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Selective Internal Radiation Therapy

 

 

What is Selective Internal Radiation Therapy?

SIRT is a revolutionary treatment for cancers of the liver that uses new technology to deliver radiation directly to the site of the tumor.  SIRT delivers millions of microscopic radioactive spheres, called SIR-Spheres or Therasphere, directly to the site of the liver tumors, where they selectively irradiate the tumors.  The targeted nature of SIRT lets doctors deliver up to 40 times more radiation to the liver tumors than would be possible using conventional radiotherapy.

What to expect before, during, and after treatment



 

 

Selective Internal Radiation Therapy is known by a number of names that include: SIRT, Sir-spheres, Therasphere, radioembolization, Yttrium 90, Y90,  brachytherapy, and has been coined by YES co-founder as "little magic beads."  We understand that being diagnosed with liver cancer or metastases to the liver from other cancer is terrifying, to say the least. Exploring the treatment options available and choosing the one best suited for your individual condition is an important decision. Your physician and loved ones need to be included in this process.

"What to expect" before, during, and after SIRT as described below may vary depending on the individual hospital and your specific disease burden and physical condition. The following is provided to give you a general idea of what you might experience while undergoing and recovering from SIRT. Patients who have previously undergone treatment with Y-90 therapy have contributed their voice of experience to help you make more informed choices regarding SIRT. Hopefully, this will help to make your experience easier and
more comfortable.

There will be several specialists involved during your microspheres experience. They may include an interventional radiologist, your oncologist, radiation therapist, and nurse among others. With your spheres team working together you will receive the highest quality of care because all aspects of your treatment and recovery will be covered.

Most important, you can be matched with other patients who have undergone SIRT. Through speaking with other patients, you can gain important knowledge about what to expect as well as receive emotional support before and after treatment.

For more information on selective internal radiation therapy (SIRT) and the patient treatment process, please visit their websites at the following:

www.sirtex.com or www.mds.nordion.com/therasphere 

The Screening Process

Many patients learn about Yttrium 90 microspheres therapy through their own research. Quite often, the treating oncologist will know very little about the procedure. Finding an interventional radiologist near you that is specially trained to administer the spheres will be your first step toward the screening process. You may be able to send your records and medical history for an opinion. If it appears that you may indeed be a candidate an appointment for evaluation will be set.

For a list of treatment centers near you, please refer to the list we have provided on our web-site or consult with either Sirtex or Nordion.

The Evaluation

At this point, you know there is a good chance that you qualify for SIRT and the evaluation is the next step. You might find that you are anxious about this visit and the possibility that it holds. This experience will be much like the actual implantation of microspheres. In essence, it is a dress rehearsal. You may want to arrive at the hospital with a book to read, music to listen to, or something else that requires little movement but will occupy your time. It is always nice to bring a family member or friend to keep you company before and after the procedure.

You will be asked not to eat for a specific amount of time before your evaluation. You will bring labwork and recent scans for review. You will be prepped for the procedure and your interventional radiologist will make a tiny incision in your leg and carefully place a small but long, flexible plastic tube called a catheter into the femoral artery (which is the major blood vessel in the leg). He/she will use an x-ray that allows him to view the inside of the body on the screen as he guides the catheter through the blood vessels to the hepatic artery (which is one of two blood vessels that feed the liver). He will ease the tube into the branch of the hepatic artery that feeds the cancerous tumor(s) in your liver. This process will ensure that the microspheres are going to be distributed appropriately. It will also indicate whether or not they will be likely to go into areas that could be dangerous - such as the lung or abdominal cavity. Sometimes blood flow will have to be redirected. You will be awake for the procedure and can even watch the monitors if you so choose. You may feel some pressure but should not feel pain. Once the procedure is complete, the catheter will be carefully removed and pressure will be applied to the incision. You will have to lie flat for several hours to ensure that bleeding does not occur. If all goes well and Yttrium 90 Microspheres therapy is possible, then a date for the procedure will be set and you should be able to return home shortly after the evaluation.
 
Treatment Day

Arriving

On the day of your scheduled SIRT you will need to check in at the facility and will be directed to the radiology suite. Wear loose, comfortable clothing. Again, you may also want to bring a newspaper/magazine to read or headphones and a CD for any waiting time before your treatment. It is always nice to bring a family member or friend to keep you company before and after the procedure.

Just as with the evaluation, you will be asked not to eat for a specific amount of time before the procedure. You will be prepped for the treatment and the same actions that were required for your evaluation will be performed. Your interventional radiologist will make a tiny incision in your leg and carefully places a small but long, flexible plastic tube called a catheter into the femoral artery (which is the major blood vessel in the leg). He/she will use and x-ray that allows him to view the inside of the body on the screen as he guides the catheter through the blood vessels to the hepatic artery (which is one of two blood vessels that feed the liver). He will ease the tube into the branch of the hepatic artery that feeds the cancerous tumor(s) in your liver and "the little magic beads" will be infused. Once the procedure is complete, the catheter will be carefully removed and pressure will applied to the incision. You will have to lie flat for several hours to ensure that bleeding will not occur. If the treatment goes as planned, return to home with a few simple precautions will be allowed within 24 hours. The wait for results begins......

Precautions 

After the implantion of the microspheres, some simple precautions must be taken for a week following the procedure. These include:
No public transportation
No close physical contact with others for longer than 2 hours
The patient should sleep in bed alone
No contact with anyone who is pregnant
No contact with young children

Pets should not sit on the patients lap

Side Effects

Generally, there are few side effects from treatment. Most patients will feel only flu-like symptoms. We talked to patients that experienced these along with a slight fever. Some had abdominal cramping that ranged from low to intense. Most complained that fatigue was the biggest factor and that very little activity was accomplished in the days following the treatment. Severe side effects rarely occur, but can.
 
Follow Up

Follow-up appointments are very important as they will determine your response to treatment. Be sure you do not miss any! Your tumors or lesions will need to be monitored periodically for progress.

**Be aware that scans often show inflammation of tumors for a period of up to three months post procedure and may be alarming to someone who has not evaluated the after effects of SIRT.  A good discussion from a previous webinar conducted by Dr. Charles Nutting can be replayed.

For more information on the SIRT, please contact either Sirtex by phone at 1(888)474-7839 or through their web-site at www.sirtex.com  or Nordion by phone at 1-866-363-3330 or through their web-site at www.nordion.com/therasphere.
 

For more detailed information about what to expect before, during, and after treatment with SIR-Spheres microspheres follow the link for patient and physician video interviews.
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