Chemoembolization: A direct hit against liver cancer
There it sits in all its glory, the heavyweight champion of the body - the liver. Weighing in at about three pounds, the adult liver is the body's largest organ, located in the right upper quadrant of the abdominal cavity. It's an amazing high-tech factory that performs hundreds of critical functions. The liver metabolizes proteins, fats and carbohydrates. It removes toxic elements from alcohol, nicotine and drugs. It helps create red blood cells. And these are just a few of its complex and critical functions. When a diagnosis of liver cancer is made, all the systems of the body can go downhill very fast.
Dramatic results for people with liver cancer
A direct attack on the tumor
Not for everyone
The steps before chemoembolization
How it works
Dramatic results for people with liver cancer
"Unlike standard or systemic chemotherapy which distributes medication throughout the entire body, chemoembolization is a more direct way of administering chemotherapy and, at the same time, cutting off the blood supply that feeds the tumor," explains
Robert T. Harvey, MD, a Virtua board-certified radiologist.
The liver has two main blood supplies which keep it alive and functioning. The portal vein supplies 75% of the blood entering the liver and the hepatic arteries supply the remaining 25% - although the hepatic arteries are the ones that provide nearly 100% of the blood that feeds a liver tumor.
A direct attack on the tumor
"During chemoembolization, powerful chemotherapy drugs are injected directly into the hepatic arteries that feed the tumor. Afterward, the blood supply that feeds these arteries is blocked off or embolized with an oil-based mixture. This embolization seals in a concentrated level of chemotherapy, 10 to 25 times higher, than that of standard chemotherapy, a very strong assault on the tumor cells," says Dr. Harvey.
Studies have shown that chemoembolization is two times more effective than standard chemotherapy for people with primary liver cancer that has not spread to another part of the body.
Not for everyone
It's important to remember that treatment for liver cancer and for all cancer are highly individual. Candidates for chemoembolization include patients whose primary liver cancer (cancer that started in the liver) has not spread to another part of the body. It also may be indicated for primary tumors such as colorectal, islet pancreatic and gastrointestinal cancers and sarcomas, which were successfully treated but later metastasized (spread) to the liver.
The steps before chemoembolization
First, a physician determines if a patient will benefit from this therapy. Dr. Harvey explains: "We take cross-sectional images of the liver using either a CAT scan or MRI to determine the location and size of the tumor. These 'pictures' also provide baseline images for the physician to use after therapy, to see if the tumor has shrunk as a result of the chemoembolization. A battery of other tests are also performed to make sure the liver is still functioning properly."
How it works
During the procedure, the patient is sedated and a very small catheter is inserted into the groin. Studies are done on-the-spot to determine the number of hepatic arteries a person has, which arteries are the dominant blood suppliers, and whether or not the portal vein is open so that the liver continues to receive blood after the procedure. If everything look good, the radiologist injects the chemoembolic mixture into the hepatic arteries through the tiny catheter. Most patients stay in hospital for about a day and a half after the treatment. For those with more than one hepatic artery, the second round of therapy takes place about a month later.
Three weeks following a chemoembolization, laboratory tests are performed to determine how well it worked. Once treatment is successfully completed, patients receive CAT scans and laboratory tests every three months for the first year, every four months for the second year and bi-annually for the third year and beyond to determine continued success. "Although chemoembolization is not a cure for liver cancer, it can dramatically increase survival time for people with the disease and can greatly reduce pain and increase quality of life," concludes Dr. Harvey.
For more information on chemoembolization, Virtua cancer services or support groups, call 1-888-Virtua-3.