Jefferson GI Cancer Expert Discusses Photodynamic Therapy as a New Treatment Option for Bile Duct Cancer Patients
Ron Whitehead lives on borrowed time. That is how the grandfather of 16 from Wilmington, Delaware feels when he talks about having bile duct cancer. Diagnosed in June 2009, Whitehead's tumor is inoperable because of its placement in the liver. According to the American Cancer Society, only two percent of bile duct cancer patients like Whitehead live five years after diagnosis. Unfortunately, his prognosis was bleak.
But thanks to a unique approach to cancer treatment called photodynamic therapy (PDT), Whitehead feels he's had the chance to live longer than he would have and with a better quality of life. The therapy, available at the Jefferson Digestive Disease Institute, was pioneered in the treatment of some esophageal cancers and obstructing lung carcinoma, and is now being applied for bile duct cancers. More commonly used in Europe, Whitehead is among just a handful of U.S. patients who have received this treatment for bile duct cancer (cholangiocarcinoma).
David Loren, M.D., gastroenterologist and Associate Director of Medical Endoscopy at Thomas Jefferson University Hospital, is among the researchers working to expand PDT's use. He is leading Jefferson's efforts to investigate the efficacy of PDT in increasing the survival time of bile duct tumor patients.
"PDT involves administering a photosensitizing drug intravenously." explains Dr. Loren. "The precancerous and cancerous cells bind to the drug, allowing us to target them. Then we carefully thread a flexible fiber down through the intestines into the bile ducts and expose the cells to a laser which destroys them. Over the subsequent days and weeks, the tumor cells die and the bile ducts are opened."
Because the treatment is given from the center of the tumor, the laser cannot penetrate through the entire mass, so some tumor cells remain. "The treatment is not a cure," explains Dr. Loren "but we have seen patient survival increase dramatically, more than with chemotherapy or radiation.
"With this specific type of cancer, the bile ducts become blocked. Bile fluids help us digest our food. These tumors obstruct the path from the bile duct to the intestine, leading to jaundice, liver failure, malnutrition, and infection. This procedure keeps bile ducts open, decreasing the likelihood of those complications, and improving the quality of life for those with this devastating disease."
Dr. Loren says there is one major side effect of photodynamic therapy - susceptibility to sunburn. Whitehead, who has red hair and freckles, says he wasn't cautious at first and got severe sunburn because of it. Now he stays away from bright light for several weeks after a treatment.
It's been two years since his diagnosis and Whitehead says he's grateful he found out about photodynamic therapy. "I come to Jefferson to have my stents replaced every six weeks," he says. "The photodynamic therapy treatments are done every three months. I tried radiation and chemotherapy, but this is the only treatment that doesn't make me feel worse than I already did. And it's buying me time."
Unlike radiation, patients can repeat the photodynamic therapy treatments as often as needed, says Dr. Loren.
Whitehead, who retired from General Motors after 37 years, enjoys spending his time with his wife. He has four children, two living in the U.S. and two living in Ireland, in addition to his 16 grandchildren.
"One in 200,000 people get bile duct cancer each year," says Whitehead. "I want people to know about this treatment option. If I can help just one person by spreading the message, then it'll make me feel good."
Media Only Contact:
Jennifer McGowan-Smith
Thomas Jefferson University Hospital
Phone: (215) 955-6300
Published: 6/28/2011