WHAT IS SELECTIVE INTERNAL RADIATION THERAPY?
Selective Internal Radiation Therapy (SIRT) is a targeted treatment for liver tumors that delivers millions of tiny radioactive beads called SIR-Spheres Y-90 resin microspheres directly to the liver tumors. SIRTS is used for the treatment of inoperable colorectal liver metastases in combination with hepatic arterial chemotherapy using FUDR (floxuridine). These liver tumors are also known as secondary liver metastases because the cancer cells have spread to the liver from the primary colon or rectal tumor.
At NYC Surgical Associates, the SIRT procedure is conducted by an interdisciplinary medical team that includes a radiation oncologist and specially trained vascular surgeons.
WHO IS SIRT SUITABLE FOR?
SIRT is only suitable for patients who have liver tumors where either the liver is the only site of disease or the liver is the major site of disease. SIRT has no effect on tumors outside the liver. Before SIRT can be offered as a treatment option for patients, there are a number of other factors that have to be considered by your doctor. Most importantly, you need to have a sufficiently healthy liver that is working satisfactorily. This is usually determined by a simple blood test.
MORE ABOUT THE SIRT PROCEDURE
To perform the SIRT procedure, our interventional radiologist makes a small puncture, usually into the radial artery in the wrist or femoral artery near the groin. From there, a catheter is guided through the artery into the liver and the SIR-Spheres Y-90 resin microspheres are administered.
WHAT ARE THE POTENTIAL BENEFITS OF SIR-SPHERES® Y-90 RESIN MICROSPHERES?
Clinical data shows that when used in combination with chemotherapy, SIR-Spheres Y-90 resin microspheres may shrink patients’ liver tumors more than chemotherapy alone, improve quality of life and increase life expectancy. For a small number of patients, treatment can cause sufficient shrinkage of the liver tumor to permit its removal by surgery at a later date. In patients whose liver tumors are no longer responding to chemotherapy, SIR-Spheres Y-90 resin microspheres have also been used successfully to shrink these tumors and extend patients’ survival. There are many publications in the scientific literature on the use of SIR-Spheres Y-90 resin microspheres in the treatment of patients with liver metastases.
FREQUENTLY ASKED QUESTIONS
WILL I HAVE TO STOP MY CHEMOTHERAPY TREATMENTS TO RECEIVE SIRT?
Generally, most patients’ chemotherapy is stopped before the SIRT procedure. However, your oncologist will determine if your chemotherapy needs to be stopped during the treatment period.
WHAT WILL HAPPEN AFTER I HAVE RECEIVED TREATMENT?
Immediately following the SIRT procedure, you may be taken for a scan to confirm that the SIR-Spheres microspheres have been infused into your liver. You will also be monitored for a few hours after the procedure to enable the treatment team to determine if you have any side effects or complications that require additional medication. Since you will have received a radioactive treatment, there are some simple precautions that need to be taken during the first 24 hours following the SIRT procedure. These precautions include: thorough washing of your hands after going to the toilet; cleaning up any spills of body fluids such as blood, urine, or stools and disposing of them in the toilet. You will be provided with further information on these precautions when you leave hospital. Your treatment team will also monitor your progress using blood tests and radiography scans at periodic intervals.
HOW SOON CAN I GO HOME AFTER TREATMENT?
Normally, you can be discharged 4-6 hours after the procedure. Most patients can resume their normal daily activities two to three days after the treatment. In rare instances, some patients may need to stay overnight in the hospital for observation.
WHAT SIDE EFFECTS ARE ASSOCIATED WITH TREATMENT?
Almost all treatments and drugs can produce unwanted side effects. Some side effects can be minor, making you feel uncomfortable, but a small number can be serious. Everyone is different in how he or she reacts to a treatment. Many patients experience abdominal pain and/or nausea which normally subside after a short time and/or with routine medication. Many patients also develop a mild fever that may last for up to a week and fatigue which may last for several weeks. As a precaution, you may receive additional medications such as pain-killers, anti-inflammatory, anti-nausea and anti-ulcer drugs with your treatment with the aim of preventing or minimizing these side effects.
WHAT ARE THE POTENTIAL COMPLICATIONS?
In rare instances and even in experienced hands, there is the possibility that a small number of microspheres may inadvertently reach other organs in the body, such as the gall bladder, stomach, intestine or pancreas. If SIR-Spheres Y-90 resin microspheres reach these organs, they may cause inflammation of the gall bladder (cholecystitis), stomach (gastritis) or intestine (duodenitis). These complications are rare, but if one of these occurs, they normally require additional treatment. Your treatment team will have received special training to minimize these risks and to prevent them from happening.
WHAT SHOULD I DO IF I EXPERIENCE A SIDE EFFECT?
It is important that you contact your doctor or nurse if you experience a side effect. Your doctor might prescribe medications to ease any discomfort. Although it is rare that side effects become life threatening, it is important to tell your doctor as soon as you experience any unwanted reactions.
WILL I LOSE MY HAIR?
Hair loss (alopecia) has never been reported following treatment with SIR-Spheres® Y-90 resin microspheres. If you are receiving chemotherapy this may cause hair loss; however SIR-Spheres Y-90 resin microspheres will not make this worse.
IS THERE ANYTHING I MUST AVOID?
You must not receive SIRT treatment if you are pregnant and you must not become pregnant within two months of being treated as this may cause irreversible harm to the unborn baby. Effective contraception must therefore be used at all times during this period. You must not breastfeed during the first two weeks after treatment and must not use any milk expressed during this period for bottle feeding of your baby.
WILL I HAVE TO CHANGE WHAT I EAT OR DRINK?
No. You can and should continue to eat and drink as normal. Adequate levels of food and, in particular, fluids will help your return to normal daily activities. Your doctor is the best person to advise you regarding alcohol consumption.
INTERESTED IN LEARNING MORE ABOUT THE SIRTS PROCEDURE & TREATMENT OPTIONS?
Contact NYC Surgical Associates today to learn more about receiving treatment. We can be reached via our online contact form, or at 888.286.6600.