Music to a Survivor’s Ears
September 19, 2023
Recording engineer Brian Boyd has a knack for synthesizing all the elements of a musical piece. So he can appreciate the finely tuned collaboration of the University Hospitals Seidman Cancer Center specialists who orchestrated his innovative treatment for colon cancer when it had spread to his liver.
With the insertion of a small infusion pump into a branch of the hepatic artery that feeds the liver, a patient can receive 400 times the chemo dose targeting tumors in an approach that may be advantageous over systemic chemotherapy processed throughout the entire body. In 60 percent of colorectal cancer cases, the cancer spreads to the liver, and liver metastases are the most common cause of death from colorectal cancer.
“UH is a leader in this area,” says oncology surgeon Lee Ocuin, MD, FACS, Co-Leader of the GI Disease Team at UH Seidman, who surgically inserted the hepatic artery infusion (HAI) pump in Brian and plans to publish the team’s initial experience soon. “In terms of volume over the past year, we’re the busiest HAI pump center in Ohio and the region, and one of the 10 busiest centers in the country.”
Anything but Routine
When he turned 50, Brian decided it was finally time for the recommended colonoscopy that marks this milestone birthday for so many – and is becoming increasingly common starting at age 45 due to updated guidelines from the U.S. Preventive Services Task Force. With no cancer in his family history, he never expected much to come of it. All those years of stomach upset and munching on antacids were not particularly noteworthy, he had thought.
“I figured it was time I have that checked out,” said Brian, who lives in Edinburgh Township near Ravenna and chose UH Portage Medical Center for his care. “Nobody in my family has ever had cancer on either side. It wasn’t even a thought in my mind that anything could be cancerous.”
But it was, and he was quickly referred by general surgeon John Gusz, MD, to Dr. Ocuin, who felt Brian was a perfect candidate for the HAI pump. In a combined case, colorectal surgeon Ronald Charles, MD, in the Division of Colorectal Surgery, removed part of Brian’s large intestine, and Dr. Ocuin implanted a port for systemic chemotherapy and the HAI pump for additional chemo administered straight to Brian’s liver. The chemotherapy doses were managed through regular appointments with Jennifer Eva Selfridge, MD, PhD, Medical Director, Hepatic Artery Infusion Pump Program at UH Seidman Cancer Center. All cases are discussed with a multidisciplinary team for optimal patient care.
“Given how young and healthy he is, we offered him this approach as we felt it was the most aggressive option,” said Dr. Ocuin, adding that HAI therapy for colorectal cancer/liver metastases can be considered in three types of cases: palliative care for unresectable disease; treatment of currently unresectable but potentially downstageable disease; or adjuvant therapy, after clearance of all liver metastases.
More Toxic to Tumor, Less Draining on Patient
An audio engineer who is a professor at Cuyahoga Community College’s metro campus, Brian understands signal flow, with multiple streams and inputs of sounds. He plays guitar, bass and drums and likens chemo flowing through the body to sounds moving from a microphone to pre-amplifier through the console.
While the chemo directed through the HAI pump is highly concentrated, it doesn’t have the same draining effect on the patient as systemic chemo often does.
“That stuff that goes through your chest, that kicks your butt – it did mine,” Brian said. “But with the pump, I didn’t feel it.”
All Brian felt was a vague shape, approximately the size of the palm of an adult hand, just below his ribs on the left. His team used chemotherapy to shrink the tumors in his liver. About seven months later, after the chemo had time to work, Dr. Ocuin performed a liver resection. Brian recovered through the attentive care of the nurses on the fourth floor at UH Seidman Cancer Center on the main campus of UH Cleveland Medical Center.
Part of the Team, Made for You
Brian appreciated the support of his two children and his wife, who had lost her mother to colon cancer just before his diagnosis. His sentiment about their support is exactly how he speaks of his physicians.
“I knew they were always on my side, and they were always there,” said the college professor, who was able to continue teaching throughout his treatment. “With Dr. Ocuin and Dr. Selfridge, I feel like I’m part of the team as well.”
Brian has relied on a strong faith – and faith that grew in the years prior to his diagnosis – to carry him through this cancer journey. His faith has been essential in giving him peace as he faces the fight of his life.
“It blows my mind how situations, medical advancements and people can arise almost like they are made just for you,” said Brian, who recently returned from an epic trip with his family to Ireland and is feeling well. “Dr. Gusz knowing to refer me to the precision of Dr. Ocuin and his amazing team; Dr. Selfridge and her team, who fight cancer like bulldogs while showing just the right amount of gentleness and empathy; the nurses on the fourth floor and at the infusion center, like Sandy at Seidman, who are so amazingly caring; and nurses like Dawn, who draws my blood work every other Wednesday. The list goes on and on.
“They all save lives and have gone through lots of training to do so. But whether they know it or not, they have become intertwined in my life like threads in a giant tapestry. Faith is what allows me to see my cancer journey in this way.”