Brian Johnson, 49, poses for a photo with his wife, Danyel, and two of his children, Kade, 10, and Tatum, 8, on Sept. 30, 2025 at their home in Portland, Oregon. (Photo provided to MLive by Danyel Johnson) Courtesy | Danyel Johnson

By Justin P. Hicks | jhicks3@mlive.com

As if an appendiceal cancer diagnosis for a middle-aged father wasn’t scary enough, learning there were little to no promising local treatment options left Johnson feeling alone.

Then came the hope.

Danyel Johnson, his wife, found a new treatment option in Detroit that specializes in treating metastatic cancers where traditional chemotherapy often falls short.

“When I come here, they understand my type of cancer,” said Brian Johnson, 49. “You feel like they know what they’re doing and they treat me like family.”

The treatment is known as PIPAC — Pressurized Intraperitoneal Aerosol Chemotherapy. It’s a laparoscopic procedure that delivers aerosolized chemo directly into the abdominal cavity.

Henry Ford Health’s St. John Hospital in Detroit was the first facility in Michigan to offer PIPAC. Since January, the care team has used it in about 30 cases of advanced colorectal, appendiceal, gastric, and ovarian cancer.

PIPAC is minimally invasive and takes about 90 minutes. It can be used in combination with traditional chemotherapy to attack tumors on multiple fronts.

Johnson underwent his first PIPAC treatment in June. He and his wife traveled to Southeast Michigan and stayed at a neighboring patient house during the visit.

Weeks later, he felt the best he could recall in at least six months. He returned for a second treatment in July, a third in September, and he’s expected to get a fourth later this fall.

“For the most part patients can feel quite well and even go home the same day without side effects and disruptions to their quality of life and normal activities,” said Dr. Richard Berri, Chief of Surgical Oncology at St. John Hospital.

Unlike other treatment options that seek to cure the patient’s cancer or eradicate the disease, PIPAC has a more short-term goal. It’s used to prolong survival and improve the patient’s quality of life.

“A lot of stage four patients aren’t offered any treatment and told from day one they have maybe a six-month survival regardless of what they do,” Berri said. “(PIPAC) offers these patients hope in the form of treatment that can be tolerated.”

Appendiceal cancer is very rare, with a rate of about one or two cases per 1 million people in the U.S. annually, according to the National Cancer Institute.

It’s difficult to detect, often going unnoticed until it spreads throughout the abdomen. Once it has spread, removing the appendix isn’t seen as an effective solution. Similarly, Berri said it’s not recommended to remove the appendix as an precaution, even for Johnson’s children given their father’s diagnosis.

“There is no evidence appendix cancers are hereditary,” Berri said. “Although for these patients it’s a major problem, the incidence is so low it doesn’t make sense to undergo unnecessary surgical procedures.”

In 2011, Berri brought another cancer treatment program to Southeast Michigan. Known as Hyperthermic Intraperitoneal Chemotherapy – HIPEC, it’s a two-part process that involves surgically removing visible cancer cells, followed by using heated chemotherapy to eliminate cancers that have spread to the lining of the abdomen.

HIPEC is an aggressive treatment that formed the basis of the new PIPAC program.

“Our experience in that procedure as one of the leaders in the U.S. brought us to the point where I determined a need to innovate further and bring a different procedure for patients who wouldn’t benefit from HIPEC,” Berri said.

In some cases, successful PIPAC treatment has been a bridge that leads to eligibility for HIPEC. It’s too early to know if Johnson will follow that care path, but buying him more time could open doors for other treatments or clinical trials in the future.

For now, Johnson is taking things day by day. In between PIPAC and traditional chemo treatments, He likes to spend time with his kids — Kade, 10, and Tatum, 8. He’s an Oregon State football fan and enjoys spending time on the river.

Since getting PIPAC treatment, he has felt better. He can throw a football in the yard with Kade, though in shorter increments.

“The thing with cancer is it’s a mind game,” he said. “I just want to go back to work and take care of my kids, That’s what I’m trying to get back to.”

Going to the doctor wasn’t a regular occurrence most of Johnson’s life, but a unique pain in his side led him to get a medical opinion spring of 2024. Doing so may have bought him more time with his family — a thought that drove the usually private man to share his story.

“I feel blessed that I pushed myself to do something,” he said. “If I had waited a couple of months, the cancer could have spread more. I might have been too far down the road.”

“If something doesn’t feel right, go to the doctor.”