In a fast-paced kitchen, Sonny Sweetman couldn’t see people or objects entering his right side peripheral vision until they were too close. “Things were just appearing on that right hand side when normally I would have seen them a while ago,” Sweetman, 53, of Redondo Beach, California, tells TODAY.com.
“I literally thought, ‘Hey, I’m getting older, maybe I need some new glasses.’” After enduring several weeks of blurriness, he finally visited an eye doctor who sent him to a retina specialist who stayed late for Sweetman. “It was like 3 or 4 o’clock in the afternoon,” he recalls.
“I was like nobody in LA is staying around to help me unless something’s really wrong.” He soon learned what caused his hazy sight — Sweetman had uveal melanoma, an uncommon type of melanoma that develops in the middle layer of the wall of the eye, the uvea, according to the . Sweetman, a professional chef and one-time personal chef to Oprah, thrives in “fast-moving places,” such as the kitchen or LA’s highways.
When the blurriness began in 2022, he thought he needed a new eye prescription. About six to eight weeks after his vision troubles began, he scheduled an appointment with his eye doctor. “I was like, ‘Glasses should fix that,’” he says.
“But I was not correct.” His doctor knew “something was wrong right away,” and stepped out to contact the retina specialist late in the afternoon. That’s when Sweetman knew being middle age likely wasn’t to blame.
“I just had this sinking feeling,” he says. “When (the retina specialist) looked at my eye he was like, ‘You don’t have an eye problem. We have to send you to the hospital.
’” Sweetman went to the emergency room where he underwent scans and tests. “They were able to tell me that it was melanoma,” he says. He was stunned by the April 2022 diagnosis especially because he had no family history of melanoma.
“I don’t know how it comes about,” Sweetman says. Doctors at UCLA Medical Center came up with a treatment plan that spared his eye. “There’s other options and one of them is that you would lose your eye,” he says.
“What they did is they use a patch, and it goes directly on your eye and it’s a measured dose of radiation.” Sweetman wore the patch for about a week with a lead eye patch over it to try to keep the radiation from leaking from his eye. “They put some type of oil solution behind the eye, so the radiation doesn’t go to other parts of the body.
So, the radiation is really well contained,” he explains. “Over time, the radiation kills the cancer.” While he felt grateful for the eye-sparing procedure, the treatment “wasn’t comfortable,” and required frequent eyedrops.
“You can’t move your head a lot initially so you’re laying for days in place,” Sweetman explains. While it was tough to not be able to work or do other things, Sweetman was relieved when he was able to resume life soon after doctors removed the radiation patch. “You get back to normal very quickly,” he says.
“There’s an ...
extremely high success rate.” After about 20 days, Sweetman returned to the kitchen. While the treatment worked on the cancer, he still had some vision troubles.
The blurriness “is minimized but they’re not able to restore the vision totally,” he says. “They were able to shrink the tumor ..
. like taking a grape into the size of a raisin. But you’re still going to have the raisin.
So, there’s a small spot in the corner of my peripheral vision in my right eye that’s still blurry.” Sweetman’s adjusted, though. “I just really turn my head more and double-check there’s nothing in the blind spot," he says.
Every three months, Sweetman undergoes scans to make sure the cancer had not returned or metastasized. In April 2023 doctors noticed something on his liver. “It was almost exactly a year to the day (of my diagnosis) when they told me that it metastasized to my liver,” he says.
“In an instant I went to, ‘What are we going to do about it? What does it mean? What are the treatments?’” Sweetman now had Stage 4 cancer and he soon learned that treating uveal melanoma liver metastases “was a little tricky.” Doctors gave him chemotherapy for about nine months. It seemed like it worked for about six months before it stopped.
“It leveled off,” Sweetman says. “The cancer was starting to grow. So, we had to make an alternative plan.
” He then tried Y90 radioembolization, a type of radiation treatment that goes through an artery in the groin to deliver radiation directly to the liver tumors’ blood supply, according to . “The Y90 worked in those spots,” Sweetman says. “But what happened again is cancer is crafty and the metastases showed up again a few months later.
