NEW LIVER CANCER TREATMENT SAVES FRANEK’S LIFE

By Connie Wirta at Essentia Health Photography by Scott Thuen/ Thuen Design

Rose Marie Franek said a new treatment for liver cancer has given her a new lease on life.

In 2013, what Franek thought was a lingering cold turned out to be a neuroendocrine tumor on her thymus gland. The rare cancer behind her breastbone was at stage 4 and had spread to her liver. Her prognosis was bleak: just six months to a year to live.

But Franek wasn’t ready to give up and her sister, Bonnie Nagel of Fargo, had read about a new treatment for liver cancer offered by Dr. Richard Coursey Jr., an interventional and vascular radiologist at Essentia Health in Fargo.

“I figured what do I have to lose? Let’s make an appointment,” Franek recalls.

Dr. Coursey explained he could treat the tumors in Franek’s liver with a new procedure called TheraSphere, but the first step was to put together a team of Essentia Health cancer experts to develop a comprehensive and individualized treatment plan.

“When I met Dr. Coursey, I had such a good feeling,” Franek said of her appointment on Nov. 23, 2013. “He’s a smart man and so personable. I told my daughter this is the one I want. I put my life in his hands.”

“Dr. Coursey gave us hope,” said Franek’s daughter Michelle. “Up to then, it was all gloom and doom. He reassured us that he could help my mom.”

Two physicians at the Essentia Health Cancer Center joined Dr. Coursey: Dr. Shamudheen Rafiyath, a medical oncologist, and Dr. Mark

Cooper, a radiation oncologist. Their plan combined chemotherapy and TheraSphere to attack the liver tumors and chemotherapy and radiation for the thymus tumor.

TheraSphere delivers radiation directly into a liver tumor through microscopic glass beads that contain radioactive material, Dr. Coursey explained. During the procedure, he makes a small incision in the groin and, using realtime imaging to guide him, carefully threads a tiny catheter into an artery in the liver. Next he injects the radioactive beads that flow directly to the liver tumor and lodge in the tumor’s small blood vessels. Over several weeks, the beads emit radiation that destroys tumor cells from within.

“With TheraSphere, we can give a big punch to a tumor with little negative effects,” Dr. Coursey said, comparing it to radiationinfused “seeds” used to treat prostate cancer.

TheraSphere has several advantages over traditional radiation therapy for liver tumors, Dr. Coursey said. It directly attacks the tumor, working from the inside out, so it mostly affects the tumor and not the normal liver or other nearby organs. TheraSphere can often kill and shrink tumors faster than chemotherapy alone, he said. The procedure also can treat tumors where chemotherapy and traditional forms of radiation haven’t been effective.

Dr. Coursey said Franek was a good candidate for TheraSphere because her tumors were inside the liver.

Franek said she felt no pain during the procedure on Dec. 17, 2013, and went home the same day. Over the next few weeks, she said she felt very fatigued. The tumors in her liver’s right lobe responded so well that she had a second treatment on her left liver lobe last Aug. 14 after those tumors could not be controlled by chemotherapy alone.

“Rose Marie has tolerated TheraSphere extremely well and has had an excellent outcome,” Dr. Coursey said. “She has had massive reductions in her tumors―around 95 percent of their overall volume is gone. Some were larger than four centimeters and they’re microscopic now.”

While TheraSphere can be a cure for early stages of liver cancer, it also can be helpful in advanced stages when treatment options are limited, Dr. Coursey said. “In advanced stages, TheraSphere decreases the tumors and can keep them at bay for a long period,” he explained. “It can improve quality of life and lead to longer life.”

That’s proven true with Franek, who said she’s back to taking care of her home and yard. She’s cheering on her four grandchildren at wrestling meets and basketball games. The treatment hasn’t cured her cancer but it has made the disease less burdensome.

“Mom still has stage 4 cancer but there’s nothing new and she’s stable, which is the best news we can expect,” said Michelle, who works as a nurse practitioner in Roseau, Minn.

“We didn’t think Mom would be here for Christmas this year and I believe if it wasn’t for Dr. Coursey, she wouldn’t,” Michelle said. “He has been a godsend.”