Brian Principe, 60, knew he needed to get a colonoscopy. He'd been putting it off for years. The truth was, he'd had the colorectal exam already — when he was in his 20s and experiencing unexplained abdominal pain. At the time, the colonoscopy detected polyps, which are abnormal tissue growths, but, he says, "No one told me how important it was to follow up."

Last summer, after a lot of urging from his doctor, Brian finally gave in and scheduled a screening.

"My doctor pulled me into his office after the colonoscopy and told me he was concerned about a small growth on my colon that was about the size of a green pea," says Brian. "He said it was really small, but it worried him."

After a CT scan later that day, Brian's doctor told him that not only was there a growth on his colon, but growths on his liver too. A biopsy and additional tests confirmed Brian's fears: It was cancer of the colon that had spread to his liver. 

'Patient zero' for liver pump therapy

Brian met with a medical oncologist at Mayo Clinic in Florida, who recommended standard chemotherapy every two weeks. After three months of treatment, Brian's cancer began to shrink "pretty dramatically." After six months, his tumors had shrunk by half.

Brian's cancer had spread too much to be completely removed with surgery. However, Brian's oncologist mentioned a treatment called hepatic artery infusion pump (HAIP) therapy. He told Brian that, up until then, HAIP had only been available at Mayo Clinic in Minnesota, but the Florida surgical oncology team was working to introduce it at the Jacksonville campus.

HAIP administers chemotherapy through an infusion pump. The pump delivers strong doses of cancer-killing chemicals straight to the liver while reducing the harmful side effects of traditional systemic chemotherapy, which travels through the entire body and damages healthy cells.

"My doctor said he didn't want to get my hopes up, but he wanted to talk to a surgeon about my case," Brian recalls.

Dr. Katherine Poruk, surgical oncologist and leader of the HAIP program at Mayo Clinic in Florida, reviewed Brian's case and determined he would be a perfect fit for the therapy.

When Dr. Poruk and her team presented the option to Brian, he didn't think twice. "I didn't feel like I needed to do any research," he says. "I just trusted my doctors at Mayo that this was the best path."

Dr. Poruk explained to Brian that HAIP wouldn't close any doors to treatment for him. Instead, she told him, it would actually open them.

In March, Brian became the first patient at Mayo Clinic in Florida to have surgery to implant a pump directly into his hepatic artery so he could receive liver-directed chemotherapy.

An open door to future treatments

Mayo Clinic is the only center in North Florida to offer HAIP therapy.

So far, six patients at Mayo Clinic in Florida have had a pump implanted for HAIP therapy — including Brian, who uses his status as "patient zero" to help others.

Once he learned that another patient was scheduled to have surgery to implant the pump, for example, Brian gave his nurse his name and number so the patient could call him, if he or she chose, to talk to someone who had already had the procedure.

"For me, this has been all about helping the next person in line," he says. "I want them to know what to expect and help them if I can. I may not have known what to expect, but I did know I was in good hands."

Since his surgery in March, Brian's tumors have continued to shrink and, importantly, his cancer hasn't spread further.

"Brian was the right person at the right time to introduce this therapy option here in Florida," Dr. Poruk says. "And it was the right thing for him too, based on his disease. This has the potential to give him future treatment options."

Dr. Poruk notes that if Brian's tumors shrink enough, he could be a candidate for surgery or liver transplantation down the road.

"I'm really looking forward to seeing how the rest of his treatment goes," she says. "I think he's got a great future with this therapy."

Advocating for preventive screenings

Today, Brian's not limited by the pump from doing the things he enjoys, like swimming, biking, golfing and fishing — and spending time with his family, which includes his wife, three daughters and six grandchildren.

He also likes to pay it forward by helping others prevent colon cancer. 

"I ask people if they're being proactive and getting their recommended colonoscopies," says Brian. "Many of them have called to thank me later because their test did find polyps. Encouraging people to take action early has even paid off among my own family members. I tell people that getting a colonoscopy is much easier than going through cancer treatment."

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