Karmanos patient undergoes new topical intrarenal chemotherapy for bladder-related cancer

Steve Kabara, 50, of Gibraltar, Michigan, has a family history of cancer. He lost his father to a lung-related cancer in 1988 and has other family members who have been treated for cancer. When he was diagnosed with upper tract urothelial cancer about two years ago, he anticipated chemotherapeutic treatments that would cause him to lose hair and weight. This type of cancer is similar to bladder cancer but occurs on the inner lining of the kidney and ureter.

Kabara initially underwent a procedure to have his tumor ablated by laser. All was well until the cancer returned six months later, requiring chemotherapy. Contrary to his fears, Kabara said that he’s gained weight and is able to receive his treatments on an outpatient basis with little discomfort and almost no time away from his job as a certified optician and office manager.

Kabara is receiving an innovative treatment modality called topical intrarenal chemotherapy at the Barbara Ann Karmanos Cancer Institute, one of only two National Cancer Institute-designated comprehensive cancer centers in Michigan and one of the few cancer hospitals in the country offering the therapeutic method.

Topical intrarenal chemotherapy is used to treat upper tract urothelial carincomas, which can affect the renal pelvis and/or ureter.

Intrarenal chemotherapy is an adjuvant therapy typically administered after a surgeon has ablated the patient’s tumor. It is administered via a catheter directly into the patient’s kidney by a urologist and considered a topical infusion since the chemotherapeutic agent coats the inner walls of the kidney, targeting the cancer cells, rather than being infused into the bloodstream.

The procedure has a success rate of around 75 percent, according to Michael Cher, M.D., member of the Genitourinary Oncology Multidisciplinary Team at Karmanos. Dr. Cher is Kabara’s oncologist.

The alternative to intrarenal therapy for advanced upper tract urothelial carcinomas is nephroureterectomy, which entails removal of the entire kidney and ureter.

“One of the options was to take the kidney out,” Kabara said. “I’m not very old. If at all possible, I’d like to keep the kidney. When (Dr. Cher) explained the (intrarenal chemotherapy) to me and I did a little bit of research online, I saw that there was a high success rate.”

Given the alternative, Kabara chose intrarenal chemotherapy. He recently completed a six-week round of the chemotherapy, which required him to go in once a week for about two to three hours to have the treatment done. He said the treatment method required him to move positions every 15 minutes so that the chemotherapy adequately covers the lining of the kidney. Afterwards, Kabara says he experiences “a little pressure” in his thigh and lower back, but that the treatment causes no major discomfort.

Kabara will check in with Dr. Cher in another six weeks to see if he has to continue with intrarenal chemotherapy.

“If this works, this is fantastic,” he said. “This is minimal disruption to my life. I don’t miss much time at work. Other avenues (of treatment) could have been much worse.”

For more information about intrarenal chemotherapy for urothelial cancers, please call the Barbara Ann Karmanos Cancer Institute at 1-800-KARMANOS or visit karmanos.org.

Steve Kabara with his daughter Emily