John Peterson was diagnosed with colon cancer in August 2001 at age 41, when he went into surgery for a ruptured colon and his surgeons found a polyp during the operation. After performing a biopsy, his doctors determined the polyp was cancerous.

John had the cancerous polyp removed, along with 19 lymph nodes. All of the lymph nodes were cancer free, so John’s oncologist diagnosed him at stage 0 cancer. Johns’ doctor determined that chemotherapy would not be necessary and recommended that John receive regular colonoscopies and carcinoembryonic antigen (CEA) testing to monitor his blood for proteins that only appear in people with certain cancers, including colon and rectal cancers.

For six years, John remained cancer free. But, in April 2007, when John went to his oncologist for his regular blood work, his CEA levels, which had previously never surpassed 2, were up to 7.8. By May 2007, his CEA levels had reached 11. After a needle biopsy and some scans, John’s doctor found three enlarged cancerous lymph nodes behind the original cancer site.

John’s doctor recommended chemotherapy treatment and offered a grim prognosis, stating that John would be lucky to survive five years. But after one chemotherapy treatment, John’s CEA levels dropped back down to 4. “Responding so well to my first chemotherapy session made me really optimistic about tackling this disease,” John said. “I decided to seek out additional medical opinions, to find out what other cancer centers were doing to treat colon cancer.”  

At a local cancer center, John learned he had two tumors in his liver. A nurse told John about a phase 2 clinical trial to treat metastatic colon cancer that has spread to the liver. The trial’s semi-invasive procedure involved injecting microspheres filled with radiation into an artery in John’s leg that led directly to the tumor. To stop the radiation from spreading outside of the tumor, the doctors would block off any nearby arteries or veins that might direct the radiation away from the tumor.

John was eligible for the clinical trial, and in August 2007 he underwent the procedure. “I decided to participate in the clinical trial because it offered me hope. To me, this trial was offering another chance at life when so many people were preparing me for death,” John said.

The doctors placed a tube into an artery in John’s leg, advanced it to the artery in the liver that was feeding the tumor, and injected the microspheres. Afterwards, John received a slow body scan to ensure that the radiation was dosed correctly and had hit the intended target. While in the hospital, John also received his regular chemotherapy treatment. Three weeks later, a follow up PET scan revealed that John’s liver tumors were no longer visible.

However, John still had lymph nodes with tumor cells in the area of the colon where the tumor originated that could not be treated with this approach. After participating in the clinical trial, he continued to receive chemotherapy and had surgery to remove a cancerous lymph node.

John continued to receive chemotherapy through April 2008. Tests showed that his CEA levels had fallen back to 1. However, in mid-September 2008, John’s doctors found a new tumor in his lower pelvic cavity, three new tumors in his liver and one new tumor in his lung.

John’s doctors started him on a new chemotherapy regimen, and scans in December 2008 showed great improvement. X-rays indicated that the tumor in his lung and two in his liver had disappeared. In February 2009, his doctors will perform another scan to determine if surgery is an option for John once again.

Now, John strongly advocates on behalf of the microsphere procedure, and he even spoke about his experiences at a conference in April 2008 for oncologists and radiologists from around the world. “I might not have been alive to continue to fight against cancer if I had not participated in the clinical trial,” John said. “Regimens to treat cancer will not continue to evolve unless there are clinical trials.”

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Richard Goldberg, MD, a professor of hematology/oncology at the University of North Carolina Lineberger Cancer Center and an associate editor for Cancer.Net, had the following comments about John’s clinical trial:

“The trial that John participates in is a Phase 2 clinical trial. In this type of study, generally less than 100 people with one disease (colon cancer) are treated with the experimental intervention (injection of radioactive microspheres into the tumors in the liver). Generally all subjects get the same treatment. The object of this type of study is to determine both how active the treatment is and what side effects it causes.”

“There are a number of alternative treatments for people like John. It takes a Phase 3 trial that enrolls hundreds of subjects to compare the efficacy of various treatment approaches. A phase 2 study sets the stage for Phase 3 studies. While John’s experience has been a favorable one, until such Phase 3 studies are conducted it is not possible to definitively determine whether the injection of radioactive microspheres is simply a good alternative or is the best alternative for people like John. Such a study is the next step to determine that with assurance.”

Last Updated: April 09, 2009