UK research study becomes key to cancer battle
After IV chemotherapy failed to shrink her tumor, Kathy Caldwell had another option: a clinical trial.
After a successful bariatric surgery, Kathy Caldwell of Middlesboro, Ky., kept telling her primary care provider she was experiencing recurring pain in her abdomen. Her doctor routinely dismissed her concerns, but Caldwell didn’t feel right.
One day, several months after the surgery, Caldwell started feeling nauseous and laid down to rest. When the mother of three woke up the next morning, she looked in the mirror and noticed her entire body had yellowed.
“I was yellow, head to toe, even my scalp,” she said. She called Dr. Joshua Steiner, who had performed her gastric bypass surgery. “He said, ‘Get up here now. There’s something wrong.’”
After running tests, Steiner realized that something more serious than a gallstone was causing these issues.
“He got really teary-eyed, came over to me, put his hand on my leg and said, ‘Katherine, this isn’t good,’” Caldwell recalled.
Within hours, Steiner had referred Caldwell to Dr. Roberto Gedaly, a liver transplant specialist and director of the UK HealthCare Transplant Center. “If it was my wife, [Dr. Gedaly] is who I would take her to,” Steiner said.
Diagnosis and treatment
Encouraged by Steiner’s trust in Gedaly, Caldwell went through a series of tests to address her jaundice and uncover its cause. It wasn’t until she met with liver specialist Dr. Meera Gupta in 2019 that Caldwell finally found out what had been causing her pain: intrahepatic cholangiocarcinoma, also known as bile duct cancer.
Gupta told Caldwell that her tumor was unresectable – too advanced to remove by surgery – and that patients with her diagnosis were not currently eligible for liver transplant. Caldwell’s team made a plan to start her treatment with IV chemotherapy, in the hopes that it would shrink her tumor to a size that could be removed surgically.
"I wasn't going down without a fight."
Six months in, her tumor remained unresectable, but she learned she might be a candidate for a clinical trial.
The clinical trial
Led by surgical oncologist Dr. Michael Cavnar and medical oncologist Dr. Reema Patel at the UK Markey Cancer Center, the trial was for a specialized type of treatment for cancers like Caldwell’s.
Cavnar and Patel were studying the safety of combining two separate medical devices: an implantable pump typically used to deliver pain medicine to the spinal cord and a special catheter designed to be implanted into an artery. For the study, this device combination was being surgically implanted in a way that allowed chemotherapy to be infused directly into the liver at a higher dose.
Typically, when patients receive chemotherapy, it’s administered through their entire body via their bloodstream. The method Cavnar and Patel were studying would allow more chemotherapy to be delivered directly to the tumor at a higher dose than the IV chemotherapy Caldwell had received previously.
She was eager to participate.
“I wasn’t going down without a fight,” she said. “I was like, ‘Sign me up!’ If they’re willing to take me, I’ll do it.”
Caldwell got the hepatic artery infusion pump implanted in June 2020. The trial period is for six months, but due to an issue with the catheter, Caldwell had to have the pump removed and could only participate for five and a half months. Despite being unable to continue with the implanted pump, Caldwell and her doctors are pleased with the progress she made during her time with it. Now, she’s continuing her treatment through radiation and oral chemotherapy, personalized to her cancer.
Caldwell is thankful for the treatment she continues to receive at UK HealthCare, and she’s grateful for the strength that her faith has given her.
“The doctors have all been so wonderful to me,” she said. “With them, I don’t feel like just a patient. They show concern, and they make me feel like an individual person. I feel like God handpicked them just for me.”