Medically Reviewed by Dr. K on 2 April 2021
Table of contents
Radioembolization is a cancer treatment that requires administering nuclear particles to a tumour through the bloodstream. The particles get embedded in the tumour and emit radiation, which destroys cancer cells. The most common cancers for which radioembolization is being used is liver cancers. Patients that are unable to receive other treatments can benefit from radioembolization.
What Is Radioembolization?
A technique called an angiogram is used to execute radioembolization. A catheter is initially implanted through a groyne artery by a doctor. The catheter is inserted into the blood vessels supplying the liver tumour under X-ray guidance. A liquid carrying small radioactive particles is then injected into the required artery (or arteries) by the doctor. The particles accumulate in the tumour, obstructing blood supply to cancer cells, destroying them, and shrinking it. After radioembolization, the surrounding healthy liver usually sustains only minor radiation exposure. Over the course of a month, the radiation in the particles gradually fades. The residual particles will securely remain in place indefinitely.
Tests are conducted prior to radioembolization to ensure safety and increase the probability of success. Routine blood tests and a blood flow assessment, including an initial angiogram, are among them. The first angiogram is used as a test to confirm that the arteries in the abdomen and liver are suitable for radioembolization.
Uses for Radioembolization
Radioembolization is commonly used to treat liver cancer. The disease will manifest itself in one of two ways:
- Cancer that has spread to the liver from the main tumour somewhere (metastasized) – such as colon or breast cancer
- The cancer starts in the liver and spreads across the body – such as hepatocellular carcinoma
The tumours most commonly considered for radioembolization treatment are metastatic colorectal cancer in the liver and hepatocellular carcinoma. Some tumours of the liver that have been treated with radioembolization include:
- Breast cancer or lung cancer that has spread to the liver (metastasis)
- Carcinoid tumours, for example, neuroendocrine tumours which have progressed to the liver.
- Gastrointestinal stromal tumour (GIST) – a form of sarcoma
Radioembolization is often used in conjunction with more well-known cancer treatments including surgery and chemotherapy:
- Radioembolization may be used to shrink liver tumours that are too huge to be surgically removed.
- To optimise the destruction of cancer cells, chemotherapy and radioembolization can be used simultaneously.
Radioembolization may also be used to treat tumours of the liver that are resistant to chemotherapy and cannot be removed surgically. Doctors are still determining the best uses of radioembolization due to the ongoing research.
Radioembolization is typically used for tumours that have spread primarily to the liver. Radioembolization is normally not an option for people with serious liver failure or abnormal blood flow between the liver and the lungs.
The Effects of Radioembolization
Radioembolization delayed the progression of colorectal cancer after it spread to the liver in several small studies. Hepatocellular carcinomas have also been shown to shrink after radioembolization.
There is some indication that patients who receive radioembolization and chemotherapy for liver cancer survive longer than others who only receive chemotherapy. Larger research studies are already ongoing to address concerns regarding the benefits of radioembolization.
After radioembolization, many people feel fatigued, nausea, abdominal pain, fever, and a loss of appetite. Some of these side effects are mild to moderate, and most patients are discharged from the hospital within a day or two of the operation.
The possibility of severe side effects from radioembolization is minimal. However, following radioembolization, a small number of individuals experience severe complications. The following are some of the possible side effects of radioembolization:
- Ulcers in the stomach or small intestine that are serious
- Failure of the liver or gallbladder
- White blood cell count becomes dangerously poor.
- Lung damage from radiation
Tests conducted prior to radioembolization may help to minimise some of the risks associated with the treatment.