33 – Roger: A Pancreatic Cancer Survivor Story

Rayshawnda Madison (00:00)
Welcome to the Cancer Signal, a podcast by GRAIL, where we share the stories, science, and the people behind multi cancer early detection.

I’m excited to be joining as a host of this podcast this year, as I wanted to take a moment to introduce myself to our listeners. My name is Rayshawnda Madison and I lead culture community, and employee engagement at GRAIL, where I focus on building meaningful employee experiences, strengthening culture, and helping connect people to the mission that drives our work every day;
detect cancer early, when it can be cured. 

What I love most about this podcast is that it gives us the opportunity to go beyond the headlines and hear the very human stories behind innovation. From patients and advocates, to scientists, leaders, and change makers, we’ll explore the conversation shaping the future of cancer detection, and what it means to create impact through purpose driven work. Thank you for listening, and I’m excited to learn alongside all of you in the episodes ahead.

Well, I’m honored to welcome back a returning guest, Roger, who joined us in episode 11 when we last spoke with you, Roger, in 2023 you had recently completed treatment for stage two pancreatic cancer after receiving a multi-cancer early detection test result that identified a cancer signal origin in the pancreas before you were even experiencing symptoms. 

So today, three years later, Roger is here to share how life has really evolved since, what survivorship really looks like, and why he continues to advocate for multi-cancer early detection. Roger, welcome back to the Cancer Signal Podcast. It’s so meaningful to have you here today.

Roger Royse (00:48)
Well, thank you. And you can’t believe how glad I am to be back.

Rayshawnda Madison (00:53)
Yeah, absolutely. I can feel that. You know, when you first joined us in 2023, everything was still very fresh. You had recently received the results from the multi-cancer early detection test showing a cancer signal origin in your pancreas. Can you just take us back to that moment? What do you remember feeling when you first heard the results?

Roger Royse (01:18)
Well, it was quite a surprise, of course, because I had no symptoms. And, you know, as we discussed before, it was, I was just being careful and cautious and checking boxes and ruling things out. And so I was quite shocked actually, when the doctor told me that they had found signals and I needed further testing. But even then I wasn’t super concerned because I just thought, well, that’s just additional testing. It’s just super unlikely they’re gonna find anything. This is probably nothing. So I was surprised that something popped up, but not as concerned as I should have been probably.

Rayshawnda Madison (01:54)
Mm-hmm. Yeah, who did you talk to first during that time?

Roger Royse (02:11)
I got a call from somebody. And the fact that I got a call ⁓ kind of tipped me off that something was probably wrong because I was just expecting to get an email that says everything’s fine. I didn’t get that email instead I got a phone call. As I was driving to work.

Rayshawnda Madison (02:15)
Yeah, Mm-hmm.

Roger Royse (02:41)
So I knew that it was probably going to be something. And yeah, I mean, that was the first call I got about this.

Rayshawnda Madison (02:45)
Mm-hmm. Yeah, that moment can definitely feel like everything changes all at once. You know, your cancer was diagnosed at stage two, which is significant because pancreatic cancer is often detected later, at a later stage. What did your doctors share with you about finding pancreatic cancer this early, especially before symptoms even appeared?

Roger Royse (03:16)
Well, the radiologist told me I was the luckiest person he had ever met. ⁓ Because where the tumor was and the way it had been growing, unlike most pancreatic cancers which pop up in the head of the pancreas and cause symptoms right around stage two, mine was at the tail and would not have caused any symptoms until it was just way too advanced to do anything about, frankly. So he said it was just extremely lucky that I caught it when I did.

Rayshawnda Madison (03:48)
Yeah, absolutely. Did hearing that at that moment give you hope, right? Especially after hearing the diagnosis. But hearing this feedback from your doctor, did that give you a sense of hope at that time?

Roger Royse (04:09)
Yes, because the thing is so pancreatic cancer is a very poor survival rate, but the reason why is because it typically shows up so late. ⁓ and then the survival rate gets down to, you know, roughly what other stage four cancers are. So to hear, so, so initially it’s like, gee, it’s pancreatic cancer and it’s distal, distal tail, which tends to have a even worse survival rate than most pancreatic cancers.

Rayshawnda Madison (04:15)
Yeah.

Roger Royse (04:37)
That’s bad until you peel back the onion and realize, well, that’s because it’s never caught early. You catch it early and the odds go up. So I was looking at numbers the whole time and stats and odds. And the fact that we counted early made a big difference. I went from a, really just the fact that I counted early, you know, went from a 13 % five-year survival to a 24%, just that one fact immediately.

