Liver cancer patients are spared hospitalizations and a painful recovery thanks to a procedure in which tumor-fighting globules are injected through the wrist.
The spheres – called microspheres – kill cancer cells by settling in blood vessels near the tumor, where they release small amounts of radiation over several days.
Previously, they reached the liver through a long tube inserted through the groin, which involved hospitalization and increased risk of internal bleeding. Patients also had to lie flat for six hours afterwards to prevent damage to the blood vessels in the pelvic area.
But the new procedure, which involves inserting a long tube into the wrist, allows patients to return home within two hours.
“Patients would rather sit in a chair straight afterwards than lie down and be unable to move,” says Dr Pavan Najran, consultant interventional radiologist at The Christie NHS Foundation Trust in Manchester, who performed the procedure. “We hope that more hospitals pick up on this soon.”
Every year around 6,000 people in the UK are diagnosed with liver cancer – most are over 60 years old
Around 6,000 people in the UK are diagnosed with liver cancer each year – most of them over the age of 60. Certain conditions can increase your chances of getting it, such as hepatitis, gallstones, and diabetes.
But about half of cases are believed to be related to lifestyle factors such as obesity and smoking. If the disease is detected early, surgeons can excise the tumor. Most patients undergo chemotherapy to kill the remaining cancer cells. But those who are deemed too unwell for chemotherapy or find that their cancer is returning are then offered radiotherapy.
In other cancers, a machine delivers beams of radiation to the affected area. But in liver cancer, a procedure known as selective internal radiation therapy, or SIRT, injects microspheres directly into the very small blood vessels that supply liver tumors, releasing radiation that kills cancer cells.
‘It means the radiation is more focused, reducing the risk of damaging nearby areas, such as the kidneys or bladder,’ says Dr Najran. “We can also use higher doses of radiation, because we are not afraid of affecting other organs.”
The traditional method of passing a thin tube called a catheter through the main artery in the groin — the femoral artery — until it reaches the liver carries risks. Moving the legs and groin can damage the delicate blood vessel, causing severe bleeding that requires further surgery.
‘It can be difficult to spot bleeding in the groin because the artery is deep in the body, so you don’t always get the characteristic bruising,’ says Dr Najran. “If you don’t catch it soon, it can spread, causing life-threatening complications.”
But with the new procedure, doctors insert the tube into the radial artery in the wrist, which branches to meet other vessels that supply the liver. Studies show that this can halve the risk of major bleeding. And according to surveys, three-quarters of patients prefer it.
Prior to surgery, patients are given a drug to widen their blood vessels, making it easier for doctors to insert the tube.
Once the two-hour procedure is over, patients can move around and even use their hands. They are fired later that day.
One patient who is benefiting from this is Heather Norgrove, 74, from the Midlands.
The grandmother of two children was diagnosed with skin cancer melanoma in 2013. The treatment was initially successful, but years later a scan showed it had returned and reached her liver.
Last year, specialists referred Heather to The Christie for SIRT treatment, where she underwent the traditional method, involving the artery in her groin. “The worst thing was that I lay there for hours,” she says. “I was desperate to go to the toilet and there was nothing I could do.”
Last month, Heather was given the opportunity to receive the treatment through the radial artery in her wrist.
“It was great,” she says. ‘I got up immediately afterwards. I was free to eat something and the side effects were minimal – my hand went numb and I had pins and needles, but that soon passed.
“It was well worth it for freedom.”