Mayor is facing a rare and aggressive type of cancer: a pleomorphic liposarcoma.
The Star spoke to several cancer experts unrelated to Ford’s case for insight on the cancer itself — how it forms, and what this diagnosis could mean.
Q: What is a pleomorphic liposarcoma?
A: It’s a fast-growing cancerous tumour that develops in connective soft tissues.
Dr. Howard Bailey, a professor of medicine at the University of Wisconsin, has seen hundreds of pleomorphic liposarcoma cases over the last two decades.
He said sarcomas form throughout the human body in connective tissues like bone, fat and muscle. Liposarcomas specifically come from fat cells.
“Pleomorphic” is a term meaning all the cancer cells within the tumour look different under a microscope — as in, different sizes and shapes of cells within the same tumour.
Q: How common are pleomorphic liposarcomas?
A: Dr. Nathan Pennell, medical oncologist at the Cleveland Clinic, said sarcomas in general are quite rare — around 1 per cent of all cancers.
“In the U.S. there’s probably about 20,000 sarcoma cases a year — and at most a few thousand every year of liposarcomas,” said Bailey.
The pleomorphic liposarcoma variation Ford has is the rarest of the four types of liposarcoma.
Q: What are the survival rates?
A: The five-year survival rate for pleomorphic liposarcoma is 56 per cent, according to the Liddy Shriver Sarcoma Initiative based in Ossining, N.Y. This drops to 39 per cent at the 10-year mark.
“If they can get all the disease out surgically . . . he’ll have about a 50/50 chance of beating it,” said Dr. Walter Longo, chief of gastrointestinal surgery at Yale University.
However, Bailey stressed that the likelihood for a cure is lower for advanced liposarcomas that have spread to different areas. The longest he’s seen a patient live with advanced pleomorphic liposarcomas is five to 10 years.
He added the mass in Ford’s abdomen coupled with a nodule in his buttock region is a “very poor sign.”
Dr. Zane Cohen, Ford’s physician at Mount Sinai Hospital, used the word “optimistic” when referring to Ford’s treatment plan at Wednesday’s press conference.
Bailey called that “doctor speak” — and said advanced cases are often not curable. He would not speculate on Ford’s prognosis.
“Can people prove the books wrong? Absolutely,” he added.
Q: Are there challenges to treating this kind of cancer?
A: In Ford’s case, he has three strikes against him: A tumour in his abdomen is harder to treat than one in, say, his arm or leg. Its large size is harder to treat than a smaller tumour. And the specific type of liposarcoma, pleomorphic, is most likely to spread — and come back, the experts said.
Q: Ford had a CT scan in 2011. Why wasn’t the tumour found then?
A: It’s a fast-growing type of cancer, so it could feasibly have grown over the past few years.
“From a biology standpoint of disease, was this cancer there in 2011? The overwhelming likelihood is yes — but too small to be detected,” Bailey said.
Pennell said these tumours can get extremely large by the time they’re found if the patient isn’t feeling any pain.
Q: What role does lifestyle play in developing this type of cancer?
A: It doesn’t, as far as we know, and scientists don’t yet know the cause.
“There’s no data I’m aware of that links liposarcomas to alcohol, tobacco, anything,” said Bailey. Obesity isn’t a known risk factor either.