Teaming Up Against Liver Cancers

In April, more than 175 cancer patients and medical professionals gathered in Fort Worth, Texas, for the fourth Liver Symposium, defined as a global collaboration of medical practitioners and cancer survivors. The meeting, which brought together physicians and patients to talk about treatment options, insurance, and advocacy surrounding both primary and metastatic liver tumors, was the result of a unique doctor-patient relationship between Andrew Kennedy, MD, and metastatic colon cancer survivor Suzanne Lindley of Canton, Texas.

For the past decade, Kennedy, co-medical director for Wake Radiology Oncology Services in Cary, North Carolina, has been educating physicians about radiation treatments, including radioembolization, which places millions of minute microspheres of radiation directly into liver tumors to kill them from the inside out. Radioembolization provides a treatment option for those patients with liver tumors that cannot be removed with surgery, Kennedy says. “Chemotherapy may have stopped working, and they are not a good candidate for surgical resection.”

Four spheres comprise the width of a human hair, Kennedy explains. They are charged with radiation before being sent via catheter into blood vessels that feed the liver tumors. For 14 days the microspheres give off radiation, resulting, in the best-case scenario, in tumors that shrink or disappear. Kennedy says about 60 percent of patients with metastasis to the liver see a response to microspheres.

In general, to be eligible for microspheres, Kennedy explains that patients must have inoperable metastatic tumors, sufficient remaining healthy liver tissue, and the liver as the major site of the disease.

In Lindley’s case, 65 percent of her metastatic liver tumors were eliminated with microspheres after chemotherapy stopped working in 2004, not only allowing her to continue chemotherapy but also turning her into a passionate advocate for what she calls “little magic beads.”

Kennedy says Lindley is unusual because she has responded to such a wide variety of treatments, including microspheres. The two met in 2007 when Kennedy asked Lindley to talk about her experience at a seminar for physicians. A short time later, Lindley formed a nonprofit called YES (www.beatlivertumors.org) to educate patients with liver tumors about treatment options, insurance, and living with liver tumors.

“Since we had common goals, we started working together,” Kennedy says, giving credit to Lindley for suggesting they merge their meetings into a patient and physician symposium. He also credits her for helping publicize microspheres.

“It’s an incredible conference. The patients and doctors together learning about new options often see treatment from a different perspective for the first time.”

Radioembolization was approved as a medical device in 2002, and has shown promise in prolonging life for patients with primary liver cancer, according to results from a study presented at the Society of Interventional Radiology meeting in March. In 2007, researchers from the Mayo Clinic in Jacksonville, Florida, reported that microspheres halted growth of metastatic liver tumors in 71 percent of patients tested in a small clinical trial.

Medicare and some insurance companies cover the estimated $50,000 to $80,000 cost. For those denied coverage, Lindley is ready to assist with appeals, having written more than 100 successful appeals to date.

In addition to workshops that cover myriad aspects of coping with cancer, Lindley says the Liver Symposium allows patients to have one-on-one time with the physicians to talk about options for their own situation.

“It’s an incredible conference,” Lindley says. “The patients and doctors together learning about new options often see treatment from a different perspective for the first time.”

The next symposium is scheduled for September in North Carolina. For more information, go to www.beatlivertumors.org.