Interventional radiologists use X-rays, CT and ultrasound to deliver targeted treatments via catheter throughout the body. The interventional radiologist threads a catheter from an artery in the groin directly up into the liver. Using this method, the interventional radiologist can attack the cancer tumor from the inside, reducing side effects to the whole body.
Tumors need a blood supply to grow. Interventional radiologists can target cancers in the liver specifically by delivering treatment through small catheters directly to the arteries feeding the tumors. This kind of therapy is known as infusion or embolization. Infusion is the release of a medication directly into the vessels feeding the tumors. Typically chemotherapy is used for this procedure.
Besides infusing chemotherapy, the interventional radiologist can also decrease or block the blood supply to the tumor using a procedure called embolization.
Embolization is a well-established technique that is used to treat patients with massive bleeding which can happen after trauma or childbirth. It has also been used for years before surgery to try and help decrease bleeding during operations.
In the case of liver cancer patients, interventional radiologists can use embolization to simply cut off the blood supply to the tumor using small particles or beads. Embolization beads can also be loaded with radioactivity (radioembolization), or chemotherapy (chemoembolization) to provide direct treatment to liver tumors.
These kinds of vascular therapy for liver tumors 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 is palliative, not a curative, treatment. It can be extremely effective in treating primary liver cancers, especially when combined with other therapies. Patients usually stay overnight after this therapy.
Chemoembolization has shown promising early results with some types of metastatic tumors. Although the individual materials used in this treatment are FDA approved, the treatment itself is not approved for intra-arterial therapy of liver tumors.
Radioembolization (Y-90) is very similar to chemoembolization This therapy involves the administration of spheres that have low levels of radioactivity attached to them. The radioactivity destroys the liver tumor without affecting other parts of your body using "internal" radiation.
Radioembolization is also a palliative, not a curative, treatment-but patients benefit by extending their lives and improving their quality of life. It is a relatively new therapy that has been effective in treating primary and metastatic liver cancers. It is performed as an outpatient treatment. There are fewer side effects from this treatment compared to standard cancer treatments, with the main one being fatigue for seven to 10 days.