janousek said at the time his father and brother developed the cancer, the prognosis was 6 to 9 months. In the years since, treatment has improved, he said, enough so that when his uncle, Ernie Brenneis, who lives in Blair, was diagnosed with the disease he was able to have a surgery to remove the part of his pancreas with cancer.
Though some surgeries are available to fight the disease once its been diagnosed, Janousek said that isn't enough for him.
He wants to be proactive in fending off cancer. He doesn't want to count his birthdays — ages which now fall between the ages of his father and brother — as one more year beating the curse. The upcoming surgery, he said, will help give him a peace of mind he hasn't had in 20 years.
"I could still develop (a different) cancer, or I could get hit by a bus," Janousek said. "This is one less bus I have to worry about."
Tough surgery, but tougher cancer
The pancreas is an organ located in the abdomen, behind the stomach. It produces and releases insulin in the blood, which helps control blood sugar and secrete enzymes that help digest foods.
Pancreatic cancer disrupts the normal function of the pancreas. It can spread to nearby organs, such as those Janousek will have removed, and is often found in a late stage. According to the American Cancer Society, the five-year survival rate for people of all stages is 9 percent.
According to a fact guide on Nebraska Medicine's (UNMC) website by oncologist Kelsey Klute, pancreatic cancer is difficult to diagnose because early stages don't often have symptoms or they may be similar to common problems such as heartburn or back problems. Other symptoms might be jaundice, light colored stools, dark colored urine, fatigue or unexplained weight loss.
The cancer also can't be detected with routine tests like X-rays or blood tests, nor are there any effective screening tests.
"We're learning that even after aggressive surgery, pancreatic cancer can later show up in other organs," Klute writes in the guide. "This is because of cancer that we can't detect with scans."
A full pancreatectomy isn't the only surgical option. Other surgeries involve removing all or part of just the pancreas, leaving other organs.
Janousek's decision to remove other organs came after doctors found cysts on his pancreas months ago. His family doctor, knowing his family history, said Janousek should see an oncologist. He did, opting for a full pancreatectomy.
"If I come in with a hangnail, I ask 'Could this be related to a pancreatic family?'" Janousek said. "I'm kind of hyper aware about that … Just seeing my history and seeing my lab results, (the doctor) said I needed to consider this."
Janousek's surgery has a 6- to 9-month recovery time. Without his pancreas producing insulin, he'll become a diabetic and he'll lack some digestive enzymes. He'll have a stricter diet to manage, he'll take enzyme supplements with meals and, with a stomach reduced by one-third, he'll watch his portion sizes, too.
"That's almost just math," he said of the diet changes. "I think in the end, it will be a healthier diet."
The culinary restrictions might seem a lot for someone who left the news industry to graduate from the Orlando Culinary Academy, a Le Cordon Bleu School, become personal chef and publish multiple cook books.
But, Janousek said, that just gives him a chance to write another book. Maybe it will be a new recipe book based on his diet. Maybe it will be more of a look at his family history and his personal journey through being close to cancer and having surgery. Either way, the food and writing isn't as important as a relaxed conscious.
"In some ways, this is a way to stress less," Janousek said. "I know no matter how terrified I am, I'm making the right decision...I love to travel. I'd rather go that way."
Janousek's surgery, and associated medical costs, will cost upwards of $100,000. Insurance, he said, covers about 80 percent of it. He has set up a GoFundMe page to help pay for the remaining $20,000.
He hopes his story helps others avoid being the person with, or the family member of, someone with pancreatic cancer.
"I really want to encourage people to keep an eye on it," Janousek said. "It's horrible, and it's fast acting … I just want people to get checked."