Interventional Oncology

  • Chemoembolization
  • Drug Eluting Beads
  • ThereSphere for Liver Cancer
  • Radiofrequency Tumor Ablation
  • Cyroablation
  • Regional Tumor Therapy
  • SIRT / Yttrium Microsphere Radioembolization

We have specialists who are specially trained in such advanced procedures:

Chemoembolization

Chemoembolization is a minimally invasive treatment for liver cancer that can be used when there is too much tumor to treat with radiofrequency ablation (RFA), when the tumor is in a location that cannot be treated with RFA, or in combination with RFA or other treatments. Chemoembolization delivers a high dose of cancer-killing drug (chemotherapy) directly to the organ while depriving the tumor of its blood supply by blocking, or embolizing, the arteries feeding the tumor. Using imaging for guidance, the interventional radiologist threads a tiny catheter up the femoral artery in the groin into the blood vessels supplying the liver tumor. Click here to learn more about this treatment for liver cancer.

Drug Eluting Beads

Hepatocellular carcinoma (HCC) is the fifth most prevalent cancer worldwide and the third highest in terms of mortality. Liver transplantation, surgical resection and percutaneous ablation are generally accepted as the only curative treatments for hepatocellular carcinoma. At present, in excess of 70% of HCC patients with intermediate-advanced stage cancer are not generally eligible for curative treatments because of poor liver function or the presence of advanced liver disease. For these patients, transarterial chemoembolisation with drug eluting beads is a minimally invasive treatment option which while not curative provides a survival benefit.

Using imaging for guidance, the interventional radiologist threads a tiny catheter up the femoral artery in the groin into the blood vessels supplying the liver tumor.The tiny beads which contain a chemotherapeutic drug are injected through the catheter placed into the artery feeding the tumor. The beads become lodged in the small arteries around the tumor depriving the tumor cells of oxygen resulting in tumor cell death. The drug contained within the beads is slowly released to the surrounding tissues resulting in additional tumor cell death. The drug is locally released which reduces side effects.

About TheraSphere® for Liver Cancer

State-of-the-art brachytherapy for unresectable liver cancer

TheraSphere® builds upon growing medical knowledge of liver structure and function and previous experience with other types of therapy to offer a new, more convenient treatment option. TheraSphere® also builds on knowledge physicians have gained in recent years with brachytherapy, radioactive implants that are now increasingly used to treat prostate cancer.

Previous attempts to treat liver cancer with radiation from external sources (radiation beam therapy) showed some easing of symptoms, suggesting that liver cancer is sensitive to radiation. But there is a major drawback to external radiation: it cannot be tightly focused on the tumor, but instead, affects a larger area of the body that includes the tumor.

This lack of precise focus exposes healthy areas of the body to radiation and produces unpleasant side effects, including changes to healthy tissue, nausea and vomiting. Therefore, researchers began to develop ways to place radiation directly into the liver, targeted as precisely at the tumors as possible, with the least effect on healthy liver tissue or surrounding organs.

To direct TheraSphere® treatment at tumors in the liver, a physician first makes a small incision in the patient’s leg and places a long, flexible plastic tube called a catheter, into the femoral artery, which is the major blood vessel in the leg. Guided by fluoroscopy (an X-ray imaging technique that projects views of the inside of the body onto a screen) the physician then moves the catheter up through the blood vessels to the hepatic artery, which is one of two blood vessels that feeds the liver. The physician guides the catheter into the branch of the hepatic artery that feeds the cancerous tumor in the liver and infuses the TheraSphere® beads through the catheter into the blood that supplies the tumor. This is usually performed in a hospital’s radiology suite and patients remain conscious throughout the procedure.

Radiofrequency Ablation

For inoperable liver tumors, radiofrequency ablation (RFA) offers a nonsurgical, localized treatment that kills the tumor cells with heat, while sparing the healthy liver tissue. Thus, this treatment is much easier on the patient than systemic therapy. Radiofrequency energy can be given without affecting the patient’s overall health and most people can resume their usual activities in a few days.

In this procedure, the interventional radiologist guides a small needle through the skin into the tumor. From the tip of the needle, radiofrequency energy (similar to microwaves) is transmitted to the tip of the needle, where it produces heat in the tissues. The dead tumor tissue shrinks and slowly forms a scar. The FDA has approved RFA for the treatment of liver tumors. For more information about this treatment for liver tumors click here.

Cryoablation

Cryoablation is similar to RFA in that the energy is delivered directly into the tumor by a probe that is inserted through the skin. But rather than killing the tumor with heat, cryoablation uses an extremely cold gas to freeze it. This technique has been used for many years by surgeons in the operating room, but in the last few years, the needles have become small enough to be used by interventional radiologists through a small nick in the skin, without the need for an operation. The “ice ball” that is created around the needle grows in size and destroys the frozen tumor cells.

For more information regarding IR treatments for cancer:

SIRT / Yttrium Microsphere Radioembolization

SIRT (selective internal radiation therapy) is similar to chemoembolization but uses radioactive microspheres (microscopic particles or beads). This therapy is used to treat both primary and metastatic liver tumors.

This treatment incorporates the radioactive isotope Yttrium-90 into the embolic microspheres to deliver radiation directly to the tumor. Each sphere is about the size of five red blood cells. The spheres are injected through a catheter from the groin into the liver artery supplying the tumor. The beads become lodged within the tumor vessels where they deliver local radiation that causes tumor death. This technique allows for a higher dose of radiation to be used to kill the tumor without subjecting adjacent healthy tissue to harmful levels of radiation. The Yttrium-90 exerts its effect from within the body, and thus it is referred to as internal radiation. In former treatment of liver tumors, a beam of radiation was directed through the skin from an external source resulting in higher doses to normal surrounding tissue.

SIRT is a palliative, not curative, treatment, but patients benefit by improvement in the quality and duration of life. It is a relatively new therapy that has been effective in treating primary and metastatic liver cancer. The patient is often discharged on the same day as the procedure, but occasionally an overnight stay is required. There are fewer side effects from this treatment compared to standard cancer treatment, so normal activity can be resumed in a few days. However, the patient may experience fatigue following the procedure for 7-10 days.