Treatment gives liver cancer patients hope

In In The News by Barbara Jacoby

Thumbnail for 6942By: Anna Rumer


“Are you nervous?” clinical coordinator Rob Williamson asked 80-year-old cancer patient Alice Mauk.

“Yes,” she replied, a quavering voice emanating from the pile of blankets covering her small body on the hospital bed.

“I’ll take care of that,” Williamson said. “I’ll give you a big shot of courage.”

Wheeling her into a room filled with sterile drapes and high-tech machinery, Williamson shouts back to people waiting for her, “Don’t you worry. She’s tough.”

Waiting friends know that is true and are hopeful because Mauk, who is fighting stage 4 liver cancer, is just one of the patients Genesis Good Samaritan Hospital is treating using a therapy only two other hospitals in the state are equipped to provide: TheraSphere treatment.

TheraSphere, also referred to as radioembolization or selective internal radiation therapy, has been in development since the 1960s but has only recently been approved in the past decade for the widespread treatment of liver cancer.

Genesis HealthCare System, in addition to the Cleveland Clinic and the University of Cincinnati Medical Center in Ohio , is one of 122 health centers using the treatment internationally. In the past four years, oncology and hematology specialist Dr. Scott Wegner has worked with about 30 doses of the TheraSphere therapy.

This low-toxicity treatment is designed to destroy Mauk’s liver tumors more deliberately than more traditional treatments. During her June 11 procedure, millions of glass beads only about a third of the width of a human hair and containing radioactive yttrium-90 were injected into her liver’s hepatic artery through a small catheter. The beads then traveled into her tumors’ blood vessels, where the radiation hopefully began to destroy her cancer from the inside out.

Dr. Valerie Drnovsek, who performed Mauk’s “textbook perfect” procedure, said it allows for a more targeted approach to treating liver tumors.

“It destroys the tumor from the inside while preserving the healthy liver tissue,” she said.

That can effectively treat patients such as Mauk who have the bulk of their cancer residing in their livers and still with good liver function, she said.

Mauk originally was hospitalized for what doctors thought was a routine appendectomy. Once surgeons began working, however, they found extensive colon cancer. The cancer was removed, and Mauk and her husband, Whitey, thought they were in the clear until a follow-up scan found more cancer, this time in her liver.

“You could have picked Whitey and I up off the floor,” she said. “I said, ‘I thought you got it all,’ and Dr. Wegner said, ‘We did, but it just came back.’ ”

Since then, Mauk has dealt with numerous chemotherapy and radiation treatments, which she said have been devastating to her and her family. The process has especially affected her husband, who tries to stay strong for his wife of 56 years.

“I see the look in his eyes,” she said. “He tells me he’s fine and that I look good, but all I really need to do is look in the mirror.”

At the beginning of her liver cancer treatment, Wegner said, the plan was to administer “gentle chemotherapy” and see how the tumors responded. Mauk tolerated it well, but so did her tumors. That led to him searching for answers with the TheraSphere treatment.

“She’s a great candidate,” Wegner said. “She’s well, her disease is pretty much confined to her liver … and she’s symptomatic. So it’s good for people like that when chemotherapy isn’t doing what you want it to.”

Mauk will have to wait three to four weeks after her therapy to see whether the tumors have responded, but Wegner is optimistic about what they’ll find.

“There are some dramatic successes,” he said. “It’s difficult to say that you make people live longer, but you certainly improve people’s quality of life immediately, and then they have a longer interval of high-quality life, for sure.”

Mauk said she hopes to live out her life staying in the present and seizing the joy from every moment of life, something she realized in part on the way to her granddaughter’s 29th birthday.

“You take things for granted,” she said. “As we were driving up, I was looking at the beautiful hills of Ohio, and I was thinking that we’ve made this trip for years and I just never noticed. I’m so appreciative of the little things now. I saw a butterfly and got so excited. … I think there was a reason for me to go through this. Maybe just to appreciate life more.”

Mauk glowed when she spoke of her “bucket list,” the things she wants to do while she still can.She wants to see her grandson graduate from the University of Akron in August, to visit the ocean one more time, and to direct “Fiddler on the Roof” at a local theater. As chairwoman of the Genesis HealthCare Foundation and a member of the board of directors, she also has a timeline.

“I have to see that new hospital,” she said. “Dr. Wegner promised me that we would open that Cancer Center together, and I’m going to hold him to that.”

Part of what could let Mauk achieve those goals is the milder nature of TheraSphere’s side effects.

“It’s surprisingly nontoxic,” Wegner said. “Sometimes they have flu-like symptoms for a day or two, and then they’re better. They don’t have a lot of pain and they certainly don’t have a lot of nausea and vomiting.”

That came as a relief to Mauk, who has experienced just about every negative side effect radiation and chemotherapy can cause, from nausea and sickness to numb hands and swollen feet. Only a week out from her TheraSphere treatment, she said she’s dealt with some fatigue and pain, but the numbness has started to recede and the other side effects have been absent.

“It’s a shame that they still send referrals to other hospitals when we are capable of doing so much here,” she said. “Would I recommend people go through this? Yes. If it’s a matter of life or death, I think you need to do everything you can, no matter how miserable you are. You have to keep on. There’s always hope.”