Ivan Dagg is a medical phenomenon. In a world first, Leeds surgeons have been able to operate on his liver after it grew a new vein. Catherine Scott reports.
When Ivan Dagg was told by doctors that his cancer of the bowel had spread to his liver his future looked uncertain.
He was given only a six per cent chance of surviving five years with chemotherapy treatment and a 50 per cent chance at best if he had liver surgery.
Today, five years after he was first diagnosed, Ivan, 53, an engineer from Hull, is celebrating the start of a new year with his family cancer-free.
It’s a year he thought he might not be here to see.
After having four surgical procedures and chemotherapy to remove recurring tumours on his liver, his latest procedure in Leeds, which is being hailed as ‘a world-first’ has given Ivan a reason to feel hopeful.
“The last few years have been a rollercoaster. I’m finally feeling positive about my future,” says Ivan who is married to Kathryn and has two daughters, Steph, 21, and Georgie, 19.
Ivan’s symptoms first started in 2013 when he began to experience extreme exhaustion and lost weight.
“I’d hardly ever been ill. I knew something was wrong, my condition worsened, and I started to pass blood,” says the father of two.
Ivan spent the remainder of 2013 going back and forth to GPs before remembering he had private health insurance through work. He went to the Spire Hull Hospital where within days they discovered he had stage 4 bowel cancer.
“I was very angry at first. People say men are embarrassed to go the doctor but I wasn’t emabrrassed, I went but they told me I was took young for it to be cancer. They were wrong. But I don’t want to waste my energy being angry, I need it to fight this disease.”
Ivan had surgery in Hull to remove the tumour, but doctors then discovered it had spread to the liver. He was referred to Professor Peter Lodge, consultant hepatobiliary surgeon at Spire Leeds Hospital and one of the world’s most experienced liver surgeons who has a national and international reputation for taking on the most complex liver surgery cases.
Ivan had four tumours in his liver which were too large for surgery and he was given chemotherapy to shrink them.
He underwent his first liver surgery under the care of Professor Lodge in August 2014, which was followed by more chemotherapy.
But the cancer returned, and he had two more operations in the following years to remove more tumours.
Last year a routine scan at Spire Leeds Hospital showed a new secondary tumour located in a difficult position, made worse by the fact that previous operations had involved removing large portions of his liver along with the associated major blood vessels.
This was to prove a challenge for his next surgery.
Ivan underwent his fourth liver resection in January last year which involved a world first in liver surgery.
Professor Lodge says initially he was worried that he might not be able to go ahead with the operation.
He describes the procedure, which was paid for privately through Ivan’s work health insurance.
“This is a brand-new liver surgery operation, truly a world-first,” explains Prof Lodge.
“During Ivan’s three previous operations I had to remove major blood vessels called hepatic veins. The new tumour was involving all of the remaining hepatic veins. These major veins drain blood out of the liver and are essential for survival.
“I did not think that the situation was operable initially, but I saw that Ivan had grown a new vein in the part of the liver that had regenerated following the previous liver resection operations.”
Prof Lodge decided to go ahead with the operation.
“Things went well so we were able to remove the tumour successfully along with the major hepatic veins, leaving Ivan’s liver surviving on only the new vein.
“If he had not grown a new vein then I would not have been able to do the surgery.”
The fact Ivan’s liver grew a new vein means a new avenue for developing liver operations.
“There is still a lot we don’t know about how the liver regenerates after liver surgery; Ivan’s case demonstrates how we must be more imaginative and strive to improve outcomes as much as we can,” adds Prof Lodge. “This was very high-risk and extremely complicated liver surgery and one of the most difficult that I have ever had to do. Spire Leeds Hospital is one of only a very few private hospitals in the UK to have the necessary facilities for this type of complex surgery. Part of my work at Spire is to offer patients a second opinion when they have been turned down for liver surgery elsewhere.
“Obviously, there are many patients who I sadly cannot help but we have had some remarkable successes over the years.”
Without surgery, Ivan would have been faced with having only a few months to live.
“I think that chemotherapy may have given him a few extra months but that’s all. It’s still early days but I’m very pleased with Ivan’s progress. We will be keeping a close eye on him but I’m hopeful that he will continue to do well.” he added.
For Ivan. he can now look to the future.
“I woke up after surgery and Professor Lodge told me he had been able to remove the tumour. That was fantastic to hear,” says Ivan who is back at work. “He is an amazing man. Nobody knows what’s going to happen in the future but I feel very lucky. There could have been a very different outcome.” Ivan will continue to return to Spire for scans every three months.