Patient Stories

Recovery from Acute Leukemia Gives Teacher Something to Celebrate

Allogeneic stem cell transplant recipient Dottie Lobbs (center) joined her physician, Muthu Veeraputhiran, M.D., (left) and husband Mike Lobbs at the first-ever UAMS Cancer Institute's Celebration of Life.

Dottie Lobbs (center) joins her physician, Muthu Veeraputhiran, M.D., (left) and husband Mike Lobbs at the first-ever UAMS Cancer Institute’s Celebration of Life. Lobbs underwent an allogeneic stem cell transplant at UAMS after being diagnosed with chronic myelomonocytic leukemia-2 .

Recovery from Acute Leukemia Gives Teacher Something to Celebrate

By Susan Van Dusen

May 31, 2018 | It was the summer of 2015 and Dottie Lobbs should have been enjoying her summer break. Instead, Lobbs, a special education teacher at Glen Rose High School in Malvern, was experiencing such severe fatigue that she knew something was wrong.

It was probably bronchitis or some other easily treatable condition, her doctor said. But the antibiotics she was prescribed did not make a difference. As the first day of the new school year rolled around, Lobbs went back to the doctor and was quickly hospitalized. Still, however, no one could not determine the cause of her fatigue or abnormal blood work.

That’s when she asked for a referral to UAMS.

Within three days of her first appointment she was diagnosed with chronic myelomonocytic leukemia-2 (CMML-2), a type of cancer that starts in the blood-forming cells of the bone marrow and spreads to the blood.

Allogeneic stem cell transplant patient Rhonda Young was joined at the event by Lane Johnson, her unrelated stem cell donor. Johnson traveled from Houston to attend the celebration.

“It was totally out of the blue,” she said.

While some other types of cancer are staged by the size of the tumor, CMML is split into two groups based on the percentage of immature cells, called blast cells, in the blood and bone marrow. In healthy people, blast cells make up 5 percent or less of normally developing marrow cells. In CMML-2, the percentage of blast cells is between 5 percent to 20 percent in the blood and 10 percent to 20 percent in the bone marrow.

With a team led by Muthu Veeraputhiran, M.D., director of the UAMS Allogeneic Stem Cell Transplant Program, Lobbs was admitted to the UAMS hospital Jan. 8 where she spent about the next 25 days undergoing her first round of chemotherapy.

“For patients who are diagnosed with acute leukemia and have high-risk features, we use chemotherapy to get them into remission while we search for a suitable stem cell donor,” said Veeraputhiran, who also is an associate professor in the UAMS College of Medicine Department of Internal Medicine.

An allogeneic stem cell transplant is the only curative treatment for CMML and requires a donation of blood-forming stem cells from another person. The first allogeneic stem cell transplant in the UAMS Winthrop P. Rockefeller Cancer Institute’s program was conducted May 13, 2015. “Our first transplant patient is still doing amazingly well today,” Veeraputhiran said.

UAMS has the only adult allogeneic stem cell transplant program in Arkansas and performs about 20 transplants per year for patients with acute leukemia and relapsed lymphoma. Veeraputhiran was named director of the program in February 2017.

About 60 guests attended the UAMS Allogeneic Stem Cell Transplant Program’s first-ever Celebration of Life on May 11.

Luckily for Lobbs, her brother was a suitable match and agreed to undergo the process to donate his stem cells to her.

Finding a stem cell donor is not always that easy, although research is improving the odds, Veeraputhiran said. Siblings have only a 25 percent match rate, and often people must turn to the national Be the Match stem cell donor registry to search for an unrelated donor.

A new process, however, can use donors who are a half-match, by incorporating novel combinations of therapies that minimize the rejection process.

For racial minorities, this is an especially important breakthrough, as African-Americans and Hispanics have less than a 30 percent chance of finding an unrelated donor through the national registry.

“The number of racial minorities in the registry is not as high as we would like it to be,” Veeraputhiran said. The unrelated match rate for whites is 60 percent to 70 percent due to higher rates of participation in the registry.

