New technique gives hope to cancer patients

University researchers are running photodynamic therapy trials in an effort to battle deadly cancers. John Harms was expected to die. During surgery last August to remove a tumor in his lungs, doctors found the cancer had spread. Traditional medicine had run out of options. It was a dead end. But now there is a good chance Harms will live to teach computer science again, thanks to a team of University doctors who, using unprecedented methods during a 9-hour procedure last month, gave him that chance. How they did it: A photosensitizer, or light-activated drug, was injected into the patient one or two days before the surgery. After doctors removed the tumor, they focused a laser on the cancerous area, stimulating the drug. After being activated, the drug produces an activated form of oxygen which kills any remaining cancerous cells. "It's funny -- I don't know if even now I've let it fully sink in," said Harms, 47, of Springfield, Pa. "Every once in a while it's just nice to know that all that stuff is out of there." Known as photodynamic therapy, the method is already used to ease swallowing for patients with esophageal cancer and is particularly effective against cancers that spread too wide for radiation to be safe. The light used to activate the drug, however, only penetrates to a depth of a few millimeters, limiting the opportunity to apply the treatment to the time during which the chest cavity is open -- a one-time opportunity. "You'd be hard pressed to find a cancer treatment where given one treatment, you can cure the patient," said Stephen Hahn, director of the University's Photodynamic Therapy Program, which began trials last May. The results so far are encouraging. On December 9, Harms underwent surgery to remove the tumor using the new techniques. After the procedure, Harms said one of the surgeons told him that he "had to use every technique in my books to get it all." But as of yesterday, no trace of the cancer remained in Harms' body. Although Harms is one of only two patients treated for cancer of the lining of the lung, 12 others have undergone surgery using similar techniques for abdominal cancer. Hahn and co-investigator Joseph Friedberg, a Surgery professor, expect the trials to run one to two years and include 154 subjects. The trials encompass three types of cancer: abdominal cancer, lung cancer and mesothelioma, or cancer of the lining of the lung. While trials of photodynamic therapy in mesothelioma are also being conducted at Wayne State University in Detroit, the Hospital of the University of Pennsylvania is the only hospital doing trials with the other two types of cancer, according to Hahn. The procedure is not without side effects. Most prominently, subjects must avoid exposure to sunlight for six to eight weeks following the treatment. The treatment may also damage healthy, non-cancerous cells, creating further complications. As with all experimental treatments, Hahn emphasized the importance of providing the patient with as much information as possible. Among other things, Hahn puts patients in touch with others who have undergone the treatment. According to Hahn, one woman who underwent the treatment tells patients that "this is the worst surgery she went through." "She felt like she'd been run over by a truck," he said. Three or four patients, given the opportunity, have chosen not to have the surgery. Still, Hahn said that "the majority of patients who really have no other treatment options, if something sounds reasonable, will pursue it." Run over by a truck or not, the woman -- whose cancer is in remission as a result of the surgery -- is a believer, as is John Harms. When Harms first saw his doctors after the surgery, "[they] were grinning. They really felt like they'd gotten it all. "I don't think there are many [doctors], maybe no one, who could have done what they did," Harms said.