The patient was in her 80s when diagnosed with primary liver cancer. She underwent surgery, but the disease recurred and spread within the liver. She was experiencing significant abdominal pain. She wanted to live longer, but did not want treatments that would negatively affect her quality of life.
This patient became the first treated through the Baystate Regional Cancer Program using a high tech treatment: intra-arterial yttrium-90 radio embolization, or Y-90 for short. The treatment attacks the tumor, but does not damage tissues in the body outside the liver, says Dr. Njogu Njuguna, a diagnostic and interventional radiologist at Baystate.
Njuguna says the Y-90 treatment can be an option for patients with primary liver cancer or cancer that has metastasized to the liver, such as colon cancer. It also can be used for treating neuroendocrine tumors that have metastasized to the liver.
“The radioembolization particles are beads made of glass or resin smaller in diameter than a human hair,” Njuguna says. In a roughly hour-long outpatient procedure in an angiography suite in the hospital, the beads are injected through a catheter, and carefully directed to the right or left lobes of the liver, depending on where the tumor lies.
“Most patients do great,” Njuguna says. “The most common side effects reported by patients are mild fatigue for several weeks to a month.” This is in comparison to the other often-used therapy, chemoembolization, which is associated with post-procedure side effects including fever, chills, nausea, and/or pain.
Njuguna says Y-90 treatment is often used after chemotherapy and radiation options have been exhausted, and he notes that the treatment is palliative, not curative.
Both Dr. Njuguna and Dr. Michael Yunes, a Baystate radiation oncologist, are the only authorized users of Y-90 in the region designated by the federal Nuclear Regulatory Commission and the state Department of Public Health.
Comprehensive Care for Liver Cancer
Yunes says any patient with a liver tumor has treatment choices that include surgery, chemotherapy, and interventional approaches such as radiofrequency ablation, radiation, or embolization to block off the blood supply to the tumor.
“You choose the options that are most appropriate based on the location, size of the tumor, the patient’s tolerance level and overall health,” Yunes says.
The physicians do not make those choices alone, however. Baystate’s Multidisciplinary Liver Tumor Conference meets every two weeks to discuss treatment plans for patients. Participants include a diagnostic radiologist, a pathologist, an interventional radiologist, a hepatic (liver) surgeon, a gastroenterologist, a medical oncologist, and a radiation oncologist.
“We are extremely lucky to have an experienced team of specialists who can handle almost any issue involving the liver, and we have all the necessary therapies to treat the liver here through the Baystate Regional Cancer Program,” Yunes says. “The fact that we have such a team available with a comprehensive array of treatment options puts our patients in an exceptional position.”