If you have primary liver cancer, or liver cancer that has metastasized from elsewhere in your body, radioembolization may be part of your treatment. Our multidisciplinary, interventional radiology team* works closely with your referring physician to ensure you receive the best treatment to meet your needs. In addition, our clinical nurse coordinators assist you in planning, scheduling and following up after your treatment.

What is radioembolization?

Radioembolization is a minimally invasive treatment that uses tiny radioactive beads, called microspheres, to deliver radiation directly to cancerous tumors in your liver. The beads are extremely small, measuring about one-third the diameter of a human hair, and are placed directly inside the tumor. Over a period of 10 to 12 days, the beads emit high radiation, causing the tumor to shrink. Radioembolization may also be called intra-arterial brachytherapy, selective internal radiation therapy or Y-90.

Radioembolization is a palliative treatment used to treat liver cancer that cannot be removed with surgery. Radioembolization has the potential to shrink tumors or downstage them, so you are eligible for other treatments, surgery or a liver transplant. Radioembolization has been shown to help you live longer, and improve your quality of life.

Initial evaluation

Your physician will discuss all your treatment options with you before scheduling you for a treatment. You will meet the interventional radiologist who will perform your procedure and the nurse that will follow you before and after your treatment. They will review your health history, current list of medications, labs, CT scans, MRI or PET scans.

You may not be a candidate for radioembolization for several reasons:

• Abnormal liver function
• Abnormal or no arteries near your liver tumors
• A very large portion of your liver is covered by tumors
• Your bilirubin, albumin or other lab values are out of normal range

If you are not a candidate for the treatment, your physician will work with your medical oncologist to help you choose the best options for you.

Benefits and risks

Benefits of radioembolization include:

• Minimal injury to the surrounding healthy liver tissue.
• Decreased side effects from the radiation.
• Once you have received the radioactive microspheres, the external radiation exposure to other individuals is very low and highly unlikely to cause harm. To be cautious, minimize contact (within a yard) with children under the age of 10 and pregnant women for three days following therapy.
• Radioembolization is the only treatment approved in the United States to treat primary liver cancer in patients with portal vein thrombosis.
• The recovery period after radioembolization is generally short.

Risks following radioembolization, include:

• Fatigue (usually lasts 10 to 12 days)
• Mild abdominal discomfort and bloating
• Due to sedation medications, nausea and vomiting may occur one to two days following your procedure
• Fever (10 percent of patients)
• Infection or bleeding
• Allergic reaction to the contrast dye used for the X-ray
• Kidney damage for those with diabetes or pre-existing kidney disease

Even after a safety planning session, there is a very small risk (less than one percent) that radiation could be delivered to your lungs and/or digestive tract. Lung damage might occur causing swelling, scarring or shortness of breath. Irritation of the gastrointestinal tract could result in chronic pain, nausea, vomiting, ulcers, bleeding or pancreatitis.

Side effects vary for every patient. Medicines are given to help prevent or relieve most of these side effects. Also, steps can be taken to prevent allergic reactions to contrast dye and lessen the chance of kidney damage for those at risk. If you have any questions on these risks, discuss them with your physician.