Health

Tampa hospital tries new cancer therapy

It treats breast cancer spread into the liver.

By JUSTIN GEORGE
Published July 5, 2007

TAMPA - Once breast cancer spreads to the liver, the prognosis can be a death sentence. It's a vital organ difficult to treat without harming it.

But St. Joseph's Cancer Institute announced this week it has received permission to become the first U.S. hospital to offer a potential new treatment for such cancer and study its effectiveness.

The FDA approved St. Joseph's application for a clinical trial using Selective Internal Radiation Therapy to treat breast cancer that has become advanced liver cancer. St. Joseph's will investigate whether the treatment kills tumors selectively without harming the organ, something radiation beams can't do.

Breast cancer is a chronic disease, which can be treated but tends to come back in other parts of the body. It is initially treated with hormones and chemotherapy, said Dr. Alison Calkins, St. Joseph's medical director of radiation oncology.

But in its advanced stages, the cancer can spread to the liver, and chemotherapy treatments offer little resistance at this point. Surgery isn't an option because the liver can't be removed. Radiation beams, while effective, not only hit tumors but healthy parts of the liver, damaging it, Calkins said.

With Selective Internal Radiation Therapy, millions of microscopic sand-like radioactive resin beads are injected into the blood vessels that feed tumors. In the liver, those blood vessels have grown just for the tumors and don't serve healthy parts of the organ, Calkins said.

The injected beads, known as spheres, are three times larger than red blood cells and clog up the blood vessels, effectively starving and shrinking tumors, Calkins said. The radiation in the spheres also kills cancerous cells without hurting the liver.

Selective Internal Radiation Therapy has been used effectively on colon cancer, Calkins said, and could someday treat pancreatic cancer and melanoma that affects the liver.

Will it work for breast cancer that has spread to the liver?

"I don't know, " said Calkins, who is optimistic but realistic. "I truly don't know. That's why we're testing it."

The FDA spent 18 months reviewing St. Joseph's application before it approved it for an Investigational Device Exemption to use the treatment.

An Australian medical company, SIRTEX, developed the outpatient treatment, which is being used in Australia, New Zealand and Hong Kong.

A cancer center at the University of Maryland already offers the treatment for other types of liver cancers.

Given in one or two doses, the treatment St. Joseph's offers costs about $50, 000, $11, 000 of which goes toward the radiation particles. Medicare has indicated it will cover the treatment, which could make other insurance companies follow suit, Calkins said. Otherwise, patients themselves might have to cover the cost.

Fast Facts:

Who's eligible

St. Joseph's can treat 50 patients with Selective Internal Radiation Therapy. To be eligible for treatment, prospective patients with breast cancer that has spread to the liver should have undergone at least one type of chemotherapy. Their livers also need to have reasonable function. Patients must sign a consent form acknowledging the treatment is experimental.

For more information, call St. Joseph's Radiation Therapy Department at (813) 870-4160.

[Last modified July 5, 2007, 00:09:38]