To prepare for his donation, Lobbs’ brother underwent four days of stem cell stimulating shots and had a port inserted into his chest for the blood to be drawn. Most stem cell donations are done through a blood draw.

While her brother was undergoing his preparation for the donation, Lobbs’ process was much more intense. After her first 25-day stay in the hospital, she went home for five days before returning to UAMS for 25 more. A 10-day round of outpatient chemotherapy followed, and, another 10-day stint in the hospital, culminating with her stem cell transplant on April 20.

Merchel Moore (center) brought guests to help celebrate her treatment and recovery.

After another 20 days in the hospital, she was released, but still had daily appointments at UAMS that required a one-hour drive back and forth from her home in the Brush Creek community outside Malvern.

Finally, on the 100^th day after her transplant, Lobbs was declared cancer free. After easing back into the regular routine, she returned to work full time in December 2016.

“I had the most positive experience at UAMS that I possibly could have had. Dr. Veeraputhiran and his team were so wonderful. I am so grateful,” she said.

Even after having spent so much time at UAMS, Lobbs did not hesitate to accept an invitation to return on May 11, 2018, for an event honoring all of the patients who have undergone allogeneic stem cell transplants at UAMS, along with their donors and loved ones.

The program’s first-ever Celebration of Life welcomed about 70 people to the UAMS Cancer Institute to reminisce and reconnect over their shared experiences.

“I made a lot of friends while I was undergoing treatment, and it was good to see them,” Lobbs said, adding that visits from former transplant patients while she was hospitalized gave her hope that she would make it through as well. She hopes someday to pay it forward by volunteering with the program and offering living proof to patients that their disease can be overcome.

“Cancer is always scary, but acute leukemia and recurrent lymphoma are life-threatening emergencies. These patients beat the odds. We had this event to tell them we are honored to be part of their journey, and we believe their recovery is worth celebrating,” Veeraputhiran said.

In addition to Veeraputhiran, the transplant team includes physicians Pooja Motwani, M.D., and Appalanaidu Sasapu, M.D., both assistant professors in the UAMS College of Medicine Department of Internal Medicine; registered nurses, advanced practice registered nurses, case managers, social workers and staff of the UAMS hospital’s E7 wing and the UAMS Cancer Institute’s Infusion Clinic 4; and transplant coordinators.

Clinical Trial Promising for Ovarian Cancer Treatment

Jan. 18, 2017 | Eighteen years ago, Gail Clayton received news that changed her life. Looking back, she says finding out she had breast cancer marked the beginning of new perspectives.

“When I was first diagnosed with cancer, it wasn’t the end of life as so many people think. To me, it was the beginning of life.”

Clayton and her husband, Raymond, have been married 46 years. He calls UAMS one of Arkansas’ best kept secrets.

“I don’t think people realize how amazing this institution is,” Clayton said. “You become friends with your doctors and nurses. It takes a village and I believe that village is right within these walls at UAMS.

She had breast cancer twice and was recently diagnosed with ovarian cancer. That prompted Clayton’s oncologist, Laura Hutchins, M.D., to refer her to gynecologic oncologist Kristin Zorn, M.D.

“Anytime we see a patient with a new diagnosis of cancer in the ovaries, fallopian tubes or the peritoneum (the internal lining of the abdomen), we think of a possible hereditary source for that cancer,” Zorn said.

Clayton and Zorn discussed genetic counseling and ultimately found Clayton had a mutation in one of the BRCA genes, commonly known as the breast cancer genes. Every person is born with the BRCA1 and BRCA2 genes, but women who inherit mutations of the genes have an increased chance of developing breast, ovarian, and other cancers.

Researchers’ knowledge about these genetic mutations has helped lead to development of a new class of drugs known as PARP inhibitors.

“PARP inhibitors capitalize on the genetic defect that’s already present in people who carry one of these mutations,” Zorn said. “It helps to kill the cancer cells that are accumulating DNA damage.”

There are three types of PARP inhibitors that have been FDA-approved over the past few years: olaparib, rucaparib and niraparib. Clayton is a part of a clinical trial that includes her taking olaparib.