Rayshawnda Madison (04:44)
Hmm. Yeah, absolutely. Absolutely. And I bet the numbers are grounding, right? You kind of need some of that data to be like, you know, I need something to compare this to something to ground me. So I’m really glad that you were able to get that both from your doctors and your own research. So fast forward to today. It’s three years later. How are you doing? You know, how are you feeling physically, emotionally, and just overall?

Roger Royse (05:33)
Oh, I’m fine. I mean, I’m in fact, ironically, my health is better now than it’s been in many years because I’m just paying much more attention to things that I did not pay attention to before because I just didn’t think that I had to. Now I know that I do. I mean, I’ve got some lingering effects from the chemotherapy, a little bit of neuropathy, but it gradually and slowly gets better. But I’ve gotten I’ve recovered for the most part.

Roger Royse (06:02)
And the chemo, you know, didn’t talk too much about the effects of chemotherapy because everybody’s already heard enough about that, but it is what it did to me. I mean, I was a complete physical mess by the time I was done with treatment and I’ve managed to basically reverse almost all of that. And it just takes time and effort and a good plan.

Rayshawnda Madison (06:23)
Wow. Yeah. And what does that recovery or survivorship kind of look like over time? I know you said right after chemo, you know, physically and emotionally you felt, you know, a little depleted. What has that evolved like over time?

Roger Royse (06:45)
Yeah, little bit of pleated doesn’t quite capture it. I mean, I lost a ton of weight. I lost all my hair. All my numbers were a mess. People that I’d known for 20 years did not recognize me. Yeah, that’s the thing about chemo. I mean, it’s the maximum tolerable dose. They give you as much as you can tolerate. And unfortunately, it turns out I can tolerate quite a lot.

So they gave me quite a lot and I did the full six months plus surgery. So what does it look like? Lost muscle mass, I lost bone density, my vascular system was a mess, my calcium went up, all my blood numbers were messed up, my liver numbers were high. All of that has come back to normal ranges. So there is hope. You just got to recover, but it doesn’t happen automatically. mean, it, it, you know, it takes good, good lifestyle habits, eliminating all the things that increase your risk at the start and adopting habits that decrease your risk going forward.

Rayshawnda Madison (07:56)
Yeah, I really love your story. And I’m most curious about, you know, how has this experience just changed your relationship with cancer? You know, I know a lot of people when they hear cancer, period, no matter what it is, no matter what stage it is, people can feel very like this is permanent, right? Like this is it. For you, going through this experience, how has that maybe changed your relationship with cancer? Would you say you feel, you know, less of like it’s a permanent thing and more of like something, you know, you can really move past and, you know, move forward with? What would you say?

Roger Royse (08:42)
Yes, in a way, I feel like I’ve kind of gotten this behind me and I’ve moved past it. And now it’s just a matter of continuing to monitor and make sure that this doesn’t recur. So I think there was a time when

Rayshawnda Madison (09:02)
Mm-hmm.

Roger Royse (09:03)
You know, that was it. And I heard doctors say that. They say, gee, pancreatic cancer at any stage is a death sentence. Well, you know what? I’m exhibit A for the fact that no, it doesn’t have to be. Catch it early and treat it right doesn’t have to be. so that part is, you know, so that’s one part of it. I really do think that this is behind me. On the other hand, I realize and acknowledge that I am at a high risk of recurrence just because once a person has cancer, they’re just at risk of recurrence. 

And that’s always in the back of my mind. And for example, if I sleep wrong and my back hurts in the morning, you know, a little voice in the back of my mind says, well, that could be a sore muscle or you know what, maybe it’s a recurrence. You know, we’ve always got that worry. Every little thing now, it’s like, is this something benign or is it recurrence? And so far, I’m, you know, four years out from diagnosis and I am NED, no evidence of disease. So, and my doctors tell me, I mean, he actually used the word cured. He said likely cured. I, intellectually, I know that I’m probably beyond all this, but you know, there, there still is the, I guess the visceral reaction to every little thing, which is kind of funny because before this,

Rayshawnda Madison (10:29)
Yeah.

Roger Royse (10:31)
None of this stuff would have given me a second thought at all. But now I’m just much more sensitive.

Rayshawnda Madison (10:35)
Yeah, for sure. Yeah, and vigilant, right? Which I think also adds to your just awareness around health and wellness so that you’re more proactive than reactive, which is a change in a muscle that I think we all have to grow in some ways, right? Especially when we’re just thinking about health. How can we be proactive with finding out things while they still can be cured? So thank you so much for sharing that. I know you’ve become an advocate for multi-cancer early detection and for raising awareness just more broadly. What motivates you to share your story and to help others really understand the potential impact of early detection?

