What is liver cancer and how is it treated with targeted radiation therapy?

The liver is the biggest organ inside the human body. Located in the upper right portion of the belly, it’s roughly the size of an American football and weighs about three pounds. This big organ has an equally big job of processing nutrients in the blood and filtering out toxins. Unfortunately, chronic liver diseases like cirrhosis can erode the liver’s functioning. What’s more, damage done by these diseases can increase the risk that liver cells, in their effort to multiply and repair the damage, can grow out of control, resulting in cancer.

The most common type of liver cancer is hepatocellular carcinoma (HCC), accounting for about 75% of all liver cancers – and representing the third leading cause of cancer deaths worldwide.[i] Liver cancer can be treated in a number of ways, including via:

• surgery
• chemo-, immuno- or drug therapy
• destroying the cancer cells with heat or cold (ablation)
• closing off blood flow to tumors (embolization)
• radiation

Radiation uses high-energy rays or particles to kill cancer cells. Doctors often recommend it as the most helpful choice for people whose cancer is too large to be surgically removed, is too close to a blood vessel, has spread to other areas or can’t be treated with ablation or embolization; radiation is also often used as part of a multifaceted treatment plan.

Radiation treatment options for liver cancer

The most common form of radiation therapy sends beams of energy onto the cancer from a source outside the body while the patient holds very still. Unfortunately, this method also comes with well-known risks, including that of killing healthy tissue along with the tumor, as well as serious side effects, which may include skin blisters, fatigue, nausea, vomiting and cognitive impairment. To make treatment more tolerable, external radiation therapy is typically given in small doses, requiring the patient to return again and again over a period of days or weeks.

Another type of radiation therapy, called transarterial radioembolization (also known as selective internal radiation therapy, or SIRT), takes a vastly different approach: Instead of beaming radiation to the tumor from the outside of the body, it strategically places a powerful dose of radiation inside the tumor.

This radiation is delivered in the form of tiny glass microspheres that contain yttrium-90 (Y-90) – a highly concentrated isotope that’s strong enough to fight cancer but whose radiation only travels a short distance, making it ideal for precise placement within the body that spares nearby healthy tissue.[ii] The irradiated spheres are injected directly into the blood vessels feeding a liver tumor. They become lodged in the tumor’s small vessels and emit their Y-90 radiation, killing cancer cells and suppressing tumor growth. Once the spheres are exhausted of their contents, they simply become inactive.

Radioembolization using Y-90 has been proven to shrink and destroy HCC liver tumors and improve patient outcomes, often with a single outpatient procedure.[iii] Learn more about how it works here:

The promise of a novel radiation delivery system

Only one Y-90 treatment for HCC has been approved by the U.S. Food and Drug Administration: TheraSphere™. Here’s how the procedure unfolds.

First, a vial of TheraSphere is personalized for a patient’s individual needs – filled with anywhere from 750,000 to five million microscopic glass beads – and sent to the facility where the procedure will be performed. Then, while the patient is under local anesthesia, the interventional radiologist makes a quarter-inch incision in their groin and threads in a small, flexible tube called a microcatheter until it reaches the tumor. Once there and precisely placed, the doctor pushes out the millions of beads, each smaller than the thickness of a human hair, to embed themselves within the tumor. Patients typically go home the same day. Some experience mild flu-like symptoms that last about a week – far more tolerable than the side effects of traditional external radiation or of chemotherapy alone.

“A cancer diagnosis is life-changing,” said Peter Pattison, president of Interventional Oncology & Embolization, Peripheral Interventions, Boston Scientific. “This technological advancement gives patients another option in the fight against HCC – a way to improve their health outcomes while also improving their quality of life during treatment.”

So far more than 100,000 patients with liver cancer worldwide have been treated with TheraSphere, which has been approved in over 30 countries worldwide. The Boston Scientific team is now exploring how this therapy might be used to treat other types of tumors, including prostate cancer and a type of brain tumor called glioblastoma. In the UK, the National Institute for Health and Care Excellence has issued guidance that TheraSphere can be used to treat neuroendocrine tumors, and patients there can receive the therapy through the National Health Service. The ultimate goal: to provide even more patients with a more targeted radiation therapy option, a better quality of life and better outcomes in their cancer journeys.

Learn more about liver cancer (HCC) treatment with TheraSphere.