Sunday September 25, 2011
AS a total eradication, or cure, of cancers are often rare, the main goals of cancer treatment is to “downstage the lesion, arrest the progression, alleviate symptoms, offer a better quality of life, and prolong life,” says consultant vascular and interventional radiologist Dr Alex Tang.
When a patient’s cancer or tumour in the liver cannot be removed by surgery, here are a few options their doctors can offer.
“These treatment options are very effective in treating focal malignant and benign diseases,” says Dr Tang. However, they are often carried out together with ongoing systemic chemotherapy for optimal clinical care.
While these brief descriptions provide a general overview of the treatment options, it is best to consult your attending doctor, oncologist, or interventional radiologist before deciding on treatment strategies.
Percutaneous Ethanol Injection
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| Dr Tang explains the various treatment options for liver cancer. |
Radio Frequency Ablation (RFA), Microwave, High Intensity Focused Ultrasound (HIFU), Cryotherapy
Besides “poisoning” cancer cells, interventional radiologists can also burn or freeze cancer cells.
In RFA, interventional radiologists locate the cancers or tumours in their patients with the help of an ultrasound or CT image and heat up the needle tip (with radiowaves) to “burn off” the cancer cells. The microwave technique follows the same principle, but as its name indicates, the needle tip is heated up with electromagnetic waves (microwave).
HIFU is a non-invasive procedure that uses a focusing lens to concentrate sound wave energy and burns the tumour cells through the skin.
In cryotherapy, the doctors freeze and kill cancer cells using very low temperatures by injecting inert chemicals (chemicals that do not react with our cells) into them with a needle. Chemicals that are used for this purpose are often liquid nitrogen (-196 degrees Celcius) or argon (-185 degrees Celcius).
Transarterial chemoembolisation (TACE), Radioembolisation with Selective Internal Radiation Therapy (SIRT), Portal vein embolisation
As cancer cells also need oxygen and nutrients to live, they need blood supply to continue to live and multiply. Therefore, one of the ways of killing them is cutting off their blood supply. In TACE, interventional radiologists will locate the arteries that supply the tumour by doing a hepatic angiogram (a special x-ray of the arteries) and infuse anti-cancer drugs through them. Sometimes, they may choose to infuse special plastic beads that are coated with anti-cancer drugs (called DC beads) so that the drugs can be released into the cancer cells over time.
Portal vein embolisation is often done when a patient is suitable for surgery, but the remaining liver cells may not be enough to work properly on their own. By cutting off a branch of portal vein that supplies the segment of the liver that contains the tumour, it can shrink it down and allow the other segments (with normal cells) to grow larger.
This may allow surgeons to reduce their patients’ risk of liver failure when they remove the affected part of the liver.
Sorafenib
Sorafenib is an oral anti-cancer drug that is usually prescribed for patients with advanced and terminal kidney and liver cancer. Patients who are prescribed this drug usually have to take them until they no longer work or have intolerable side effects.
All the above treatments are available in Malaysia except HIFU.
http://thestar.com.my/health/story.asp?file=/2011/9/25/health/9507059&sec=health
