When Lorenzo Abeyta finally saw his doctor for worsening back pain, cancer was the furthest thing from his mind. The 60-year-old teacher and counselor for troubled youth had endured years of pain after hurting his back while lifting heavy boxes. However, the MRI of his aching back showed something unexpected: ominous spots on his liver. Shortly thereafter, Mr. Abeyta and his wife Vickie received a call from his physician with the devastating news – he had liver cancer.
“When I first got the diagnosis, I was very concerned and nervous. I didn’t really know what I was dealing with and had just recently lost my best friend from liver cancer. I was quite honestly very scared and thought ‘I’m not going be living too much longer.’”
Mr. Abeyta contracted hepatitis C during his days as a troubled youth. He turned his life around when he met Vickie. The couple sits side-by-side, hands clasped tight as he tells his story. Despite 41 years of sobriety, the hepatitis C infection continued to damage his liver, leading to irreversible scarring and eventually liver cancer. By the time he was diagnosed, the cancer was already quite advanced, with multiple tumors involving so much of the liver that surgery was not an option. Moreover, his kind of liver cancer, called hepatocellular carcinoma, responds poorly to conventional chemotherapy. Mr. Abeyta’s only chance for a cure was a liver transplant, but he did not qualify because of the extent of his disease.
When his doctors told him that he had less than one year to live unless he received some kind of treatment, Mr. Abeyta feared there would be nothing they could offer him. Instead, his doctors sent him to Interventional Radiology.
Interventional Radiologists are physicians who use medical imaging to perform minimally invasive procedures that diagnose and treat disease throughout the body. Mr. Abeyta had no idea about this cutting-edge world of nonsurgical treatments or what it meant for his liver cancer until he met Daniel Sze, M.D., Ph.D., of Stanford University Medical Center.
“Interventional Radiology was something very new to me, but I was very fortunate. Dr. Sze gave me an explanation that made it very clear for me.” The goal was to shrink the tumors so Mr. Abeyta would qualify for a liver transplant. Dr. Sze compared the procedure to a sniper that can specifically target the tumors while minimizing collateral damage to the healthy liver. Dr. Sze’s “sniper rifle” is a long thin tube called a catheter that he can maneuver from the groin to the blood vessels feeding each tumor. Dr. Sze uses real-time medical imaging to see the catheter’s location inside the body. Once the catheter is in place, he injects tiny beads soaked in chemotherapy to cut off the tumor’s blood supply while poisoning it from within.
The procedure is called transarterial chemoembolization, or TACE. TACE works where conventional chemotherapy doesn’t because it is targeted. Treating the tumors directly allows doctors to expose the cancer to 10 times higher levels of chemotherapy than the body would otherwise tolerate, all while avoiding most adverse effects. Dr. Sze explains: “We killed the tumor, we spared the liver, Mr. Abeyta did not throw up, he did not have low blood cell counts, he did not lose any hair. So this is not like chemotherapy that most people get into their veins, which causes a lot more side effects.”
On the day of the procedure, Mr. Abeyta walked into Stanford Medical Center confident in his team. Because Interventional Radiology procedures are performed through a pinhole, patients can avoid being put to sleep. Instead, they get medicines to keep them comfortable and pain-free. “Throughout the procedure, I was awake. I was able to talk to Dr. Sze and ask him any questions I wanted, and he would explain what he was doing. He made me feel relaxed and comfortable throughout the procedure, so I really wasn’t scared.” After TACE, most patients go home in 24 hours or less.
Dr. Sze’s TACE treatment of Mr. Abeyta’s liver cancer would not only shrink the tumors and prolong his life, but also would help to qualify him for a cure: liver transplant. TACE gave Mr. Abeyta hope and a fighting chance to beat his cancer. “I felt that, you know what, I’m not dying of cancer, I’m living with cancer, and I’m going to continue to live with it until they knock it out.”
Since receiving a series of these targeted procedures, Mr. Abeyta’s tumors have shrunk to the point where he is eligible for transplant and is feeling well: “My last treatment was ten days ago. They targeted three tumors at that time and, as you can see, you probably couldn’t even tell I went through a treatment like that.”
Although most major hospitals have Interventional Radiologists capable of performing TACE procedures, very few people are aware of their options. Mr. Abeyta wants people to know how these procedures performed through a pinhole can be life-changing.
“Sometimes people get cancer and they just say, ‘Okay, I’m done.’ They just won’t go any further…hopefully this will get the word out, ‘No, go for it. You can extend your life!’ I’m living and still able to enjoy my grandchildren, my children, my wife, my friends, and my family. I’m very happy that there’s Interventional Radiology. For me, I feel blessed that there are places that you can go and do these procedures.”
As much as a cancer diagnosis can seem like the end, Dr. Sze’s minimally invasive procedure provided Mr. Abeyta with a second chance and reinforced his passion for life and for his family.
“Thanks [to] the help that I’ve gotten here,…I enjoyed another birthday, another Christmas, another Easter, my childrens’ birthdays. I mean, I could go on and on and on, the things I’ve been able to enjoy. Because they’re able to keep me alive with the fine work that Dr. Sze does, I’m sure there are other patients who will be just as appreciative as I am. Hopefully this article gets the word out about these procedures. Interventional Radiology can extend your life, give you a quality of life, and most of all, gives you that time with your family.”
Mrs. Abeyta kisses her husband’s cheek then offers this advice to patients and their families facing liver cancer: “it’s not just darkness right away, you know. There is light. Look for it, and get out there and ask questions, talk to your doctors, and go for it…”
To learn more about TACE or other minimally invasive, image-guided procedures for liver cancer, visit www.theii.org.