“With PARP inhibitors, we first focused on people who carry a BRCA or similar mutation. We’re now finding many patients with ovarian cancer who do not have a mutation are responding to the drugs.”

Another advantage of this new class of drugs is that they can be taken orally rather than through intravenous infusion, making it more convenient for patients. This works especially well for Clayton who spends a great deal of her time seeing the world.

“If someone says go, we pack a bag and go.”

Since her first diagnosis, Clayton says she takes nothing for granted and began living in a way she may not have if not for the illness. She and Raymond Clayton have made lots of memories abroad. Sometimes their adult son Randy joins them.

“We’ve been to the Baltic States, Russia, Berlin, Sweden…”

She’s responded well to the clinical trial and shows no indications of slowing down.

“…England, Paris, the Caribbean, Ireland. It’s been a journey.”

“Part of the reason I’m so passionate about practicing at a place like UAMS, is that it helps us bring cutting-edge therapies to our patients,” Zorn said. “Sometimes we’re talking about a surgical advance, sometimes we’re talking about an advance in treatment.”

Zorn says genetic counseling and testing has become a standard of care in some of the most common gynecological cancers.

“While many parts of the country are having trouble keeping up with the change in the standard of care, UAMS has a genetic counselor embedded in our clinic so that we can accomplish that.”

“The way I see it,” said Clayton, “Even if the clinical trial didn’t work for me, maybe it would work for someone else. I’m grateful for the strides scientists have made in treating this disease.”

This clinical trial was developed through the NRG Oncology cooperative trial group of the National Cancer Institute. The only access to this trial in Arkansas is at UAMS.

Little Rock Man Beats Cancer Twice with Help of UAMS

Dec. 18, 2017 | After 40 years, Jerry and Sharon Moskwiak were ready to leave the cold Michigan winters behind.

They considered a move to their favorite vacation spot in South Carolina, but there was one catch: The nearest academic health care center was at least one hour away.

Because Sharon had worked for 35 years at the University of Michigan, including several years in their medical school, the couple was familiar with the advantages of receiving health care in an academic research setting.

And, because Jerry was a 25-year lung cancer survivor and lived with other chronic illnesses, access to quality health care was one of their top requirements when searching for a new place to call home.

That’s when they turned their sights to Little Rock.

“I grew up in Little Rock and knew the health care was exceptional. That was one of the main reasons we decided to move back here,” Sharon said.

After getting settled into their new home, the Moskwiaks set about finding a primary care physician. Their first and only stop was at the University of Arkansas for Medical Sciences (UAMS), Arkansas’ only academic health care center. During one of his initial appointments, Jerry received some unexpected news that convinced them they had made the right move at the right time.

“The doctor noticed a spot on my chest X-ray, and the next thing I knew we were discussing a plan for chemo,” Jerry said.

The spot was diagnosed as a subtype of non-Hodgkin lymphoma known as mantle cell lymphoma (MCL). This type of lymphoma can be fast growing and is most commonly found in men older than 60.

He was referred to Appalanaidu Sasapu, M.D., a hematologist oncologist at the UAMS Winthrop P. Rockefeller Cancer Institute, who scheduled him for six rounds of chemotherapy to occur every 28 days. Sasapu also is an assistant professor in the Department of Internal Medicine in the UAMS College of Medicine.

“Dr. Sasapu was very clear and told us exactly what his course of action would be. He was confident that what he was prescribing would work for me, and he was right,” said Jerry.

In fact, after Jerry’s fifth round of chemo in October 2016, Sasapu gave the couple good news: The treatment was successful, and he did not need to receive the final round.

“I’m very happy with Mr. Moskwiak’s progress. He is a wonderful gentleman who always has a smile on his face, and his wife is a great caregiver for him,” Sasapu said.

Unfortunately, the good news was short lived when a follow-up scan revealed that Jerry was now facing another challenge: His lung cancer had reappeared after 25 years.

“The first time Jerry was diagnosed, he had surgery to remove the upper lobe of his right lung. This time the spot was in the lower lobe of his left lung, and he wasn’t a candidate for surgery due to his other health concerns,” Sharon said.