Roger Royse (11:19)
I think there’s a lot of room for improvement is the biggest thing. And I have talked to so many cancer patients since my diagnosis and pancreatic cancer patients. And the thing that keeps surprising me that even now in 2026, I hear people say, they discovered my cancer at a late stage or they discovered my cancer by accident because I broke my leg and they happen to be doing a scan or something like that. And that to me, that’s just, that’s outrageous. I mean, we’ve got the technology to find this, you know, without having to wait for some accident to happen and just, oh, by mistake, you’re sort of picking it up. And I just think we would get much better results and much better outcomes and much better overall health if the world knew about this, if it just became part of standard of care.

And that’s what I’ve been advocating for is to just get these sorts of tests into the mainstream. Because for me, it was not, you know, wasn’t something that was obvious. I mean, I had to go out and search it, seek it out, find it. And most people won’t do that. Most people, they go for their annual checkup and whatever their doctor tells them to do, that’s what they do. 

Rayshawnda Madison (12:40)
A thousand percent.

Roger Royse (12:42)
Yeah, and what we want to have happen is a doctor should be saying, hey, you know you’ve reached a certain age, you better start, you’re at risk of these diseases. And there’s stuff we can do about it if you find it early enough. So let’s try and find it early. That’s where I think the system ought to be.

Rayshawnda Madison (12:59)
Yeah, I’m with you with that 1000%. I think that goes back to that more proactive model rather than reactive, right? So thank you so much for sharing that. I just want to go back to when you were first going through this, when you were going through treatment, you know, you already talked about that it was more than depleting, right? And I’m sure it affected not just you, but, you know, everyone around you as well. When everything felt… really uncertain, what helps you stay grounded? Were there any particular people or routines or just mindsets that helped?

Roger Royse (13:39)
Yeah, several things. ⁓ I would say that my daughter was my very absolute best advocate because she was really the only one who shared my ⁓ unrealistic enthusiasm and optimism. And ⁓ she, ⁓ you know, she really, like I say, was good to have somebody who kind of, like I say, was as optimistic as I was because most people were not. ⁓ 

Rayshawnda Madison (13:53)
Mm-hmm. Yeah. Yeah.

Roger Royse (14:08)
But after six months of seeing me on chemo, optimism faded a little bit. And that’s when it occurred to me that, that, it’s not just about me. I mean, this is having a real impact on all the people around me. And it’s easy after a diagnosis like that, you know, I had three doctors tell me I probably wasn’t going to make it. So after hearing that, you know, it’s easy to be a little bit, I guess, self-focused. Or inward looking and not realize what this is doing to everybody around you. And I think, you know, there is an impact, there’s a huge impact. So while I was kind of psyching myself up to get through another round of chemo, you know, I would get to the point where, okay, you know, we can do this. I didn’t realize just how much people were watching me deteriorate. Maybe not, you know, maybe not having as much, let’s say it affected them more than I thought that it would.

Rayshawnda Madison (15:09)
For sure, and I’ve heard that before, right? That cancer doesn’t just affect the person that has it, it certainly has a ripple effect on the people that love them, right? And watching people you love mourn you while you’re still living can be hard. 

So I love that you had your anchor, which was your daughter, and in those moments where you seen it was hurting her, it sounds like you needed to take a moment to…look inward yourself. Would you say any mindset changes helped you stay grounded during that period as well?

Roger Royse (15:45)
Yes. And I’ve talked to a lot of survivors and, you know, and I always ask, what’s the common thread? And what I found is that I couldn’t find like a common therapy or a common treatment or a magic pill or anything like that. But one thing I did find in common was a survivor’s attitude.

Roger Royse (16:06)
And the one thing to have in common is the ability to hold two very conflicting thoughts at the very, at the same time. And one is that I might die and that’s, if that’s what happens, that’s okay. I’m not going to be afraid, but at the same time, I am going to fight this as hard as I can with everything I’ve got. I’m not willing to accept it. So I’m not gonna fear it, but I’m not going to accept it. And those are two difficult thoughts to hold at the same time, but I think it’s important because otherwise the fear can overtake you. On the other hand, you can’t be so… I guess, accepting the death that you don’t do anything ⁓ to, or unwilling to, you know, to take the medicine, so to speak, and do the hard things that you have to do to get past it.

Rayshawnda Madison (17:06)
Mm-hmm. Yeah, wow, that was really beautiful, Roger. And I love what you said about not letting fear keep you down, but really trying to stay inspired during it. And I love also what you said about holding two truths at the same time, right? And needing to be flexible in that. So thank you so much for sharing that. As you just reflect on the experience now, what do you wish more people understood about what it really looks like to go through something like this? What surprised you most or what felt hardest that people may not see?

