Clinical Study Helps “Lucky” Man Beat Aggressive Lymphoma
Oncologists Destroy Tumors, Save Vision in Difficult Cancer Case
Friday, March 19, 2004
When Duane Wrisley was diagnosed with cancer four years ago, he set his sights on beating the disease. He never expected the cure would come at the expense of his vision.
Wrisley, of Burlington, Pa., about 30 miles south of Elmira, is doing well today, more than a year after oncologists recommended he seek hospice care after exhausting all treatments for his advanced lymphoma, which produced tumors throughout his lymphatic system.
“They told me I’d probably have about two months to live,” recalls Wrisley, 66.
That was during the holiday season in 2002, just about the same time hematologists at the James P. Wilmot Cancer Center at Strong Memorial Hospital in Rochester were beginning to study a new medication to combat advanced lymphoma. Wrisley’s son learned about the study on the Internet and was hopeful this could eradicate or control his father’s cancer.
Gallium nitrate, the medication typically used to treat hypercalcemia, a common condition among people with cancer that results in elevated calcium levels in the blood, has properties that scientists believe fight lymphoma cells, squelching their ability to grow and reproduce. The medication is potentially less toxic than other cancer-fighting drugs, making it ideal for people like Wrisley, who’ve already been through a number of aggressive treatments.
Wrisley was diagnosed with advanced lymphoma in 2000, when he complained of back pain. Doctors found a softball-size tumor near his right kidney. The aggressive cancer spread quickly.
He recalls a time when he felt a lump on his jaw. Then he noticed a bump there. Within days, the tumor grew so large he couldn’t see his ear in the mirror.
The excavating contractor endured six chemotherapy regimens and two rounds of radiation therapy to treat the disease over a three-year period. Then, oncologists exhausted treatments for him and suggested hospice care. That’s when he sought help at the Wilmot Cancer Center at Strong.
Wrisley tolerated six, week-long infusions, through a slow pump worn on his waist, over an 18-week period. The infusions were given 24-hours a day, for seven days, followed by no medication for two weeks. That cycle was repeated five more times.
The investigational therapy proved successful in destroying the seven tumors that had spread throughout Wrisley’s body.
"Mr. Wrisley is a very lucky man," says Jonathan Friedberg, M.D., a hematologist and leader of the gallium nitrate sutdy, which was open in just five sites across the country. Researchers are analyzing study results now.
“We found the overall response rate for this drug was higher than we had hoped. Mr. Wrisley’s tumors responded well to the therapy and he is a success story,” Friedberg said.
That success didn’t come without a significant threat to his vision. The medication caused his optic nerve to swell and he rapidly went blind.
Wilmot Cancer Center oncologists and ophthalmologists from the University of Rochester Eye Institute at Strong researched this side effect of the cancer treatment. There were few other cases in the country that linked gallium nitrate with blindness.
After studying that case, the team worked together to maximize Wrisley’s cancer treatment and regain his sight.
“We had to time this right so that he could get the maximum response to the cancer treatment and help him get a complete recovery of his vision,” says Ronald Plotnik, M.D., an associate professor in the Department of Ophthalmology at the University of Rochester Medical Center. He worked closely with Friedberg and neuro-ophthalmologists to restore Wrisley’s vision.
It was a balancing act, to some degree, but “Mr. Wrisley was very clear that he wanted to go back on the gallium nitrate to save his life – even if it meant he’d be blind,” Plotnik recalls.
Wrisley was emphatic about the decision.
“I was going to die if I didn’t get the gallium nitrate treatments. I’d rather be alive and blind than dead,” he says.
Heavy doses of steroids and iron sulfate, known to reverse the effects of the gallium nitrate, reduced the swelling and his vision returned.
“That was very scary for all of us,” Wrisley recalls. “But I knew I was in good hands and within five days, I was able to go home and start reading again.”
The James P. Wilmot Cancer Center is a leader in cancer care, research and education in Western New York. It provides diagnosis and comprehensive, multidisciplinary clinical care for all forms of cancer. With oncology specialists in various cancers working closely with scientists, nurses and staff, the Wilmot Cancer Center is dedicated to a single mission: to beat cancer. For more information about cancer care, call (585) 275-5830 or 1-866-4WILMOT