Pump sends chemotherapy directly to the liver

[RandyW]

www.news8austin.com

Pump sends chemotherapy directly to the liver

Updated: 12/18/2006 4:18:04 PM

By: Ivanhoe Broadcast News

Most of the time when cancer is found in the liver, it did not start there but spread there from a cancer that began somewhere else. Because of its blood supply, the liver is a common site for cancers to spread. Some of the most common cancers that spread to the liver are those that start in the colon, pancreas, lung and breast.

Colon cancer is one of the most common causes of metastatic liver cancer. Up to 50 percent of liver metastases come from cancer that has started in the colon. Many patients with colon cancer will have their cancer spread to the liver.

"Up to 60 percent of patients with colon cancer will develop the disease in their liver at one time or another," Dr. Mark Roh, a surgical oncologist, said.

In people who have metastatic colon cancer, there are several different treatments that can be tried. Standard chemotherapy is often given, but the drugs are delivered throughout the entire body. As a result, only about 25 percent of the chemotherapy drug makes it to the liver. Many doctors feel delivering the chemotherapy directly into the liver is a more ideal treatment. This therapy -- called hepatic arterial infusion therapy -- uses a hockey puck-sized pump implanted into the abdomen. The pump is hooked up to the hepatic artery (the artery that feeds the liver) and delivers the chemotherapy directly to the liver.

"All 100 percent of that drug will be seen by the tumor in the liver. The advantage is obvious -- [the liver] gets a higher dose and it's right away. The drug enters the body, and it's just inches away from where the tumor is," Roh said.

The pump is refilled about every two weeks, and it can stay in the body for months, even years, at a time. It is powered by body heat, so it pumps 24 hours a day, seven days a week. Delivering chemotherapy to the liver this way results in fewer side effects.

"You don't lose your hair, upset stomach, diarrhea, all the other symptoms you don't have. It's very rare to have that with this way of giving the drug," Roh said.

In fact, he says 72 percent of patients are able to maintain full time employment while undergoing their therapy.

In a recent study published in the March 20, 2006 issue of the Journal of Clinical Oncology, researchers compared systemic chemotherapy with chemotherapy given via the pump.

Researchers randomly assigned 135 patients to receive standard chemotherapy or hepatic arterial infusion therapy with the pump. Results reveal patients who got the pump survived significantly longer than those receiving systemic chemotherapy. Quality-of-life measurements also showed improved physical functioning in the pump group as compared to the systemic chemo group.

Roh said not everyone is a candidate for this chemo pump. Patients who have liver cancer that starts in the liver (primary liver cancer) are not good candidates for this therapy. He said patients with colorectal cancer that has spread to the liver are the best candidates. This is also not recommended for patients who have disease outside the liver in the lymph nodes or if their liver is more than 50 percent cancerous.