When people are diagnosed with an advanced stage of cancer, the news is devastating and comes as a total shock to them and their family. The prospect of treatment, while offering some hope for the future, is also another shock to the system, and one that doesn’t always go so well.
It was Mother’s Day when Darla Rogers started to experience chronic pains in her lower stomach and abdomen. When the pain became too intense, her loving husband Tim rushed her to the local ER, fearing appendicitis.
It was Mother’s Day 2014, but all was not going according to plan for Darla and Tim. The celebration was going well, but that nagging pain in the pit of Darla’s stomach was becoming more of an ache, and a painful one at that. While Darla and Tim assumed it might be appendicitis, Tim rushed to her to the nearest ER to get it checked out, just in case.
Having taken Darla’s blood count, doctors were sure that a short-notice CAT scan was warranted, as she wasn’t showing signs of appendicitis. When the doctors saw the results of the scan, they were crestfallen, and the course of Darla’s life would take a serious turn for the worst. When they gave her the prognosis, Darla and Tim were shocked and left feeling numb.
The last thing they were expecting was the terrible look on the doctor’s face, let alone the words he said. “I’m sorry, Darla, you have stage IV colon cancer,” he told the devastated couple. “There’s nothing I can do for you – you’re going to die.” With that, Darla and Tim’s world came crashing down on the spot.
Just Six Months
What made things even more tragic was that Darla and Tim had just embarked on a new life together, having been married for just six months. Having both had kids and even grandchildren from previous relationships, the new couple were still in their honeymoon phase and looking forward to a new and fulfilling life together. The devastating news couldn’t have hit at a worse time.
Fight for Life
Possibly the most chilling thing for Darla at the time were the words uttered but her oncologist who recommended chemotherapy. When the specialist doctor said “Darla, you need to fight for your life,” chills went down her spine as she wondered if she’d even make it that far. Darla knew she had an advanced stage of Colorectal cancer which had metastasized to other parts of her body; in Darla’s case, to her liver and lungs. She knew she had to fight for her life and fight she would.
Those initial chilling words from Darla’s first doctor were eating away at her. How was it possible that nothing could be done to save her life? Darla thought. She decided at that moment to switch hospitals and ended up attending the Huntsman Cancer Hospital to begin aggressive chemotherapy in a bid to lengthen her life. Her new doctor, Glynn Gilacrease, an Associate Professor of Oncology, knew Darla’s road to recovery was a long one, and her first six months of chemo didn’t go so well.
Dr. Gilacrease was concerned that the aggressive chemotherapy was having a detrimental effect of Darla’s liver, so he went ahead and put her on a maintenance chemotherapy dose instead. “It’s a very common site for metastatic colon cancer,” Gilacrease explained according to a report on the University of Utah School of Medicine website. “But it can hold a large bulk of the disease, which can create pain and fatigue and greatly lower someone’s overall quality of life. If we can control the amount of cancer someone has, they would have virtually no symptoms.” He added.
Dr. Gilacrease wanted a second opinion on the tragic case of Darla Rogers, so he consulted with a close colleague, Ryan O’Hara, a section chief for Interventional Radiology. In discussing Darla, Gilacrease reported, “We spoke at several points about the right time to do liver-directed therapy,” he recalled. “Because we had such good control of her primary tumor due to chemo and she was scared of continuing on maintenance chemo, we felt that about nine months into her maintenance chemo was a good time for a different treatment.”
The colleagues ultimately decided that it was a good idea to carry out what’s called radioembolization on Darla. This technique involves delivering millions of radioactive beads through Darla’s bloodstream straight to the liver, where they lodge themselves and begin to irradiate tumors, at least in theory. But every person is different, and there was no guarantee the treatment would help Darla.
