When doctors at a major Mid-Atlantic teaching hospital told John Auldridge last year that his liver cancer was inoperable and nothing more could be done to help him, the 69-year-old Dagsboro, Del., man rushed for a second opinion. He got a better prediction from Hopkins interventional radiologist J.F. Geschwind, M.D., who had helped develop a new way to kill liver tumors through a catheter. Within weeks, four of the five lesions in Auldridge’s liver had been destroyed, and the fifth was scheduled for similar demise. "This is a patient who had unresectable liver tumors with a life expectancy of six months or less," Geschwind says. "Now he’s almost tumor-free."
The treatment, called chemoembolization, is a palliative measure—one that has been shown to extend the lives of patients rather than completely cure them. In the procedure, Geschwind feeds a catheter through the femoral artery from the groin to the liver artery that supplies blood to the tumor. He then injects a mix of chemotherapy drugs and an oil derived from poppy seeds that acts as an emulsion to prevent the chemo agents from washing out of the lesions. The formula works both by blocking the blood supply that feeds the tumor and killing cancerous cells within the lesions. Geschwind explains that the chemotherapy is carried to the tumor by the oil, and because the mix is somewhat viscous, it will stay confined to the tumor. Geschwind uses oil in his mix because Japanese studies have shown that the liver tumor sucks up and accumulates this substance, like a sump pump. At the end of the infusion, Geschwind may also add particles to prevent the chemo drugs from washing out of the liver. The results? Of this radiologist’s patients with inoperable liver tumors, 80 to 88 percent have survived for one year and 60 to 75 percent for three years. Untreated, patients usually die within three to six months of diagnosis. "We were practically in tears," Auldridge said of the procedure. "Any extension of life is priceless, even if it’s just two or three years." — Gary Logan
Hopkins Medical News, Spring 2001 |
