CLEVELAND – The Ireland Cancer Center at University Hospitals Case Medical Center is the first in Northeast Ohio to use a new radiation treatment that provides hope for patients with colon cancer that has spread to the liver. The noninvasive procedure uses microscopic radioactive spheres that target inoperable tumors without damaging the surrounding tissue.
Called Selective Internal Radiation Therapy (SIRT), the procedure uses SIR-Spheres® microspheres infused with the radioactive element yttrium-90. The spheres deliver 40 times more radiation directly to the site of the liver tumors than is possible using conventional radiotherapy. The minimally invasive procedure is not considered a cure, but studies have found it reduces tumors more than chemotherapy alone in patients with metastatic colon cancer and has fewer side effects than standard chemotherapy and radiation therapy.
“During the outpatient procedure, a small catheter is guided into the hepatic artery in the liver and then placed in the artery that specifically supplies the tumor. The spheres lodge in the small blood vessels of the tumor and expose the tumor cell to high doses of radiation locally,” explains Joseph LiPuma, MD, interventional radiologist at University Hospitals Case Medical Center. “The radiation from the spheres travels only one centimeter from the source, therefore there is only minimal exposure of adjacent normal liver tissue. The spheres’ radioactivity reduces the size of the tumor and halts its growth.”
“Shrinking the tumors to a smaller, more manageable size gives patients more treatment options, which can help prolong life and, in some cases, even produce a cure,” says Christopher Siegel, MD, PhD, liver surgeon at University Hospitals Case Medical Center. “There are not a lot of treatment options for metastatic colon cancer and this is a promising new treatment for patients with this diagnosis. We are excited to be able to offer this innovative procedure which has the potential to truly help our colon cancer patients.”
At UH, potential patients are evaluated by a multidisciplinary team comprised of members from hepatobiliary surgery, medical oncology, radiation oncology, nuclear medicine and interventional radiology. The procedure, approved by the Food and Drug Administration in 2002, is not for everyone, and is best used on patients who:
- • Are healthy enough to withstand the procedure
- • Have a healthy, well functioning liver
- • Have colon cancer metastatic to the liver which is inoperable
- • Have the liver as the primary location of the metastatic disease
- • Meet the pre-selection criteria, as determined by their physician
- • Have vascular anatomy suitable for the injection of radioactive spheres
After the procedure, most patients are allowed to go home the same day and participate in regular activities. The radioactive spheres attack the tumor for two weeks following the procedure. Once two weeks have passed, the majority of the radiation effect has worn off, and the spheres can remain inside the liver for the entire life of the patient without causing harm.
This year in the United States it is estimated that over 153,000 people will be newly diagnosed with colon cancer and over 56,000 people will die from the disease. In Ohio, over 6,500 people will be diagnosed and over 2,500 will die. The Ireland Cancer Center of University Hospitals Case Medical Center has been a pioneer in bringing new treatments to northern Ohio to help provide these patients with the most advanced treatment options available today.