” This time they were smaller and dotted across his liver. Y90 didn’t seem likely to work again. “They needed a different plan,” Sweetman says.
Uveal melanoma is “rare” and affects about 1,000 people in the country annually, says Dr. Siddharth Padia. There aren’t any known risk factors for developing it and it seems almost random.
“Uveal cancer is actually very treatable, but unfortunately about half the people who get it will eventually develop spread of the cancer into the liver,” Padia, an interventional radiologist at UCLA Medical Center involved in Sweetman’s treatment. “The average survival rate is one maybe two years.” Padia says doctors don’t understand why so many people with uveal cancer experience liver metastases or who is even at greater risk of developing one.
There are no markers to test for in blood and scans are the only way they’re found. “These people are, in general, very healthy. No risk factors,” he says.
“It just happens all of a sudden and once you develop liver metastases you’re doing fine and then all of a sudden you have a really bad decline, and you end up dying.” The current treatments for uveal melanoma that spread to the liver aren’t very effective, working in about 10 to 15% of patients, he notes. Last year, the U.
S. FDA approved a new treatment called the Hepzato Kit that allows doctors to send a high dose of chemotherapy directly into the liver via an artery while filtering the chemotherapy out of the blood. Using a hollow catheter in an artery of the left leg, doctors snake a tube into the liver using X-ray guidance.
“Then we infuse the high doses of this chemotherapy,” Padia says. “We have another catheter that goes into the right leg all the way up into the veins of the liver and it withdraws the chemotherapy in the bloodstream out of the body, sends it through a filter and the filter extracts the chemo out of the blood and then we return the blood back through another catheter in the vein.” This allows doctors to give “very high doses” of this chemotherapy, which “kills the tumor in the liver.
” “Interestingly, it doesn’t actually have any bad effects or any downward effects on the normal liver tissue,” Padia says. “It’s actually very safe and very well tolerated if done appropriately.” Patients who undergo the procedure are under anesthesia and it takes about two to three hours.
They remain in the hospital for the night and then go home the next day. “They can honestly resume their normal activities,” Padia says. “They go home with a couple of band aids.
There are no real stitches.” Sweetman was “one of our very first patients and really one of the first patients in the country,” to be treated with the Hepzato Kit. Padia says researchers only examined its effectiveness in these specific metastases.
“I don’t know this for sure but I’m guessing since there were no good therapies for this cancer, that’s why they tried it,” he says. “These patients are desperate.” Though, he believes it could be effective for other liver metastases, such as those found with breast or colon cancer.
“This is really designed as a liver-only treatment,” Padia says. “It can’t really be applied to other organs.” Sweetman underwent two treatments — Padia says the standard protocol is up to six treatments.
Recently, Sweetman underwent an MRI to see what his staging is so they can understand if he needs more treatments. Right now, only a handful of hospitals offer this treatment, but Padia feels hopeful that other centers might adopt it. He says Hepzato Kit offers hope to patients who otherwise had little.
“This is a very deadly cancer where there are few options. It’s highly aggressive,” he says. “I would say this is a big leap in patient outcomes for uveal melanoma.
” While some might shy away from being one of the first to try a new treatment, Sweetman had no problems with it. “The surgeons made me feel very comfortable,” he says. “I don’t get really nervous.
I’m kind of analytical about it. If it’s going to help, if it’s the way forward I’m super excited and fascinated by the whole process.” He can work between treatments if he likes but cannot lift anything too heavy for a few days.
Still, he feels grateful to receive such an innovative treatment that allows him to embrace life. “There’s certain things you shouldn’t do right away but as soon as that time period is over, I feel pretty normal,” he says. “I have a pretty active job .
.. I go right back to it.
” Having cancer has taught Sweetman the importance of “living in the now.” “You don’t want to make mistakes professionally or you don’t want to miss time with the family,” he says. “Time isn’t infinite anymore.
It’s finite ...
I’ve changed by appreciating things more, family and friends.” Meghan Holohan is a digital health reporter for TODAY.com and covers patient-centered stories, women’s health, disability and rare diseases.
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