Planting Seeds of Hope for People with Liver Cancer

In 2016, Jason Runnalls was just 42. An energetic guy, he had everything to live for – a wonderful wife and family, a home in Rose Hill, Kansas, southeast of Wichita, and a great job with Kansas Big Brothers Big Sisters.

Then, on September 21, Jason experienced abdominal pain that sent him to the emergency department near his hometown. The ED physician suspected a gallbladder problem. However, tests revealed something more egregious. Jason had one tumor on his sigmoid colon, with metastatic disease to his liver and lymph nodes.

Overnight, Jason joined the growing number of Americans under the age of 50 being diagnosed with colorectal cancer.

Jason was quickly started on a chemotherapy regimen prescribed by Wichita oncologist/hematologist Nassim Nabbout, MD. After 8 rounds, Jason’s colon and lymph node tumors responded to treatment, but the tumors in his liver did not. That’s when Dr. Nabbout referred Jason to The University of Kansas Health System.

Stopping liver cancer in its tracks

When colon cancer goes undetected, it can spread to the liver. Interventional radiology is one of the best treatments for metastatic liver tumors.

“We care for patients from Wichita and other communities throughout Kansas who don’t have access to interventional radiology services,” says Zachary Collins, MD, an interventional radiologist with The University of Kansas Health System.

For metastatic liver tumors, interventional radiologists use a minimally invasive procedure called SIR-Spheres^® Y-90. Tiny resin “seeds” filled with radiation are delivered into the liver’s bloodstream. The particles travel to the tumors, where they emit radiation that destroys cancer cells without damaging healthy tissue.

“We’ve been doing the Y-90 with SIR-Spheres since 2012 with phenomenal results,” explains Dr. Collins. “Our experience with the Y-90 procedure goes back to 2009.”

Jason first met Dr. Collins through an i-TV video consultation. Jason and his wife, Mindy, sat in a room in Wichita, while Dr. Collins sat in an office in Kansas City. “Dr. Collins explained everything in a caring way,” Jason recalls. “We were so relieved we didn’t have to travel for that meeting.”

Jason eventually did travel to the health system’s main campus for 2 Y-90 outpatient procedures – one for the right side of his liver and one for the left. Within 30 days, Jason’s liver showed dramatic improvement.

“At this time, there is no evidence of tumors in his liver,” says Dr. Collins. “If the tumors recur, we can repeat the Y-90 treatment after 6 months.”

Seeking a second opinion

Jason’s liver was stable, but he still had to deal with his primary colorectal cancer. He requested a second opinion at The University of Kansas Cancer Center with surgical oncologist Mazin Al-kasspooles, MD, and medical oncologist Anup Kasi, MD.

“Jason wanted to be aggressive in managing his cancer,” says Dr. Kasi. “He had heard about bowel resection (removing the diseased part of the colon) and hoped to be a candidate.”

Sigmoid colon resection has positives and negatives. After conferring with Drs. Kasi and Nabbout, Dr. Al-kasspooles agreed to present Jason’s case to the cancer center’s tumor board. The tumor board comprises physician experts in different specialties, such as medical oncology, surgical oncology and radiation oncology.

“This was exactly what I wanted, a roomful of experts who would collaborate on my case,” says Jason. After much discussion, they approved his colon resection.

Surgery was scheduled for less than a week later. As a safety measure, Dr. Al-kasspooles sent Jason for a colonoscopy. Much to the surprise of the gastroenterologist, there was no sign of cancer throughout Jason’s colon. The residual chemotherapy had continued to shrink Jason’s tumor.

At home again

Throughout Jason’s treatment, his physicians at The University of Kansas Cancer Center shared results and recommendations with his Wichita oncologist, Dr. Nabbout. Jason will continue seeing Dr. Nabbout, knowing that his cancer team in Kansas City is just a phone call away.

“The good news is that Jason’s cancer proved to be chemo-sensitive,” says Dr. Kasi. “The original treatment he received from Dr. Nabbout worked well on his colon and lymph node tumors. Thanks to the interventional radiology team, Jason’s liver is stable. Nevertheless, Jason will probably need chemotherapy indefinitely.”

Speaking out about colon cancer

Today, Jason wants to get the word out about colorectal cancer prevention and early detection. He knows the risk is increasing among millennials.

“There are many studies trying to discover whether this is true and if so, why,” says Dr. Kasi. “We need more data.”

Jason is thankful he was referred to The University of Kansas Cancer Center. “I wish more people living in small towns throughout the state understood the cancer center’s capabilities,” he says. “I’m so grateful for everyone there. But the person I owe the most to is my wife, Mindy. If not for her, I would have given up a long time ago. Her support means everything to me.”