Dr. O’Hara, as well as six of his colleagues, specialize in interventional radiology; a procedure which can be life-saving for certain patients. The procedure uses targeted, image-guided technology to perform what are traditionally surgical procedures such as biopsies and stent placements. These experts are highly-trained to perform procedures on the most difficult of cases, like Darla’s. Their skills at navigating the human anatomy with nothing more than catheters and fluoroscopy imaging are second to none.
SIR-Spheres, made by Sirtex, are microspheres infused with a radioactive isotope called Yttrium-90, or Y-90. As a by-product of Uranium from nuclear reactors, Y-90 has numerous medical uses, especially when it comes to fighting cancer. Y-90 is special in that it emits beta-ray radiation which travels a far shorter distance than gamma or X-rays. At the same time, Y-90’s scope is limited and safe as it only emits radiation for roughly ten days.
Before carrying out any treatments, doctors needed to be sure that Darla would be able to tolerate the procedure. They started by doing a mapping angiogram of Darla’s hepatic artery. A catheter was carefully threaded through an artery in her groin so that experts could check the artery feeding the tumors to the liver. By checking this, doctors were able to confirm that Darla could tolerate the groundbreaking treatment she was about to undergo.
After the initial tests were carried out, Dr. O’Hara ordered a specific dose of Y-90 for Darla, precisely in line with her physiology and the number of tumors in her liver. Then the dose was delivered directly to Darla’s liver as everyone waited to see what the outcome would be. But the procedure was a painful one, as Darla explained.
Turning a Corner
Despite the first eight days of the treatment being torturous for Darla, she said she woke up one day and knew she’d turned a corner. “It felt like my insides were melting,” Darla said, as a reaction to the highly radioactive medicine. But after just more than a week, things changed for Darla. “It seemed like I was getting better every day,” she said at the time, feeling better than she’d felt in a long time. But Darla wasn’t out of the woods yet, as she needed invasive surgery to remove the tumor in her colon.
As if by way of a miracle, the metastatic tumors on Darla’s liver and in her lungs disappeared and she was able to take her first “chemo holiday” in two years. The operation to remove the colon tumor and a foot of her bowel was also a success and Darla was cancer-free against all the odds. But Darla reacted well to the treatment, as Dr. Gilacrease explained.
“Chemo holidays are usually 3-6 months,” explained Gilcrease. “It’s quite rare to see a patient have such a long time without chemo, especially with active metastatic disease in the liver. Having treated quite a few patients, I think that it’s certain Y-90 helped her quite a bit.” One of the things Gilcrease and O’Hara like about Y-90 treatments are that they concentrate on the dangerous and stubborn liver tumors, enabling other types of healing to take place.
Soon after her recovery, Darla was introduced to a 19-year colon cancer survivor called Suzanne Lindley. Lindley is also the co-founder of a Texas-based support group called ‘Yes! Beat Liver Tumors!’ As Darla explained, “she took me under her wing, and I became one of her poster children.” Darla was inspired as she worked with her new friend and was even invited to the People’s Choice Awards, to be a model for Fashion Week and even attended the Oscars.
Darla also spoke about how amazingly supportive her husband Tim had been throughout the difficult process. “Tim is a rock, and I wouldn’t be here without him. When we were told we should do the Y-90 again, I cried all the way home, but then we thought another two years, and how fabulous would that be?” She said. But it was all down to the Y-90 treatment at the end of the day, and Darla also recognizes that.
Darla reacted very well to the Y-90 treatment and took every opportunity to extol its virtues. “Once again, the mighty Y-90,” she said to reporters. “Once you get past that initial period, every day, every hour you feel better and better. I feel like a million dollars now – no pain and my energy level has come back.” She added. But the bigger picture of how this treatment could help tens of thousands of cancer sufferers is even more remarkable.
In Dr. O’Hara’s mind, the future of cancer treatments very much lays with the Y-90 treatment program. According to him, the future could be bright for survivors who have suffered from certain types of aggressive cancers. “New technologies and techniques emerge every year,” he said, “and the future has never looked as optimistic for so many patients.”