SIR-Spheres microspheres are an
innovative means of treating liver cancer. In
cases where it is not possible to surgically
remove the liver tumors, SIR-Spheres microspheres
can be used to deliver targeted,
internal radiation therapy directly to the
tumor.
Liver
tumor being treated with
SIR-Spheres
This new therapy is called Selective
Internal Radiation Therapy also known as SIRT.
This technique uses millions of tiny polymer beads
or microspheres which contain a radioactive
element called yttrium-90. SIR-Spheres
microspheres are very small, approximately 32
microns in size, and are about one-third the
diameter of a strand of hair. SIRT is usually
administered as an outpatient procedure by a
specially trained physician known as an
interventional radiologist. A small catheter is
guided into the liver and the SIR-Spheres
microspheres are infused through the catheter. The
microspheres with the radioactive yttrium-90 are
carried by the bloodstream directly to the tumors
in the liver where they preferentially lodge in
the small vessels feeding the tumor and deliver
their dose of radiation. Unlike conventional
external beam radiation, which can only be applied
to limited areas of the body, SIR-Spheres
microspheres selectively irradiate the tumors and
therefore have the ability to deliver more potent
doses of radiation directly to the cancer cells
over a longer period of time.
SIR-Spheres microspheres were developed in the
1980's in Perth, Western Australia. Since then,
the product and the procedure has been refined and
many hundreds of patients have been treated.
SIR-Spheres microspheres received PMA approval by
the Food and Drug Administration (FDA) in
2002.
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Radiation is an
effective agent for destroying tumors and is
widely used in cancer treatment. However, organs
in the body are sensitive to radiation and high
doses can seriously affect or injure a patient.
SIR-Spheres microspheres and the SIRT technique
enables specific targeting and destruction of the
tumors within the liver, while sparing the normal
healthy tissue. Scientists and doctors at Sirtex
understood that liver tumors are hypervascular and
derive most of their blood supply from the hepatic
artery while healthy liver tissue is fed
predominantly by the portal vein. By administering
the SIR-Spheres microspheres into the hepatic
artery they are carried preferentially to the
tumor thereby sparing the normal liver. Once
infused into the hepatic artery, SIR-Spheres
microspheres travel in the bloodstream to the
tumors, where they become lodged around the
tumors. The dose of radiation from the SIR-Spheres
microspheres in conjunction with their proximity
to the tumor, destroys the tumor and preserves the
healthy liver tissue. The SIRT procedure allows a
more pin-pointed delivery of radiation to liver
tumors than other radiotherapy techniques, making
it more effective in killing the cancer.
How Are They
Administered?
SIR-Spheres microspheres are administered by a
specially trained interventional radiologist. Your
individual treatment plan will be reviewed by
other specialists experienced in the treatment of
liver tumors. The procedure is usually performed
as an outpatient procedure under local sedation in
the radiology suite. A small incision will be made
in the patient's groin and a flexible catheter
will be guided into the liver under x-ray vision.
The catheter is moved through the hepatic artery
and positioned by the interventional radiologist
to allow for targeted infusion of the SIR-Spheres
microspheres to the liver tumors. SIR-Spheres
microspheres take about 15 minutes to be infused
and the whole procedure takes about one hour from
beginning to end.
After the procedure is completed you may be
sent to have a special scan to check the level of
radioactivity of the SIR-Spheres microspheres in
your liver. You will be monitored for a few hours
after the procedure and most patients are
discharged within 24 hours. There are few
precautions you and your family need to keep in
mind the first week after treatment, with
SIR-Spheres microspheres; there should be no close
physical contact with others for longer than 2
hours, the patient should sleep in bed alone,
there should be no contact with pregnant family
members and children and pets should not sit on
the patients lap. After a week the patient will be
able to resume normal contact with family
members.
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SIR-Spheres
microspheres therapy is regarded as a regional
treatment; that is, the anti-cancer effect is
concentrated in the liver and there is no effect
on the cancer at other sites. SIR-Spheres
microspheres are used to treat secondary liver
cancer where the cancer originates in the bowel
(colon) and then spreads to the liver. This type
of cancer is called metastatic colorectal cancer.
SIR-Spheres microspheres is generally not regarded
as a cure, but has been shown to shrink the tumors
more than chemotherapy alone. Quality of life can
improve, and life expectancy may increase. For a
small number of patients, treatment with
SIR-Spheres microspheres can cause marked
shrinkage of the liver tumor allowing for surgical
removal at a later date.
How Do I Qualify?
Patients suitable for treatment with
SIR-Spheres microspheres need to establish that
they:
Have inoperable metastatic colorectal
cancer, that is, cancer that originated in the
bowel and has spread to the liver.
Have the liver as the major site of disease
Have sufficient remaining healthy liver
still functioning satisfactorily (this can be
determined by a simple blood test)
Meet the pre-selection criteria established
by the doctor's pre-treatment testing
An angiogram will be needed to determine that
the liver's vasculature is acceptable to receive
SIR-Spheres microspheres.
Basic testing
generally includes standard blood tests and a
chest X-ray or CT scan of the chest to rule out
cancer in the lungs
If you meet the criteria outlined then you may
be a candidate for treatment. Here's what you can
do: contact a treatment
center in your area that specializes in
SIR-Spheres microspheres therapy. A cancer
specialist will then make a decision on your
suitability for treatment. We will provide all the
scientific and clinical information needed for
your doctor to assist you in making a
decision.
Patients should not have any serious side
effects when SIR-Spheres microspheres are
correctly administered and do not lodge outside
the liver. However, during the infusion of the
SIR-Spheres microspheres you may experience some
pain. If you do, your doctor will provide
medication to help alleviate any discomfort during
the infusion. Sometimes patients develop pain in
the abdomen that may last for a few hours after
the administration of SIR-Spheres microspheres,
but this can also be treated with medication. Some
patients develop a fever that may last for up to a
week. Some patients may develop nausea, but this
subsides with time and medication. Most
frequently, many patients feel lethargic with a
poor appetite for several days after the
treatment, but this also subsides with time.
Patients are often placed on medication for the
first month after treatment with SIR-Spheres
microspheres to prevent gastritis and peptic
ulceration.
There is always the potential of serious side
effects if the SIR-Spheres microspheres are
incorrectly delivered into the artery supplying
blood to the liver. In this case, the SIR-Spheres
microspheres could be inadvertently supplied to
the stomach, duodenum, pancreas or other organs,
resulting in very severe and even fatal side
effects. Radiologists delivering SIR-Spheres
microspheres are given special training to inform
them of this risk and to prevent this from
happening. The dose of radiation is individually
prescribed for each patient. If the dose is too
high, some patients could develop long-term damage
to the normal liver.
Patient CD-ROM
Full of helpful information to get you started,
this CD contains information on:
SIR-Spheres microspheres and how they work
How SIR-Spheres microspheres are
administered
Qualification information
Side Effects
FAQ's
To receive your Informational CD, simply send
us an email with
your mailing address.