After an unsuccessful attempt to freeze the tumor with cold gases in a process called cryoablation, Jerry began a course of radiation therapy under the direction of Sanjay Maraboyina, M.D., assistant professor in the Department of Radiation Oncology in the UAMS College of Medicine.

“Just like Dr. Sasapu, Dr. Maraboyina had a very positive attitude and prescribed an aggressive treatment plan. They both kept the ball rolling in the right direction,” Jerry said.

Maraboyina recommended a highly precise treatment known as stereotactic body radiotherapy at the UAMS Radiation Oncology Center targeting the spot on his lung. This was again good news as only three treatments were required instead of a daily course over several weeks.

“Dr. Maraboyina was a godsend. The care I have received has been exceptional,” Jerry said.

Although both cancers are now in remission, Sasapu recommended Jerry undergo maintenance therapy with the immunotherapy drug Rituxan every two months for two years to keep the lymphoma at bay. With about one year left on that regimen, he is proud to say he feels great. “I’m more than happy with this outcome,” Jerry said.

Faith in Cancer Care Team Keeps New Mexico Woman at UAMS

Dec. 1, 2017 | Tina Farber arrived in Arkansas with one thing on her mind — meeting her two new grandbabies. Her son’s third child had arrived in April, and her daughter was expecting her third about one month later.

“I was planning to stay about two months,” said Farber, a native Arkansan who now lives in New Mexico. “I had a PET scan scheduled for July 7 and needed to return home in time for that.”

A stage 3 lung cancer survivor, Farber was considered to be in remission following surgery, chemotherapy and radiation in 2016. The PET scan was a routine follow-up to ensure the cancer had not returned.

Her plans were about to change, however, when she soon developed a cough, headache and fever, prompting a trip to the urgent care clinic. After returning to her daughter’s house with a diagnosis of pneumonia, Farber’s fever shot up to 102.4 degrees and the family took action.

“My daughter, Brittney, said to pack my bags. She was taking me to the hospital,” said Farber.

About a year earlier, while still undergoing chemotherapy, Farber also had made a visit to Arkansas. A bout with dehydration during her stay landed her in the UAMS Emergency Department, where she was impressed with the doctors and nurses who attended to her.

“Everything was in sync. They got me all taken care of. I told my kids that if I’m ever visiting again and need to see a doctor, don’t take me anywhere but UAMS,” she said.

After making the hour-long drive from her daughter’s home in Malvern, Farber again arrived at UAMS where she was quickly admitted and given the attention of a team of health care providers.

“Before I even got my wristband, they called me to triage and then immediately put me in a room where six people were waiting to take care of me. I was blown away,” she said.

After a series of tests, the doctor arrived with unexpected news. Lesions were found in her brain and bones that likely meant the lung cancer had spread.

“Once we found out the tumor had progressed to the brain and bones, we immediately got Mrs. Farber’s team together to carefully review her case and formulate an overall treatment plan,” said Fen Xia, M.D., Ph.D., chair of the Department of Radiation Oncology in the UAMS College of Medicine.

That team included Xia, who specializes in radiation therapy for brain cancer; medical oncologist Konstantinos Arnaoutakis, M.D., who specializes in lung cancer; and orthopedic oncologist Corey Montgomery, M.D., who specializes in bone cancer. Other specialists in neurology and neurosurgery also were consulted as the treatment plan took shape.

“Having a team of physicians who work together efficiently and in a timely manner is particularly critical in cancer patient care. At the UAMS Cancer Institute, our doctors and nurses communicate instantly and continuously to coordinate our patients’ care at every step, from diagnosis and care management planning to treatment delivery,” said Xia, who also works closely with nurse practitioner Nikki Baxter, A.P.R.N., at the UAMS Radiation Oncology Center.

Because radiation therapy requires daily treatments, Baxter is available to assist patients with symptom management and other issues that arise on a day-to-day basis.

“Communication and accessibility are the top priority with our patients. We all work together to provide the best care possible,” Baxter said.

