As part of our mission to eliminate cancer, MD Anderson researchers conduct hundreds of clinical trials to test new treatments for common and rare cancers.
Elsie Kroeger and her husband Tim had been looking forward to spending spring break with their grandchildren for months.
While her family headed to the resort, Elsie went to the emergency room. Doctors discovered a suspicious mass in her colon and referred her to a specialist. Further tests revealed that she had stage 4 colon cancer, the most advanced form of the disease.
“I had been having bowel problems for a year,” she said, “but I thought it was irritable bowel syndrome or a sensitive stomach.”
Kroeger sees MD Anderson Cancer Center as his best hope. Doctors prescribed chemotherapy and performed surgery, but the cancer continued to grow. Malignant cells came out of her colon and formed tumors in her liver.
“Up to 70 percent of patients with colon cancer eventually develop liver metastases,” said Armin Mahvash, MD, assistant professor of interventional radiology. “This is because the blood supply to the intestines is directly connected to the liver, so cancer cells can spread through the blood.”
As cancer spread and choices diminished, Kroger signed up for a clinical trial for patients like her whose colon cancer had not responded to chemotherapy and had progressed to the liver.
Patients in the study were injected with tiny radioactive glass beads called TheraSpheres, which travel through the bloodstream to the liver to kill cancer cells. Chemotherapy is also used to fight cancer that may be hiding in other parts of the body. The study aims to determine whether TheraSpheres in combination with chemotherapy are more effective than chemotherapy alone.
MD Anderson is one of 100 hospitals worldwide participating in the study, with more patients enrolled than any other hospital.
”This provides another option for patients who don’t have a choice,” said Mahvash, MD, who is leading the MD Anderson portion of the study.
“In this study, we injected a contrast dye into the blood vessels to identify on the X-ray the vessels that carry blood from the liver to the rest of the body,” he explains. “We then block or embolize these blood vessels to prevent the TheraSphere from leaving the liver and damaging other tissues and organs during treatment.”
Pre-treatment mapping also allows doctors to tailor bead delivery to the exact location and size of each patient’s liver tumor.
Mavash first made a small incision in the patient’s groin. He then inserts a plastic catheter into the incision and guides it through the artery to the liver.
With the tip of the catheter in place, he injected millions of radioactive beads directly into the tumor. Each tiny bead is smaller than a grain of salt and contains the radioactive isotope yttrium (also known as Y-90). The beads become lodged in the tumor’s blood vessels, blocking blood flow and delivering extremely high doses of radiation that kill cancer cells.
“Radiation kills tumors from the inside,” Marwash said, “and targets multiple tumors in the liver at the same time, while sparing healthy liver tissue.”
The tiny beads deliver 40 times more radiation than traditional radiation treatments for cancer, which use machines that fire beams of high-energy radiation from outside into the liver.
Traditional radiation therapy is given five days a week for several weeks. TeraSphere is usually carried out in one session.
For two weeks after treatment, the beads will continue to emit radiation, gradually decreasing to negligible levels with few side effects.
Patients can return home approximately three hours after treatment and return to normal activities within two days. The most common side effect is fatigue for two weeks, the same as with traditional radiation.
“This minimally invasive and precise procedure has been proven to improve patients’ quality of life and prolong their life expectancy,” Mahvash said.
In addition to treating colon cancer that has spread to the liver, TheraSpheres has been shown to treat primary liver cancer that originates in the liver.
Researchers are now starting to think about how this technology could help treat other forms of cancer. Early research suggests kidney cancer may be the next target. The kidneys have a very rich blood supply, making them good candidates for radiation.
“The more vessels there are in the tumor, the more beads accumulate in the tumor and the better the effect will be,” Mahvash said.
Treatment of colon cancer that has spread to the liver with radiation beads is considered palliative, meaning it usually cannot be cured, but can help slow or stop the progression of the disease and reduce symptoms.
”Some patients who are given six to 10 months to survive end up living significantly longer,” Mahvash said. “That means more time to attend a high school or college graduation, walk a daughter down the aisle, or witness the death of a grandchild. . born.”
Shortly after her TheraSphere treatment, Elsie felt well enough to spend a night on the town with her husband. The couple celebrated their 46th wedding anniversary at a local restaurant and danced to Johnny Mathis’ “Misty,” the first song played at the wedding.
”We rocked and hugged each other and cried,” said Elsie, who is looking forward to attending her granddaughter’s wedding later this year.
“Extending life is priceless,” Marvash said. “We want people facing this diagnosis to know about this treatment option.”
Post time: Oct-22-2024