What is Liver-Directed Therapy?
Liver-directed therapies are used to specifically target cancer cells in the liver. Cancer in the liver can originate from the liver itself or from a different site in the body and metastasize to the liver.
How Does Liver-Directed Therapy work?
All treatments are designed to specifically target the cancer or tumors in the liver. Here, the medicine, drug or other treatment is administered directly into the tumors. In this way, treatment is targeted and the potential injury to the rest of the body is reduced. This is different from chemotherapies where the drugs are generally administered throughout the body. In this way the chemotherapy goes to all parts of the body even if there is only disease in the liver.
What Types of Liver-Directed Therapies?
There are two primary types of interventional procedures called “embolization” procedures and “ablation” procedures.
Embolization Procedures: Embolization therapies are performed by threading a small catheter (flexible tubing) through a pinhole in the wrist or groin. The end of the catheter is placed right next to the cancer to directly deliver the therapy. The type of therapy delivered will depend on the type of tumor, extent of disease and goals of therapy. These therapies may include the following:
- Chemoembolization – Chemotherapy drugs are injected directly into the tumor. This may be injected in liquid form or the chemotherapy drug will be embedded into medical beads and injected into the tumor. This procedure is also sometimes called TACE (transarterial chemoembolization) or DEB-TACE (drug-eluting bead TACE).
- Bland embolization – Particles (or medical beads) are injected through a tiny catheter into the tumor. These particles block the flow of blood to the tumor denying it nutrients and oxygen.
- Radioembolization – Tiny beads are packed with a radioactive material called yttrium-90 or Y-90. By delivering the radiation directly to the tumor, it causes the tissue to break down and kill the cancer cells.
Ablation Procedures: Ablation procedures directly kill the tumor using some type of energy. For the energy to be delivered, a small probe or needle is placed directly into the cancer. Energy is then delivered to the tip of the probe to kill the cancer tissue. The energy may be delivered by microwaves (microwave ablation), heating (radiofrequency ablation), or freezing (cryoablation) the cancer cells.
Am I a Candidate for Liver-Directed Therapy?
Usually, these treatments are used as an alternative to surgery or in patients who aren’t good candidates for surgery. Goals may vary depending on your needs and condition. Some therapies may be used to shrink the tumor and to reduce symptoms, to prolong life, or in some cases, to be a cancer cure. Whether you are eligible for treatment and the goals of your therapy will depend on careful review of your unique condition.
Several nonsurgical treatment options are available to treat cancers in the liver. The first step is getting a thorough evaluation, diagnosis and plan. At NVP, we have dedicated highly specialized vascular physicians to walk you through this process and treat your condition in a comfortable outpatient setting.
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Ghosh SS, Takahashi M, Thummala NR, Parashar B, Chowdhury NR, Chowdhury JR. Liver-directed gene therapy: promises, problems and prospects at the turn of the century. J Hepatol. 2000;32(1 Suppl):238-52. doi: 10.1016/s0168-8278(00)80429-8. PMID: 10728808.