That emphasis on communication and coordination have lightened the load for Farber and convinced her to postpone returning to New Mexico in favor of continuing treatment in her home state at the UAMS Winthrop P. Rockefeller Cancer Institute.

“It’s hard to be away from my husband, but God put me here for a reason,” said Farber, who added that her family and long-time friends have offered endless support and encouragement during her extended stay in Arkansas.

“The doctors and nurses at UAMS have taken the time to get to know me. They all know my story, which is really important to me. I’m going to stay here and fight this battle because I know I’m in good hands,” Farber said.

Breast Cancer Didn’t Steal Little Rock Woman’s Zeal for Life

Oct. 12, 2017 | The past year and a half has included many challenges for Josephine Guiden — being diagnosed with cancer, then chemotherapy, surgery and radiation treatments— but none of them have snatched her passion for life.

“There’s power in knowing you have to be positive about life,” said the 70-year-old Little Rock resident. “You only come this way once and you have to make the best of it while you’re here.”

Guiden’s taxing journey began in May of 2016 when she discovered a knot in her breast under her right arm. She recognized immediately it could be cancer.

“It was shocking, but through years of mammograms and exams, physicians tell you what the knot will feel like,” she said. “You don’t quite get it then, but when I felt that knot, I knew it was malignant. I knew it was cancer.”

She called her doctor and had a previously scheduled mammogram moved up, but in the meantime, went on a bus trip to New York with the Patrick Henry Hays Senior Center in North Little Rock.

“I had lots of fun,” she said, “but my energy level was low.”

When she returned, her mammogram and biopsy confirmed what she already suspected: breast cancer. However, at stage 3 it was more advanced than she expected.

“There was anxiety and fear when it was confirmed and it was so advanced that I was upset with myself,” she said. “Even though I expected the diagnosis, I came home afterwards and had a good cry. But I knew I had to stay positive, I had to pray about the situation and that’s what I did. I told God, ‘I choose life. I want to live.’”

She was shepherded through the next several months of treatment by Daniela Ochoa, M.D., breast surgeon in the UAMS Winthrop P. Rockefeller Cancer Institute and assistant professor of surgery in the Division of Breast Surgical Oncology in the UAMS College of Medicine; Issam Makhoul, M.D., director of the UAMS Division of Hematology/Oncology and associate professor in the College of Medicine; and Loverd Peacock, M.D., radiation oncologist in the Cancer Institute and faculty member in the Department of Radiation Oncology in the College of Medicine.

“They were my guardian angels,” said Guiden. “I was placed in the midst of three great doctors who made me feel so special that no one could have ever convinced me that I wasn’t their favorite patient.”

Ochoa said the whole-team approach is one of the benefits to breast cancer treatment at UAMS.

“We have specialists who practice only in breast cancer — from radiologists and oncologists to geneticists, pathologists and behavioral health specialists,” said Ochoa. “We have team members who work closely in managing breast cancer patients and are able to provide a consensus opinion, and our patients benefit from that.”

A few days after her diagnosis, Guiden received her port for chemotherapy treatment. The first series of treatment lasted 12 weeks. In the three-week hiatus between her first and second rounds of chemotherapy, she took another cross-country bus trip. This time to Martha’s Vineyard in Massachusetts.

She began her second round of chemotherapy the day after she returned and completed it just before Thanksgiving. On Dec. 27, she had a lumpectomy, a surgery to remove the tumor, performed by Ochoa. Then she received radiation treatment for five weeks from Peacock.

Throughout her treatment regimen, Guiden says she relied on her faith, family, friends and fellow church members at St. John Missionary Baptist Church in Little Rock for support.

There was her Sunday School teacher who gave her a scripture after her diagnosis, Psalms 117:17-18, that she carried with her daily; countless prayers with her Sunday School class; her two sisters and a close friend who stopped by often to help with household chores and cooking; her son who did yard work; and her brothers who helped make sure she didn’t miss a family reunion gathering.

“I was surrounded by a wonderful group of people that supported me,” she said.

In May, one year after her diagnosis, Guiden had another mammogram performed. She was cancer free. Guiden could barely contain herself when she saw Ochoa following the exam.

