In 2012, Mark Forrester suffered leg cramps, and thought nothing of it. He was 57 and figured his body was turning creaky.

Then, on a holiday in Fiji, one of the toes on his left foot “opened up like a can of sardines”.  It then turned black.

Back home in Dubbo, NSW, Forrester’s daughter, a nurse, insisted he get to Sydney and see a heart specialist.

There he was diagnosed with peripheral artery disease (PAD), a condition that affects one in five older Australians.

You’ve no doubt heard of coronary artery disease, where plaques accumulate and narrow the blood vessels that feed the heart with oxygen.

Too often it gets to the point that a heart attack occurs and part of the heart muscle dies.

Double amputee Mark Forrester’s tissues are still prone to dying. Photo: HRI

With PAD, these plaques accumulate in the blood vessels that feed the peripheral parts of the body, notably the limbs, most often the legs.

Someone with PAD is up to six times more likely to have a heart attack or stroke.

Stents were put in Forrester’s legs to open up the arteries

Mark, who has had a triple by-pass, had other problems, starting with that black toe.

Dr David Robinson, vascular and endovascular surgeon, said the toe was dead and had to be amputated. The another died, and another.

“He took off the toes, trying to get ahead of it, before it got worse,” says Mark.

Finally, Robinson said was one option remaining: Remove the left leg below the knee, and hope this would halt the death off more tissue.

A kind of remission

Eleven years went by and Mark, with a prosthetic leg and the buoyant humour of a spectator at a weird circus, lived his life with little complaint.

Then, last year, the cramps returned, and his remaining foot felt swollen. Then he was hit with pain that was beyond his coping capacity.

Again, Robinson put in stents to open the arteries. Soon after, he amputated the right leg. When TND spoke with Forrester on Friday, he was still in rehab.

“I’ll be walking again in six weeks,” he said.

He understands that at any time the arteries above his knees could fail and his tissues will keep dying.

He’s aware of the odds that a massive heart attack might kill him. At the moment, his heart is operating at 30 per cent capacity.

“But you know, you gotta keep positive and all that sh-t,” he says jovially.

A potential cure

Forrester is aware that Heart Research Institute scientists have discovered that a commonly used cancer drug could be used to effectively treat PAD.

A pre-clinical study by HRI’s Centre for Peripheral Artery Disease has found the drug Conatumumab can effectively treat the condition “by effectively growing new blood vessels, bypassing the blockage and restoring blood flow in affected parts of the body”.

Dr Siân Cartland, the new paper’s lead author, said: “We often refer to PAD as the lesser cousin of heart attack and stroke because we know so much less about it and, as a result, treatments have been less advanced.”

She said Conatumumab “was initially designed to kill cancers cells, but we found it can promote the growth of healthy cells and so it can promote the growth of new blood vessels”.

Cartland said the drug could one day help patients like Forrester. But when?

On the upside, because Conatumumab has already proven safe in clinical trials, there’s no need for it to undergo the standard phase I trial that investigates potential toxicity and side effects.

However, more research is needed before human clinical trials can begin. And, of course, such trials need to be funded.

“So yes, the drug could stop the disease in the early stages, or be helpful to someone like Mark,” she said.

But not any time soon. … not any time soon.