Procedure attacks cancer point-blank

Father of three Timothy Forehand wants more time with his young daughters. A new procedure for patients with his form of liver cancer may give him several more months.

That's a precious gift to a man who a year ago was told he likely wouldn't survive for one more month.

Forehand underwent surgery to install the device that's expected to extend his life Jan. 8 at Sky Ridge Medical Center. He among the first patients in the United States to undergo the process, and Sky Ridge is the first of a handful of centers permitted to perform it pending approval from the Food and Drug Administration.

The Dallas man was diagnosed with ocular melanoma in January 2012. The fast-growing eye cancer already had spread to his liver, where tumors typically are lethal.

“It's a devastating diagnosis,” said Dr. Charles Nutting, who performed the procedure. “Survival is only a couple months.”

The procedure performed last week concentrates chemotherapy treatment to Forehand's liver, instead of his entire body, so high doses of cancer-fighting chemicals can saturate the organ. The idea, Nutting said, is to “try and really beat up the tumors as much as you can.”

The drug-infused blood is then collected as it leaves the liver, filtered to remove as much of the chemicals as possible, and returned to the body. The method not only targets and intensifies the treatment, but minimizes side effects.

“Normally, in chemotherapy, you have to give so much poison the patient can't handle it,” said Dr. Krishna Kandarpa, chief medical officer with the company that created the filtration device, Delcath Systems. “Now, you can isolate it to the liver instead of the whole body.”

The procedure is minimally invasive, requiring three small incisions into which catheters are inserted.

It is not a cure. Rather, it slows the tumors' progress, typically prolonging the lives of ocular melanoma patients by about six months. Some have lived an additional three to five years.

Even six months, Kandarpa said, is remarkable.

“In the oncology world, people get excited if you get 15 days, a month (of life extension),” he said.

Forehand, speaking from his Dallas home three days post-surgery, said he was exhausted but looking forward to recovery and a return to his normal pattern. That means hanging out with 5-, 10- and 11-year-old daughters and his wife.

“We spend as much time as we can together, and that's a lot,” he said. “I don't really worry about prognosis anymore because it's all irrelevant. I don't think one day at a time. I live my life the way anybody would. I do my best to enjoy my life with my family.”

Kandarpa sees its treatment in ocular melanoma as “a platform” from which researchers can work toward treating other tumors.

A significant delay in a tumor's progress, Nutting said, is a step toward the cure he believes someday will come.

“What we're trying to do is help minimize the impact of the disease, trying to make them feel better for a longer period of time until we can find that next magic bullet,” he said.