September 17, 2014 7:19 pm
Updated: April 2, 2015 3:47 pm

Doctors weigh in: What’s next for Rob Ford following cancer diagnosis?


WATCH ABOVE: Dr. Zane Cohen, a senior doctor at Mount Sinai Hospital in Toronto announced Wednesday the mayor had been diagnosed with pleomorphic liposarcoma – a rare form of cancer that grows in the fatty tissue of the body. Crystal Goomansingh reports.

TORONTO – Doctors have diagnosed Toronto Mayor Rob Ford with liposarcoma just a week after he was admitted to hospital for “unbearable” pain.

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The cancer is extremely rare and the tumour is fairly aggressive but doctors are optimistic, Dr. Zane Cohen said at a press conference at Mount Sinai Hospital.

Cohen is an internationally recognized colorectal surgeon and the doctor leading the mayor’s care team at the Toronto hospital which specializes in treating sarcoma.

“To get to the size it is now, it’s often several years,” Cohen said.

“We are treating this very aggressively, in order to eradicate the tumour,” Cohen said. Within days, Ford will begin his first three-day round of chemotherapy.

READ MORE: Mayor Rob Ford diagnosed with rare cancer

After two sessions – with a 17-day break in between – the tumour will be re-evaluated.

Doctors weighing in acknowledged the severity of the prognosis.

“The universal reaction is this is rare. Sarcomas are, in general, serious types of cancers with a lot of variability. Some act more aggressively than others,” Dr. Jeff Rothenstein told Global News. Rothenstein is an oncologist with Lakeridge Health and the Durham Regional Cancer Centre.

What is liposarcoma and why is it so rare?

Liposarcoma is a rare type of cancer that begins in the fat cells. It’s in the soft tissues and could start in any part of the body – the tendons, fatty tissues, nerves, blood vessels, and muscles.

Sarcomas comprise only about one per cent of all cancers with 60 different cell types.

“That’s what makes it a very rare tumour and a very difficult tumour,” Cohen said. He couldn’t provide an estimate on the percentage of people with this cancer who survive five years, the standard benchmark for cancer survival.

“This is something that’s uncommon, something that would be unexpected for the majority of people when you’re talking about abdominal tumours,” Rothenstein told Global News.

“In this one per cent, there are many different subtypes, they all look different under a microscope and they have different behaviours,” he explained.

Colon, colorectal, and ovarian (for women) cancers tend to be far more common.

WATCH ABOVE: The Head of Medical Oncology at Princess Margaret Hospital, Dr. Malcolm Moore, discusses the specifics of Mayor Ford’s cancer diagnosis.

What is the typical plan of attack?

Ford will undergo chemotherapy in hospital for three days, followed by 17 days of rest. Then the cycle repeats itself. After two cycles, the tumour will be reassessed with imaging.

Doctors will determine their next steps pending Ford’s results. There could be more cycles of chemotherapy, radiation could be involved and surgery is also an option.

The first two cycles will take at least 40 days to complete.

“We are optimistic about treatment. This particular sarcoma is more sensitive to chemotherapy than most sarcomas,” Cohen said.

The cancer wasn’t found in any other organ but a small nodule was in a different region of the body.

The cancer spreading outside of the localized region isn’t ideal, and only adds “an extra layer of complexity,” Rothenstein said.

Because liposarcoma is so rare there is no conventional treatment program.

“There’s not a lot to sarcoma that’s routine. It’s tailored to individual cases but [Cohen’s outline] is typical protocol,” he said.

Can he still do his job as mayor?

The doctors wouldn’t say if Ford’s treatment plan would stop him from his posting as mayor and city councillor candidate.

“I can’t recommend yes or no. He may be able to work through it…he will be able to be functional but he’s going to have rough days,” Cohen said.

Aggressive treatment doesn’t always equate to strong side effects. Potent treatment might be a lighter dosage that could yield bad response in the patient. It all depends on the patient’s response.

“Everybody tolerates chemo differently. If [going back to work] is what they want to do, it’s a reasonable thing to aim for,” Rothenstein said.

READ MORE: Tory, Chow laud Rob Ford as ‘fighter’ in wake of cancer diagnosis

He encourages patients to focus on their health, see how they’re feeling if they’re at work, what kind of support systems are around them, how flexible work is and how they’re working through side effects.

Day-to-day side effects range from hair loss, vomiting, nausea, issues in the gastrointestinal tract that could tamper taste and appetite, diarrhea, constipation, sores in the mouth and bouts of feeling flu-like symptoms.

WATCH ABOVE: The tumour in Mayor Rob Ford’s stomach is malignant, according to Dr. Zane Cohen, the doctor leading the mayor’s care team. Mark Carcasole reports.

Then there are the rare side effects: a weakening of the immune system, risk of infection, low blood count, needing a blood transfusion or if the chemo affects organ function.

The extra details

Ford had a CT scan in 2011 and nothing was detected at that time. There wouldn’t necessarily be any detectable symptoms early on with this cancer. As the tumour expands though, it can add pressure to organs. Ford’s main tumour was described as “very large.”

Cohen said Wednesday it was about 12 centimetres by 12 centrimetres, which probably explained Ford’s “unbearable” pain.

Earlier this year, Ford confessed to dealing with alcoholism and substance abuse issues. He did stints in rehab but Rothenstein notes that he doesn’t think this affects or connects to his current ailment at all.

What’s in his favour is his age – 45 years old is young.

Ford’s father, Doug Ford Sr., died of colon cancer in 2006 – it’s well documented that family ties to cancer increase your risk of developing the disease but this isn’t the case for sarcoma.

The medical community doesn’t know what causes sarcomas and there’s no rhyme or reason when it comes when it surfaces.

–          With files from James Armstrong and the Canadian Press

© 2014 Shaw Media

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