Liver Cancer Moving From Inoperable Disease To Outpatient Treatment
PITTSBURGH, July 2, 2001 — Patients diagnosed with inoperable primary liver cancer – cancer that starts in the liver and stays there – face grim treatment options: external beam radiation, chemotherapy and its vicious side effects and an average of only 1-1/2 years of life after diagnosis. University of Pittsburgh doctors are testing a new treatment option that’s done on an outpatient basis and eliminates side effects. The Food and Drug Administration says the treatment is safe for patients, and doctors are evaluating its effectiveness.
The treatment, called TheraSphere®, delivers millions of microscopic glass beads embedded with the radioactive element yttrium-90 directly into the artery that feeds cancerous liver tumors known as hepatocellular carcinoma (HCC). Cancer in the liver is often at an advanced stage when diagnosed, making surgical removal of tumors impossible. Life expectancy of someone with HCC ranges from four months to about 1-1/2 years.
According to Brian Carr, M.D., Ph.D., professor and director of the liver tumor service at UPMC, TheraSphere offers the best chance for patients with inoperable liver cancer because TheraSphere allows doctors to deliver a much higher dose of radiation – up to five times the maximum possible dose with external beam radiation.
“TheraSphere allows us to focus radiation directly on a tumor without damaging nearby non-cancerous tissues,” said Dr. Carr. “The result is that patients are more comfortable and can tolerate the treatments better.”
Healthy tissue is spared despite the high concentration of radiation in the beads, according to Dr. Carr, because the beta radiation travels only an average of 2.5 mm in tissue. The ability to localize the treatment contributes to the lack of side effects, which means that TheraSphere can be used safely in patients with hepatitis and cirrhosis. Patients also stay out of the hospital for much longer periods than standard chemotherapy patients.
TheraSphere is an outpatient procedure that lasts from 30 to 40 minutes in the hospital’s interventional radiology room. Doctors guide a catheter through the femoral artery in the thigh up through the hepatic (liver) artery that feeds the tumor its supply of blood. Once the catheter is at its destination, the doctors release the TheraSphere and let the blood carry the beads into the tumor, where they remain active with a half-life of 64.2 hours. The beads are prevented from being swept from the tumor into other parts of the body because they are too big to fit through the liver’s capillary system.
People who come into contact with a TheraSphere patient are unlikely to receive any radiation exposure, although contact between a person treated with TheraSphere and pregnant women and young children is not advised during the first three days after a patient is treated, according to Dr. Carr.
HCC kills up to a half million people around the world each year, primarily in Africa and Asia due to the high prevalence of hepatitis in those regions. Hepatitis is the leading cause of primary liver cancer. In the United States about 15,000 cases are diagnosed annually. However, the number of cases may be underestimated, due to the increasing incidence of hepatitis C.
TheraSphere is produced by MDS Nordion, a subsidiary of Canada’s largest health and life sciences company, MDS, Inc. TheraSphere is authorized by the federal government for use as a humanitarian device for treatment of inoperable liver tumors.
For more information, please call the University of Pittsburgh Medical Center Liver Tumor Service toll-free at 877-640-6746 or 412-648-3200.