SIRTEX liver cancer treatment
What is Sirtex Microspheres?
SIRTEX Microspheres is a new method of treating malignant liver tumours, whether they originate from the liver itself, or have spread from elsewhere in the body (e.g. colon).
This involves injecting millions of little “beads” into the liver, each one being 32 microns in size. To put this into perspective, this would be smaller than the width of a human hair.
Each bead is coated with a radioactive isotope which emits beta radiation. Once injected into the liver they emit the radiation to the tissues surrounding them. Thus it is essentially like a delivering a localised form of radiotherapy to the tumour cells. The benefit of this treatment being the radiotherapy is being delivered constantly for a period of days.
To assess your suitability for the microspheres treatment, all candidates will require the following investigations to be performed.
- Many of you will have had this procedure before, where a catheter is inserted into your groin and dye is injected into the blood vessels of your abdomen.
- Even if you have had this procedure before, you will require another one. This is because this angiogram specifically assesses the blood blow and mapping of the blood vessels within your liver, to ensure when the microspheres are injected they do not go elsewhere in the body.
- This will be followed by a nuclear medicine scan of your liver to calculate the correct microsphere dose to be administered to you.
Positron Emission Tomography (PET) Scan
You will need two scans, one before the treatment and one after.
- This is non-invasive imaging using a radioisotope. A radioactive tracer is injected into the arm 90 minutes before the scan. The whole body is then scanned for a further 90 minutes looking for evidence of other tumours elsewhere in the body, other than those in the liver.
Injection of the Microspheres
- The microspheres will be injected into the liver via a further visceral angiogram at a later date, possibly 3-4 weeks down the line.
- This is because SIRTEX microspheres is tailored to each individual. Therefore the dose you require will need to be ordered and made specifically for you in Australia where the company is based.
- This is virtually no different from the initial angiogram performed.
- After the injection of the microspheres you will again have a nuclear medicine scan. This is to confirm the position of the microspheres.
- You will be admitted the day before the implantation of the microspheres.
- After the procedure you will be isolated in a side room for the duration of your stay. This is expected to be 1-4 days.
- This is a safety precaution as potentially there is a risk of the radiation being given off by the microspheres leaving the body.
- The range of the radiation given off within tissues is about 11mm. Therefore in reality the radiation will not even leave your body.
- This will not prevent any of your relations from visiting you during your stay. However we recommend you DO NOT come into contact with anyone under the age of 15 years, and pregnant women for 2-3 weeks post treatment.
- During your stay and prior to discharge, specialists in nuclear physics will discuss with you the precautions you need to take at home post treatment for the next 2 weeks.
As with all treatments there are side effects to the procedure you are about to under go. These are mostly those associated with chemo-/radiotherapy. The most common being:
- Fever – can last from a few days to a week.
- Abdominal pain immediately and several days post injection.
- Nausea and vomiting
- Peptic ulcers
The above will all be treated with medications during your stay, should you experience them.
Rarer side effects include:
- Radiation pneumonitis – an expected extreme minority of the microspheres will be shunted to the lungs. Therefore you may experience some shortness of breath, and a cough. This will be treated with steroids until it subsides.
- Radiation hepatitis – excessive radiation to the liver may cause deterioration in liver function. This may appear weeks down the line. However your blood tests will be monitored. Again should this occur you will be treated with steroids until it subsides?
- Cholecystitis – inflammation of the gallbladder as a result from the radiation. Normally this will resolve spontaneously, requiring no treatment. If symptoms continue, then removal of the gallbladder may be necessary.