November 05, 2018
Brenda Adams and her husband, Darrell, appreciate the simple joys of life. Barbecues. Sports. Fishing. Time with family – and with 5 children and 17 grandchildren between them, there's a lot of family to fill their time.
"We are simple people who enjoy everyday things," says Brenda, who lives in Topeka, Kansas.
But even living simply became a significant challenge when Brenda faced liver failure.
Since the age of 15, Brenda experienced seizures, so she wasn't a stranger to health concerns. But in June 2010, she got very sick. She visited her primary care physician, who ordered a full blood workup. Tests revealed Brenda was diabetic. As she learned to control the diabetes, she received more difficult news. She also had hepatitis C. She had a liver biopsy and soon began vomiting blood the consistency of coffee grounds. Her local doctor referred her to The University of Kansas Health System and the care of hepatologist Ryan Taylor, MD.
"I wasn't afraid," she says. "I knew I was in good hands, and I didn't believe it was my time to go."
But additional complications were ahead. A full evaluation revealed jaundice and cirrhosis. Brenda worked with Dr. Taylor to manage her condition with medications for several years, but by February 2015, she had developed liver cancer. She received targeted chemotherapy and microwave ablation, but also was added to the waiting list for a liver transplant.
As Brenda awaited the organ, hematologist/oncologist Raed Al-Rajabi, MD, led her cancer care.
"Patients fighting cancer while awaiting transplant require significant collaboration among specialties," Dr. Al-Rajabi says. "We take a team approach to achieve the best patient outcome. When the tumor is large, we focus on shrinking it before transplant. When the cancer is small enough to meet transplant criteria, we focus on preventing it from spreading. We coordinate across disciplines to control the cancer as we see the patient through to transplant."
Microwave ablation entailed inserting a needle with a probe into the center of the tumor and heating it to a high temperature to kill cancer cells. Chemoembolization is a treatment in which chemotherapy-filled beads are delivered directly to the blood vessels feeding the tumor. Brenda's interventional radiologist used microcatheters to navigate the beads to the tumor through a small incision in the groin. Once placed, the beads cut off the blood supply to the tumor and deliver chemotherapy to the tumor.
"Interventional oncology is a leading-edge specialty that most cancer centers are increasingly emphasizing," Brenda's doctor says. "It is quite a common scenario for our team to 'bridge to transplant,' meaning focus on destroying cancer while a patient awaits a liver. Without this approach, many fewer patients would be able to receive the new organ. Brenda's specific treatment – chemoembolization combined with microwave ablation – is a new method we are researching, and one that is showing promising early results."
"We pretty much microwaved that cancer, targeting it and only it so nothing else would be damaged," Brenda says. "Then I got the phone call that changed my life."
The turning point
It was July 5, 2015.
I'll never forget it," Brenda says. "It was my husband's birthday, and I was at home planning a birthday celebration. The phone rang, and when I answered, I heard, 'A liver is available. Are you interested?' Yes, I was interested!"
Brenda woke her husband and went to her closet to decide what to wear.
"And then I laughed at myself," she says. "What was I worried about that for? I was just going to have to take it all off!"
Brenda and Darrell drove through the night, arriving at The University of Kansas Health System in time for Brenda to receive a perfect, healthy liver at 6 a.m. on July 6.