09/17/2014 06:53 EDT | Updated 06/16/2017 00:57 EDT

Rob Ford's Cancer Is Rare And Could Be Life-Threatening, Says Expert

TORONTO - The type of cancer Toronto Mayor Rob Ford has been diagnosed with can run the gamut from benign fatty deposits to aggressive and spreading tumours, an expert on liposarcoma says.

And Dr. Mary O'Connor of the Mayo Clinic in Florida said available signs point to Ford's case being further along the severity spectrum towards an aggressive form of the disease.

The fact that Ford's doctors have found a secondary tumour, that they are using chemotherapy as the first treatment option and that a 2011 CT-scan showed no evidence of this tumour all point to Ford facing a serious medical challenge, O'Connor said in an interview from Jacksonville, Fla. The Florida site is one of three for the Mayo Clinic.

"That would make me concerned that this is a more aggressive type of liposarcoma and not a slow-growing one," said O'Connor, who is not involved in Ford's care. "Because if it's as large as it is now, and it was not present in 2011, then my concern is that this would be a more aggressive type. The fact that his doctors there are doing chemotherapy also supports that it would be a more aggressive type."

"It's not a given that he would be cured. This is a serious problem for him."

O'Connor said radiation and surgery would typically be tried before chemotherapy for less severe forms of this type of cancer. "Chemotherapy would not be given to a patient ... in general with a less aggressive malignant cancer."

Liposarcomas are cancers that arise from fat cells; they can attack a variety of soft tissues in the body.

The head of Ford's treatment team, Dr. Zane Cohen, described the primary tumour as being about 12 centimetres by 12 centimetres. It is in Ford's abdomen, which is one of the main places in the body this type of cancer can develop. The secondary tumour, described as about two centimetres by two centimetres, is located in his buttock near his left hip.

Cohen said Ford will get two rounds of chemotherapy, each comprising three days of drugs, followed by 18 days off in between. An assessment of how the cancer is responding to the chemotherapy will then be done. Surgery and-or radiation may follow, he said.

O'Connor said the point of the chemotherapy is to both shrink the tumours and kill any cancerous cells that may be spreading in his body but which are currently not detectable.

The fact that Ford has a second tumour suggests the cancer is spreading, she said, but she noted that it is a good sign that there are no detectable growths in the mayor's lungs. This type of cancer often spreads to the lungs, O'Connor said.

A media report earlier this week quoted Ford saying he'd undergone a lung biopsy. But Cohen said during Wednesday's press conference that that was untrue — there was nothing to biopsy in his lungs.

Cohen said he and his colleagues were optimistic about the mayor's prognosis, but he would not estimate a survival rate for this type of cancer, which is rare. Liposarcomas make up only about one per cent of cancers, he said.

Cohen said he could not yet say at what stage the cancer is.

The Canadian Cancer Society's most up-to-date statistics on soft tissue sarcomas — liposarcoma belongs in this class but there are a number of others as well — are from 2010. That year an estimated 1,175 Canadians were diagnosed with a soft tissue sarcoma, and 471 Canadians died from this form of cancer.

Cohen also cleared up another false piece of information about Ford's medical history — one for whom Ford himself was the source. The mayor said in an interview with CTV a couple of years ago that he'd had a tumour removed from his appendix in 2009, and that in the process a piece of his colon had to be removed.

But Cohen said Ford's medical records show he had his appendix removed because he had appendicitis and the resulting inflammation required a piece of the nearby colon to be removed.


On the Web:

Dr. Mary O'Connor discusses liposarcomas in this YouTube video: http://youtu.be/3rjBHjBeGuc