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October 2006 Issue

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Glass Beads Give Liver Patients More Treatment Options

By Amanda Harper
Published October 2006

In her words, Linda Fitterer “had nothing to lose” when doctors told her a new, minimally invasive procedure was the best option for treating the 16 tiny cancerous tumors scattered across the right lobe of her liver.

Fitterer’s intestinal cancer had spread to her liver and was causing serious side effects. Her only other option was a liver transplant.

UC’s Darryl Zuckerman, MD, suggested a new radiology technique known as TheraSphere, which involves injecting patients with millions of tiny radioactive glass beads to control the cancer. No wider than a single strand of human hair, the beads kill liver cancer cells from inside the tumor.

UC is one of 28 medical centers across the United States offering TheraSphere. Zuckerman performs the procedure at University Hospital and is the only physician in Ohio trained to do it.

“The only real cure for liver cancer is an organ transplant,” explains Zuckerman, an associate professor and interventional radiologist. “But this procedure allows us to stabilize the patient’s condition by controlling cancer growth and shrinking the tumor. Then we can deal with the tumor surgically, or as the stand-alone therapy for
patients who aren’t good candidates for surgery.”

Primary liver cancer—which grows from within the organ as opposed to spreading there from another area of the body—is rare but is increasing rapidly in the United States, according to Zuckerman.

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer in adults and accounts for 80 percent of all primary liver cancers.

Currently, TheraSphere is only commonly used in patients with advanced HCC, a type of cancer that starts in the liver’s cells and develops into one or multiple tumors that cannot be removed surgically. This fall, Zuckerman expects to begin offering the same treatment to patients with breast and colon cancer that has spread to the liver.

“By delivering highly targeted radiation from inside the body,” says Zuckerman, “we can help minimize damage to surrounding tissue and slow the progression of the liver cancer in patients awaiting a transplant. For other patients, this procedure can reduce the size of the tumor to a point where it can be removed surgically, giving patients new hope for survival.”

Two weeks before treatment, patients undergo an angiogram, which allows the radiologist to identify blood vessels feeding the liver tumor. Depending on the anatomy of the blood vessels, the radiologist may place metal coils in surrounding blood vessels to prevent the beads from traveling to other organs in the body.

On the day of treatment, the patient receives a mild sedative and pain medication. The radiologist makes a tiny incision in the groin—no larger than the tip of a pencil—to access the femoral artery.

Using moving X-ray images as a visual guide, the physician directs a catheter through the artery and into the main blood vessel feeding the liver tumor. The radioactive beads are injected and carried in the bloodstream up to the tumor, where they embed and slowly kill the cancerous cells.

The outpatient procedure takes 60 to 90 minutes to complete. Because only one liver lobe can be treated at a time, some follow-up procedures may be needed three months after the initial surgery.

Fitterer recently received good news at her 30-day follow-up visit: her tumors are shrinking. She goes in for her three-month follow-up consultation this month.

“It was easy for me to decide to get this treatment,” Fitterer recalls, “because my doctors believe in the procedure. It has a very good success rate and it let me avoid open surgery.”

For more information on the TheraSphere procedure, call (513) 584-2146.

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