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In cancer war, a new ally
By CANDACE RONDEAUX, Times Staff Writer TAMPA -- Joanne McGhee tried everything. First, her doctors tried to choke off the flow of blood to the cancerous tumors spanning her liver. It only made her more sick. Next there was the experimental pill that was supposed to neutralize the cancer. It didn't work. Then there was the chemotherapy. But the four weeks of nausea, sudden bouts of diarrhea and hair loss the drugs caused drove McGhee to her limits. "I about went crazy. I just cried and cried," she said, "I thought I was going to die." Diagnosed with liver cancer in April and given just six months to live, McGhee, 71, wasn't sure she'd make it through the next day, let alone Christmas. So last month, she and her husband, Frank, traveled to the small southern Ohio farm town where they grew up and fell in love to share a final Thanksgiving meal with family and friends. "I thought it was going to be my last one," McGhee said. But an experimental new cancer therapy recently introduced at St. Joseph's Hospital in Tampa has given her some hope that she may see another Thanksgiving Day. The treatment uses microscopic radioactive glass beads called TheraSpheres to kill cancerous tumors in the liver and can add months, and sometimes years, to a patient's life without the side effects of chemotherapy or surgery. Last week, McGhee became Dr. Matthew Berlet's second patient to undergo the treatment at St. Joseph's. In just two hours, Berlet and his team of radiation specialists used a pressurized syringe to deliver millions of tiny glass beads loaded with the radioactive element yttrium-90 directly into the blood vessels of McGhee's tumors. Smaller than a grain of salt, the beads are carried through a catheter placed in the thigh's main artery and guided through the liver's hepatic artery. After two weeks, the beads are no longer radioactive, and the body safely absorbs them. "Chemotherapy is rough on you. With radiation, you end up with a lot of the tissue in the liver destroyed," Berlet said, "This is great because it targets the tumor area instead." The treatment also eliminates the months of recovery time typically associated with surgery to remove cancerous portions of the liver. Most TheraSphere patients are able to go home the same day, Berlet said. But prospective patients need to know this: It is not a cure, and it is not for everyone. Though most specialists expect the Food and Drug Administration to grant TheraSpheres approval to be used on more patients within the next year or two, the cancer treatment was approved only on humanitarian grounds in March 2000 for use on patients with liver cancer. That means the treatment can be used only at specially licensed medical centers on a disease that affects fewer than 4,000 people a year, such as primary liver cancer. So far, the treatment has largely been used on patients such as McGhee, whose diabetes and multiple tumors preclude the possibility of liver resection surgery. "This is for people who have nothing left to do in life but go home and get their affairs in order," Berlet said. "It can add another 24 months to their lives." The tiny beads were first tested at the University of Maryland's Greenbaum Cancer Center in Baltimore in August 2000 and then at seven other cancer centers nationwide. Doctors at the Baltimore medical center have successfully treated more than 100 people with TheraSpheres, on average doubling the expected life span of their patients. "We've treated people who are as old as 82, and the side effects were the same as for a patient who is, say, 36. It's mostly just fatigue," said Dr. David Van Echo, one of the doctors who helped pioneer the therapy at the University of Maryland. Nausea is another possible side-effect, and in some cases it may cause ulcers or internal bleeding, Van Echo said. Until November, patients in Florida seeking the TheraSpheres treatment were for the most part forced to travel to the Baltimore medical center. But when doctors at St. Joseph's and Safety Harbor's Mease Countryside Hospital introduced it late this fall, they became two of the first to offer the new cancer therapy in the state. The TheraSpheres alone cost roughly $20,000 at St. Joseph's, and that price does not include preliminary tests such as CT scans. Medicare and some insurance companies cover the costs of the procedure, but because it is so new, the coverage may vary. Specialists who have tried the treatment say they hope to see its use expand. Soon Berlet hopes to gain wider approval to use TheraSpheres for other cancers in the lungs and breasts. "It's a win-win. It's easy to perform, and it's easy for the patient and eliminates a lot of the pain," Berlet said. And McGhee said that's all she needs. "I just want this to work."
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