“I just grabbed her and almost picked her up off the floor,” she said. “I was so happy to have the relief. There was quite a bit of anxiety prior to the mammogram because you don’t know what to expect or what will be there.”

Ochoa said Guiden’s story conveys the importance of monthly self-examinations.

“I’ll often hear patients say they don’t know what they’re feeling for, but the idea is to be familiar so something new will stand out and feel different. The monthly interval is important because it’s enough of a timeframe that you’ll notice a difference if it occurs.”

Looking back, Guiden sees that importance, too.

“It’s so important to do self-exams,” she said. “If I had done that, I would have found this sooner, but I stopped. That was the culprit, me not taking stock in myself and my well-being.”

Breast Imaging Center’s Same-Day Results Eases Patient Concerns

Sept. 1, 2017 | Since she was in her early 30s, Tracy Lamey has been coming to the UAMS Breast Center twice a year for breast imaging. Her mother was diagnosed at 39 with breast cancer, so that put Lamey at high risk for the disease.

“I come here because of the state-of-the-art technology,” Lamey said. “I also feel that the staff and my physician are very knowledgeable about the latest guidelines and what is best for my overall health. And I get my results before I leave. That not only gives me a plan of what needs to happen next, it eliminates the anxiety that sometimes comes with waiting.”

Gwendolyn Bryant-Smith, M.D., is chief of Breast Imaging at UAMS. She says the UAMS Breast Center is a one-stop shop with highly trained professionals at every helm. Today breast imaging is more than a mammogram.

At UAMS, there are three fellowship-trained radiologists and a fourth radiologist with years of experience. Each is skilled at interpreting mammography, breast ultrasound, and breast MRI and performing breast biopsy procedures. Digital breast tomosynthesis, better known as a 3D mammogram — the newest mammography technology — is offered at the UAMS Breast Center. Bryant-Smith says it is an evolution of the 2D mammogram and was FDA approved in 2011. UAMS has had this technology since 2014.

“The value in a 3D mammogram is that we’re able to see through dense tissue. Dense tissue makes it very challenging to find cancer because it shows up white on a screen. Cancer is also white. It’s hard to differentiate between the two using 2D mammography. When using 3D mammography, we are often able to detect subtle masses that may not otherwise be seen.”

Bryant-Smith said the Breast Imaging Center does risk assessments on every patient.

“We ask them about family history, whether they’ve had children, taken hormones or had previous biopsies,” Bryant-Smith said. “Using that information, we calculate a number. Patients who score higher than 20 percent, are considered to be at high risk for developing breast cancer.”

The center offers additional screening with breast MRI for those patients considered high risk for developing breast cancer. Lamey has had a routine breast MRI for many years.

“It’s a quick procedure, 45 minutes and painless” Lamey said. “The imaging techs are very caring and thorough. I like that they’re able to see a lot more, and my physician shows me those images.”

Since she’s been going to the breast center Lamey has had three biopsies.

“For each of my biopsy results, my doctor called me personally,” Lamey said. “As soon as she gets the results, she immediately calls. The personal aspect has been huge, and it’s very important to me.”

“We really want to serve the patients of Arkansas well,” Bryant-Smith said. She encourages women to begin screening annually once they turn 40, or sooner if they’re at an increased risk. Screening mammography saves lives, she said.

“I have a family,” Lamey says. “I want to make sure I’m taking care of myself so that I can be there for them. The Breast Imaging team at UAMS gives me confidence that I’m doing everything I can to prevent cancer for myself.”

Doctor Rids NLR Man of Barrett’s Disease

July 18, 2017 | A year ago, Reg Hamman of North Little Rock was convinced he had heart problems. There was discomfort in his chest that prompted him to visit his cardiologist.

“It turns out it was acid reflux,” Hamman said. “I was referred to my gastroenterologist who found out through an endoscopy that I had Barrett’s esophagus. I’d never even heard of Barrett’s before. Now suddenly I had it.”

Barrett’s disease is a relatively common pre-cancerous condition in patients with heartburn caused by the repeated exposure of the esophagus to acid refluxing from the stomach. It occurs in about 7 percent of people over age 40 .

