Giving hope to patients with inoperable liver cancer

A new procedure using microscopic, radioactive glass beads is giving hope to patients with liver can

Thomas Bennett felt like he’d been hit by a ton of bricks when he learned he had colon cancer that had spread to his liver.

“I had no symptoms,” said Bennett, 52, of North Greenbush, who got the diagnosis in October 2005. “The only reason I’m alive is when I turned 50, I decided I needed a colonoscopy.”

In November 2005, doctors removed Bennett’s colon. One month later, he started chemotherapy.

Because liver cancer is one of the most lethal types of cancer, one surgeon gave him six to 18 months to live.

Then Bennett’s oncologist referred him to Dr. Gary Siskin, professor and chairman of radiology at Albany Medical Center.

Siskin is using a breakthrough treatment for inoperable liver cancer called TheraSphere.

According to Siskin, TheraSphere is an outpatient procedure with few side effects that uses millions of microscopic glass beads that are injected into the main artery of the liver through a small tube or catheter that is inserted into a small incision in the patient’s groin.

The radioactive beads are delivered directly into the tumor via the blood vessels that feed it. The radiation destroys tumor cells from within the tumor with minimal injury to the surrounding tissue.

“What happens is we send thousands of these spheres into the artery going into the liver, and those spheres distribute themselves into the liver,” Siskin explained. “More of them go into the tumor because there are more blood vessels bringing blood to the tumor than there is to normal liver.”

The therapy is usually performed in a hospital radiology suite, and patients remain conscious throughout the procedure.

“The therapy is extremely well tolerated,” said Siskin. “The average patient may have a few days of feeling a little tired, maybe having a slightly reduced appetite and maybe a little bit of achiness in the upper part of their abdomen where the liver is.”

In general, the liver cancer therapy is considered for patients who are not candidates for surgery, meaning their disease is in multiple areas of the liver, or for patients who have large tumors that may not respond to other forms of therapy.

“We typically use this in patients who have either primary cancer of the liver or cancer elsewhere in their body that has spread to the liver, which is what happened to Tom,” said Siskin.

In general, Siskin said TheraSphere works best when combined with other forms of treatment such as chemotherapy.

“This is part of what we call liver-directed therapy, where we understand that there may be disease in several parts of the body,” said Siskin. “But our focus is on treating the liver, especially when we think the liver disease is what is the most dangerous for the patient.”

Siskin said the main benefit of TheraSphere is that it slows down or halts the progression of the disease in some cases.

“We’ve seen many patients now like Tom where the disease has remained stable after getting the TheraSphere while continuing on their chemotherapy,” said Siskin.

The liver cancer therapy, which has been available for about three years at Albany Med, has been used on about 120 patients.

“In general, if we see a patient early enough in their disease process when the function of the liver hasn’t yet been affected by the tumor, we’ve seen patients survive longer than they should given the disease in their liver,” said Siskin. “Patients who have extensive liver disease don’t do as well, but they are patients that don’t do as well with other therapies either.”

According to the American Cancer Society, approximately 18,500 cases of primary liver cancer were diagnosed in the United States in 2006. While the rate of people developing liver cancer has stabilized, the actual number of liver cancer patients continues to increase with an aging and growing population. Presently, there are limited options available to treat the disease.

Bennett said he had TheraSphere therapy twice, in January and March last year, because he has tumors on both the right and left sides of his liver. He will need no further TheraSphere treatments unless he develops new tumors in his liver.

“Right now, Tom’s tumors are relatively stable,” said Siskin. “In general, he’s been coming along fine. He’s done very well.”

“I go to work five days a week,” added Bennett, an account executive for The Moore Insurance Agency in Watervliet. “I feel good. I live a normal life, thank God. Things are looking positive.”

The only side effect Bennett said he experiences is fatigue from the chemotherapy, which he tries to offset by staying properly hydrated and eating well.

Bennett said he will continue chemotherapy, four weeks on and three weeks off.

Married with three children in their 20s, he said he wants to see his children get married.

“I’d also like to be able to hold some grandchildren someday,” he said with a smile.

Siskin said TheraSphere is a good treatment option for patients.

“I think we are at a point where we can say this therapy has a lot of potential,” he added. “We’ve seen many people who have done very well. But this is a relatively new therapy. We still have a lot to learn.”

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