Liver transplant offers new option for rare cancer

Christopher Sonnenday, M.D., M.H.S.

Robert “Buzz” Gehle thought the itchy rash he was experiencing was a recurrence of an earlier case of shingles. But when his doctor saw he was also jaundiced, he immediately knew there was a problem with Gehle’s liver.

Gehle was diagnosed with cholangiocarcinoma – cancer in the bile duct – in October 2009, and it soon became clear that traditional surgery would not be an option.

Instead, doctors at the University of Michigan Comprehensive Cancer Center started Gehle on chemotherapy and radiation and ran him through a series of tests to determine if the 65-year-old was otherwise healthy enough for a possible new treatment – liver transplant.

Liver transplantation is often used for cancer that occurs within the liver. But U-M is one of a small number of centers around the country to offer a transplant for cancer of the bile duct, a long tube-like structure that connects the liver to the intestines.

Bile duct cancer can be extremely difficult to remove surgically, and even when surgery is an option, the cancer frequently comes back.

“This is a tumor we have always struggled with,” says Christopher Sonnenday, M.D., M.H.S., assistant professor of surgery at the U-M Medical School. Sonnenday, a transplant surgeon, is part of the Multidisciplinary Liver Tumor Clinic at the U-M Comprehensive Cancer Center.

“Historically, transplant has not been thought to be a great treatment for cancer. What we’ve learned in recent years is that if you select patients very carefully and find the right patients, those patients can potentially be helped by transplant,” Sonnenday says. Continue reading