New therapy points to better life
First nuclear fallout, then liver cancer hit Arizonan now trying high-tech treatment
Carla McClain
Arizona Daily Star
Tucson, Arizona, February 11, 2006
A "downwinder" - an Arizona man exposed to nuclear test fallout more than 40 years ago - has become one of the first patients to try a new, high-tech treatment against aggressive liver cancer at University Medical Center.
The therapy involves injecting millions of extremely tiny glass beads full of high-dose radiation directly into the liver tumor through a major artery.
Attempted so far at only 20 medical centers in the United States, including UMC, the therapy aims to prolong a higher quality of life for these struggling patients.
"From the way I am feeling now, they must have gotten quite a bit of the cancer," said John Jenkins, whose large liver tumor was discovered a little more than a year ago. He underwent the new "microspheres" therapy in October.
"I don't think I'd be gaining weight and feeling so good if this wasn't having quite an effect. It's quite a change."
Jenkins, 54, an active man who ran a firewood business and worked on ranches, has lived in Ash Fork, in Northern Arizona, since he was 7 years old. During his childhood in the 1960s, nuclear bombs were detonated in nearby Nevada during above-ground testing done by the U.S. government.
After finally admitting that thousands of people living "downwind" of the testing were exposed to significant radioactive fallout, Congress in 1990 ordered partial compensation paid to victims such as Jenkins.
Unlike most of the 14,000 Americans who yearly develop the most common form of liver cancer, known as hepatocellular cancer, Jenkins did not have cirrhosis or hepatitis, leading doctors to conclude the radiation exposure led to his cancer.
Unfortunately, this liver cancer usually develops for years without symptoms, and often is detected after it has grown too large to be surgically removed, as happened with Jenkins.
For those patients, the most common treatment has been chemotherapy followed by various attempts to block the blood vessels feeding the tumor, along with external radiation - all of it typically giving the patient six to 18 months of life after diagnosis.
Because this has been a very toxic regimen for a patient's limited time, researchers long have tried to develop more effective and less sickening therapies for those with liver cancer.
That led to the newest, and possibly the most promising: the microspheres therapy. Millions of glass beads, each only half as wide as a human hair, are injected into a catheter inserted in the patient's upper leg and threaded up through a major blood vessel to the hepatic artery to the liver.
The whole process takes less than an hour, while the patient remains conscious, then is released to go home. Radiation from the beads continues to bombard the tumor internally - doing very little damage to surrounding tissue - during the next one to two weeks.
"The goal is to extend life and to improve the quality of that life," said Dr. Lisa S. Gobar, the University of Arizona nuclear medicine specialist who works with an interventional radiologist to inject the microspheres.
"That is extremely important. If we put a patient through six months of hell to get two more months of life, what good have we done? So we really try to improve on that - to give someone a decent life, not one of pain and wasting."
Unlike chemotherapy and external radiation, which involves daily sessions for weeks, the microsphere therapy involves only one short visit to the hospital, then months of life at home before a possible second round of treatment. Also, the procedure itself is painless, and the recovery from radiation effects is fairly brief.
For the first few weeks after the process, Jenkins felt flu-ish and weak, with an upset stomach. But since that passed, he says, he has steadily gained strength, energy and weight.
During the chemotherapy before the microsphere radiation, he was intensely fatigued and nauseated, losing 70 pounds off his 6-foot frame.
However, because the microsphere therapy is so new - brought into U.S. medical centers only in the last three years - doctors are unsure just how much extended life it will mean for patients, Gobar said.
Early studies, conducted at the University of Pittsburgh, showed survival time more than doubled - from eight months to nearly two years in some patients.
"I know this is not a cure, but it sets the cancer back, and I'm feeling the best I have in many months," said Jenkins, who rejoiced in the birth of his granddaughter last week.
"It's a prolong-your-life-as-long-as-you-can deal. No one ever promised me more, and I have finally accepted that."
Saying he is "optimistic" that he'll make it another year, Jenkins said, "I don't think most people really understand what it means to gain a year of life.
"But I can tell you hands down... without this, I would never have seen my new granddaughter. Just to be able to hold her has been worth the whole ride, and I'm pretty darn grateful for that."
Contact reporter Carla McClain at cmcclain@azstarnet.com.
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