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Liver-targeted Cancer Therapy

Liver cancer is an increasingly common occurrence. Liver cancer can origninate from the liver or result from cancer that originated and spread from other organs (known as a a metastatic tumor).

Methods for treating liver cancer include surgical resection, liver transplant and liver-targeted cancer therapy. While surgery or a liver transplant may be ideal, it is often not feasible for the majority of patients. Therefore, liver-targeted therapy offers crucial opportunities for treating liver cancer through the options of ablation, chemoembolization and selective internal radiation therapy (SIRT).

Ablation

With ablation, an interventional radiologist uses imaging guidance, ultrasound or CT, to direct the placement of one or more specialized needle-like probes through the skin into the liver tumor. Because the needles are so small — 1-2 millimeters in diameter — no incision is required. Once the needles are placed in the correct position, the needles are heated up, causing thermal damage to the area next to the needles, destroying the cancerous tissue. This therapy can often be curative and is an ideal treatment option for those patients for whom surgery is not an option.

Chemoembolization

Chemoembolization is a treatment in which an interventional radiologist delivers cancer-killing drugs and small particles directly to the cancer through a catheter. This targeted treatment allows a higher concentration of chemotherapy to be delivered directly to the tumor, compared to more conventional chemotherapy. Chemoembolization cuts off the blood supply to the cancer, depriving it of the oxygen and nutrients it needs to survive with minimal harm to normal surrounding liver tissue. This procedure may slow or stop the growth of cancer in the liver.

When performing chemoembolization, an interventional radiologist inserts a catheter into an artery throught the groin or the wrist. The doctor then feeds the catheter through the artery and directs it toward the tumor, using live X-rays to guide it to the correct location. When the catheter reaches the blood vessels supplying the tumor, the interventional radiologist injects a combination of cancer drugs and small particles into the arteries.

The procedure typically requires an overnight hospital stay, with side effects lasting a few days.

After treatment, the patient will follow up with their interventional radiologist at regular intervals to assess the treatment response through imaging studies. The benefit of such a procedure is that it can be performed as many times as needed to achieve the best possible response.

Selective Internal Radiation Therapy (SIRT)

Selective internal radiation therapy (SIRT), also known as radioembolization, is a cancer treatment that delivers very high radiation doses via small beads directly to the tumor through the arteries.  

The SIRT procedure is performed by an interventional radiologist who inserts a catheter into the femoral or radial artery. The doctor uses live X-rays to guide the catheter to the tumor site and then injects radioactive beads into the blood vessels that supply the tumor. The beads release radiation in a concentrated manner inside the tumor, minimizing radiation exposure to the rest of the liver, as well as the rest of the body. 

SIRT is an effective option for cancer that cannot be removed by surgery. It is commonly used to treat cancers of the liver called hepatocellular carcinoma as well as metastatic tumors. Combining SIRT with standard chemotherapies has been shown to delay the progression of liver tumors when compared to chemotherapy treatment alone. SIRT has proved effective in reducing the size of tumors and can potentially shrink tumors to a small enough size to be resected surgically.