Hamman, 71, is a zealous learner. He spent a lot of time finding out exactly what Barrett’s disease is, how to treat it, and which doctor he should see.

“I did a lot of research. I found several different states that had physicians that did the procedure to get rid of Barrett’s,” Hamman said. “After meeting Dr. Tharian, I felt comfortable UAMS was the place to be. Dr. Tharian explained the procedure carefully and with confidence.”

Benjamin Tharian, M.D., is an assistant professor and director of advanced endoscopy in the Division of Gastroenterology and Hepatology in the UAMS College of Medicine. He sees patients in the gastroenterology clinic.

“Barrett’s is concerning because it is a pre-cancerous condition,” Tharian said. “It is to the esophagus, what a polyp is to the bowel or a lump to the breast. We want to prevent it from developing into cancer.”

About a decade ago, the only treatments for Barrett’s disease was prescribing acid inhibitors and close monitoring that included endoscopies with biopsies every three years. If any worrying changes are noted in the biopsy under a microscope, patients used to be referred for an esophagectomy (surgery to remove the food tube).

Two revolutionary treatments have come available in the last 10 years: endoscopic mucosal resection (EMR) and radiofrequency ablation (RFA). Tharian is the only physician who offers the combo-treatment in Arkansas. Cryotherapy is done if RFA/EMR fails and esophagectomy would be the last option.

In EMR, the physician removes abnormal tissue from the esophagus through an endoscope after applying a band. For the radiofrequency ablation, Tharian uses an electrode mounted on a balloon catheter or a metal plate. The ablation coagulates the lining, which Tharian then removes. The scar from the ablation heals with normal tissue in a few days to few weeks. This is an outpatient procedure and the patient is able to eat regular food as early as three to five days depending on their symptoms. Side effects and complications are minimal.

“During his last endoscopy about a month ago (about a year after finding the Barrett’s Disease), we took multiple biopsies at different levels to look for any hidden glands or any changes. There is none at all. That’s the way we confirmed his Barrett’s was gone.”

Tharian says the procedure is successful in removing Barrett’s more than 80 percent of the time and eliminates the high-risk dysplastic tissue almost always. Patients will continue to be monitored long term for recurrence of the disease.

“The whole experience has been educational and positive,” Hamman said. “I feel great and I’m thankful that I’m healed.”

Pine Bluff Man Free of Esophagus Cancer After Early Detection

June 1, 2017 | When Mark Harper went to see his gastroenterologist last September, he wasn’t expecting a cancer diagnosis.

“I never had any symptoms,” he said. “I went in because I promised my wife I’d go see Dr. Henry Rogers before he retires.”

Harper considers himself lucky. The doctor in Pine Bluff did an endoscopy and saw something he found concerning. He ordered a biopsy and found Harper was in the early stages of esophageal cancer.

“He referred me to UAMS because they couldn’t do an ultrasound in Pine Bluff. Dr. Tharian took it from there.”

Benjamin Tharian, M.D., is an assistant professor and director of Advanced Endoscopy at UAMS who sees patients in the gastroenterology clinic.

“We rechecked the sample here with UAMS pathologists and confirmed that Mr. Harper did have cancer in the lining of his esophagus,” Tharian said.

Harper has Barrett’s disease, a relatively common pre-cancerous condition in patients with heartburn caused by the repeated exposure of the esophagus (the tube that carries food from the mouth to the stomach) to acid refluxing from the stomach. Barrett’s is found in about 7 percent of those over age 40, even more in patients with reflux disease. In a small minority, Barrett’s disease develops into esophageal cancer, which why early recognition and monitoring is important.

Before he began treating Harper’s cancer, Tharian first made sure the cancer had not spread into deeper layers of the esophagus or other parts of the body by doing an endoscopic ultrasound and CT scan. The cancer was found to be limited to the inner lining of the esophagus. “It’s great the cancer was discovered at an early stage,” Tharian said.