Roger Royse (17:53)
Well, everybody knows chemotherapy is hard. I guess I didn’t realize just how hard that would be. And I had it in my head, I’m very goal oriented. And when they said, we’re gonna aim for six months, but hardly anybody ever, you know, could make it through the full six months. I said, okay, that’s my goal, six months of chemo. But it’s a… You know, the impact and it’s part physical and it’s cumulative. You know, each session is worse than the last. And it’s part the pain and the nausea and all of the, you know, all the physical symptoms, but it’s also very much mental. The thing that surprised me most is just how mentally difficult going through chemotherapy would be. So that’s one thing people ought to be prepared for. 

The second thing is something I’ve already touched on, you know, be sensitive to how this is impacting people around you, because it’s easy to be very self-focused and not appreciate that this is really hard on the caregivers. So those are probably the two biggest things.

Rayshawnda Madison (19:38)
Awesome. Thank you for sharing that. So here we are. You know, we took a look back. We’ve talked about what you’ve been doing now. And now I want to think about the future. You know, what does moving forward mean to you now?

Roger Royse (19:56)
Yeah, so the future I’m very interested, of course, I’m going to continue advocacy. And we’ve had some big wins, as you know, recently with regard to multi cancer early detection, we need to do a lot more to get this into the mainstream. But it’s not only screening that’s important, it’s also intervention and prevention. And that is something that I’m particularly personally interested in, of course, is the prevention side of this., because the best remedy to cancer is to just not get cancer. And once you got it, the next best thing is to catch it early.

Rayshawnda Madison (21:41)
Mm-hmm, for sure. That’s right. Absolutely. Is there anything you would say to someone who may be at the very beginning of a similar journey?

Roger Royse (21:55)
I would say don’t lose hope because the technology is changing so quickly. is number one, ⁓ don’t lose hope. ⁓ And secondly is to take charge, take personal responsibility, be proactive, ⁓ be assertive. ⁓ You really have to advocate for yourself because it’s like looking for that needle in a haystack, your solution might be out there, but it’s up to you to find it. And you can have the best doctors and the best advisors and the best scientists in the world, but it’s really ultimately at the end of the day, it’s gonna be up to the patient to push to get to that solution.

Rayshawnda Madison (22:47)
Awesome. Roger, thank you so much for sharing your story and for just continuing to help others understand the importance of early detection. Conversations like this really remind us that behind every scientific advancement, there are real people, real families, and real futures that can be changed. We’re so grateful for your openness and for the role you continue to play in helping raise awareness. It really truly has been an honor to hear how your journey has evolved. Thank you so much, Roger.

Roger Royse (23:22)
Okay, well, thank you and thanks for doing this. I appreciate all the work that you’re doing.

Rayshawnda Madison (23:29)
Yes, I hope to have you back in another three years and I’ll see you next time. And thank you to all for listening to this episode of the Cancer Signal Podcast. You can always learn more at GRAIL.com and we hope you will join us again next time.

 

The overall sensitivity in study participants with pancreatic cancer was 83.7%. (61.9% for stage I, 60.0% stage II, 85.7% stage III, 95.9% stage IV).

Important Safety Information
The Galleri test is recommended for use in adults with an elevated risk for cancer, such as those age 50 or older. The test does not detect all cancers and should be used in addition to routine cancer screening tests recommended by a healthcare provider. The Galleri test is intended to detect cancer signals and predict where in the body the cancer signal is located. Use of the test is not recommended in individuals who are pregnant, 21 years old or younger, or undergoing active cancer treatment. Results should be interpreted by a healthcare provider in the context of medical history, clinical signs and symptoms. A test result of No Cancer Signal Detected does not rule out cancer. A test result of Cancer Signal Detected requires confirmatory diagnostic evaluation by medically established procedures (e.g. imaging) to confirm cancer. If cancer is not confirmed with further testing, it could mean that cancer is not present or testing was insufficient to detect cancer, including due to the cancer being located in a different part of the body. False positive (a cancer signal detected when cancer is not present) and false negative (a cancer signal not detected when cancer is present) test results do occur. Rx only.

Laboratory/test information
The GRAIL clinical laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and accredited by the College of American Pathologists. The Galleri test was developed—and its performance characteristics were determined—by GRAIL. The Galleri test has not been cleared or approved by the Food and Drug Administration. The GRAIL clinical laboratory is regulated under CLIA to perform high-complexity testing. The Galleri test is intended for clinical purposes.