Most people with Barrett’s disease won’t develop esophageal cancer, though it remains the most common risk factor for this cancer. The incidence of this cancer has increased by 500-600 percent since 1970. It remains one of the fastest growing cancers in the U.S. with less than one in five surviving up to five years after diagnosis.

Patients at risk of Barrett’s disease — those with reflux symptoms, smokers, overweight, and those with history of dysplasia on previous biopsies or a family history of esophageal cancer — should be screened with an upper endoscopy.

Those with the disease should be monitored closely by a gastroenterologist with endoscopies and biopsies.

“You have to look carefully for any lumps or bumps within the Barrett’s lining and suspicious or abnormal areas. Early recognition of high-risk lesions will enable early referral to an interventional gastroenterologist.

In Harper’s case, once Tharian determined the cancer was limited to the lining of the esophagus, he performed a tissue biopsy from some lymph nodes in Harper’s chest to see if cancer was present there. It also came back negative. Tharian then endoscopically removed a portion of his patient’s esophagus with the tumor.

“Once the pathologist confirmed that the lesions were removed, I treated the rest of the Barrett’s lining of the esophageal wall using radiofrequency ablation.” The lining would heal eventually with regeneration of normal tissue.

Harper now has to make sure the disease doesn’t return. Because his esophageal junction — the place where the esophagus connects to the stomach — is not tight, Tharian said, stomach acid will continue to enter the esophagus causing a likely recurrence.

“We’ve removed the cancer,” Tharian said. “The next thing to do is prevent it from returning. He’ll need to stay on his acid suppressant medication and have the esophageal junction tightened through minimally invasive surgery. Endoscopic treatment of Barrett’s disease is a cost effective and safe treatment with excellent results. It improves the quality of life.”

Patient Searches Nation, Finds Best Cancer Care at UAMS

Oct. 20, 2016 | When Don Marshall, 58, was diagnosed with prostate cancer, he wanted to make sure he received the best possible care. He was considering traveling to California for treatment until he realized there was a state-of-the-art facility in his own backyard.

One year ago, Marshall went to a routine physical examination for an insurance company. The health care professional noticed his PSA (prostate specific antigen) test showed a higher than normal number, which is an indicator of possible prostate cancer.

“They had to do further tests. They eventually took a biopsy and found out that I was positive for prostate cancer.”

Marshall says he did what most people today would do: searched the web for articles and information to learn more about prostate cancer. He talked to several doctors about the treatment options he found available.

“I found out that proton therapy seemed to be the best out there and according to my research a facility in California was the place to go for the best treatment,” Marshall said.

Proton therapy treatment involves using a focused ray to destroy cancerous tissues while causing less damage to healthy surrounding tissues.

Marshall soon discovered that his insurance would not cover the cost of his treatment in California.

“I was going to find a way to pay and go anyway,” he said. “Because this is about my health.”

It wasn’t until he was on the phone with a health care professional at a Louisiana facility when he found out about a very similar treatment known as TomoTherapy. TomoTherapy combines intensity modified radiation therapy with the accuracy of computed tomography (CT) scanning. The radiation beams are targeted precisely to the tumor on any given day and produce less harmful side effects than conventional radiation treatments.

Marshall said he had not heard about TomoTherapy until then and began reading about it.

“I immediately called UAMS and set up an appointment. I met with Dr. Peacock. I really liked him. He reassured me that you couldn’t go wrong with this type of radiation therapy.”

Loverd Peacock, M.D., is a radiation oncology professor in the UAMS College of Medicine. Board certified in internal medicine and radiology, Peacock is also a charter member of the Board of Directors for the Mid-South Division of the Arkansas Cancer Society.

Marshall came to the Radiation Oncology Center at UAMS every morning for 45 days. He says he couldn’t be happier with his results.

“The visits took about 15 minutes. It was painless.”

Marshall’s PSA test is normal and the cancer is gone. He says he feels better now and definitely recommends screening.

“A lot of people are afraid of what they are going to find. I’m the opposite; if there’s something wrong I want to find out what it is as soon as possible. The disease is there whether you want to know about it or not. You may as well catch it early when it’s easier to treat.”