What Are Interventional Radiology (IR) Treatments for Liver Cancer?
Interventional Radiology (IR) treatments for liver cancer are minimally invasive, highly targeted procedures designed to treat tumors while minimizing damage to healthy surrounding tissue. These therapies use advanced imaging guidance (such as X-ray, ultrasound, CT, or MRI) combined with heat or cold energy, specialized catheters, and microscopic particles to destroy liver tumors or slow their growth.
Over the past several decades, IR therapies have become an increasingly important option for patients with liver cancer. Because liver cancer is often diagnosed at an advanced stage, surgical removal may not be possible. In addition, many patients have underlying liver cirrhosis, which increases the risk of liver toxicity from systemic cancer treatments. IR therapies offer a valuable alternative by directly targeting cancer cells while preserving liver function.
Benefits of IR Therapies for Liver Cancer
IR therapies can be used to treat many types of liver cancer, either as a standalone treatment or in combination with surgery, chemotherapy, radiation, or liver transplantation. Because these procedures are minimally invasive, they generally involve fewer risks and complications.
Additional benefits include:
- Most IR treatments are performed on an outpatient basis, reducing hospital stays, wait times, and exposure to hospital-acquired infections.
- Suitable for patients with large, multiple, or complex tumors that are not candidates for surgery or traditional radiation therapy.
- Precise tumor targeting helps preserve healthy liver tissue and overall patient health.
- Certain treatments can reduce tumor size, extend survival, and significantly improve quality of life.
Causes of Liver Cancer
- Hepatitis B or C
- Heavy alcohol use
- Diabetes (when combined with other risk factors)
- Obesity
- Certain chemical exposures
- Other diseases, including: Hereditary hemochromatosis
- Tyrosinemia
- Alpha-1 antitrypsin
- Porphyria cutanea tarda
- Wilson disease
- Glycogen storage diseases
Common IR Treatments for Liver Cancer
Tumor Ablation
Using image guidance, an interventional radiologist precisely inserts a thin needle or probe into the liver tumor. Once positioned, heat or cold energy is applied to destroy cancer cells. Heat-based methods include microwave ablation, while freezing techniques are referred to as cryoablation. In select cases, tumor-destroying medications may be injected directly into the tumor. Ablation is most effective for smaller liver tumors.
Transarterial Chemoembolization (TACE)
TACE is a specialized procedure that delivers chemotherapy directly to the tumor through the arteries that supply it. A tiny catheter is guided into the liver arteries through a small incision in the wrist or groin, allowing anti-cancer drugs and embolic particles to be delivered precisely to the tumor, limiting blood flow and maximizing treatment effect.
Radioembolization (Y-90)
This treatment combines targeted radiation therapy with embolization. A catheter is guided into the liver arteries, where microscopic particles containing Yttrium-90—a radioactive isotope—are released into the blood vessels feeding the tumor. These particles emit radiation that destroys cancer cells over time while sparing healthy tissue.
Types of Liver Cancer
Hepatocellular Carcinoma
The most common form of liver cancer which accounts for four out of five liver cancers
Cholangiocarcinoma
Forms in the bile ducts of the liver. It accounts for 10% to 20% of all liver cancers.
Mixed hepatocellular carcinoma and cholangiocarcinoma
A rare and aggressive form of liver cancer.
Hepatoblastoma
A rare liver cancer usually found in children.
Angiosarcoma
Forms in the lining of the blood and lymph vessels of the liver.
Hemangioendothelioma
Grows in the cells that make up blood vessels.
FAQ
1. How Are IR Treatments for Liver Cancer Performed?
Interventional Radiology (IR) liver cancer treatments are performed using advanced imaging guidance to ensure precision and safety. The interventional radiologist inserts a thin, flexible catheter through a small puncture; typically in the thigh and guides it through the femoral artery to the liver. Imaging technology (angiography) is used to locate the tumor. Once identified, the physician delivers the appropriate therapy (such as ablation, embolization, or targeted cancer medication) directly to the tumor using specialized catheters or probes.
2. How Effective Are IR Liver Cancer Therapies?
3. Can Ablation Cure Primary or Secondary Liver Cancer?
4. Can Radiofrequency Ablation Be Repeated?
5. Are IR Liver Cancer Treatments Painful?
6. What Is Recovery Like After IR Liver Cancer Treatment?
Chemoembolization
If you have primary liver cancer, or liver cancer that has metastasized from elsewhere in your body, chemoembolization may be part of your treatment. we work closely with your referring physician to ensure you receive the best treatment to meet your needs. And, our clinical nurse coordinators assist you in planning, scheduling and following up after your treatment.
What is chemoembolization?
Chemoembolization is used for tumors that cannot be removed surgically because of their location or the number of tumors present. It is a palliative, not a curative, treatment, but can be extremely effective in treating primary liver cancers and some types of metastatic tumors especially when combined with other therapies. The treatment works to reduce or cut off the blood supply to your tumor. Your liver is unique because it has two blood supplies. The portal vein provides 75 percent of the liver’s blood supply and the hepatic artery supplies the remaining 25 percent. Tumors that grow in the liver typically receive their blood supply from the hepatic artery, which make chemoembolization possible. The procedure is usually done on an outpatient, same-day basis.
How chemoembolization works?
The interventional radiologists insert a catheter into your liver’s blood supply to attack the cancer in two ways. First, chemotherapy drugs are injected directly into the blood supply of the tumor. This gives the drugs more time and contact with the tumor to work and destroy the cancerous cells. Because the chemotherapy is delivered directly to the tumor, stronger doses can be given than would be possible during standard chemotherapy, which is injected through a vein in your arm. Second, a blocking agent, called an embolizer, is used to stop the blood supply to the tumors. This starves the tumor of oxygen and nutrients, causing them to shrink. Combining chemotherapy with an embolizer has a more powerful effect than if either was given alone. Chemoembolization requires a one to two day hospital stay.
Benefits
- Injecting chemotherapeutic drugs into the cancer site lessens side effects, as only a small amount of the medicine enters your bloodstream.
- This procedure can help prevent the growth of the tumor or tumors in your liver, while potentially shrinking them, preserving liver function and allowing you to have a relatively normal quality of life.
- This treatment can be repeated every four to eight weeks or used in combination with other types of therapy to control your liver cancer.
Risks
- Fever (short-term in 10 percent of patients)
- Nausea and vomiting (nausea can last up to two weeks, vomiting for a few days)
- Fatigue
- Upper right abdominal discomfort (can last from a few days up to a week)
- Infection or bleeding
- Small chance of the embolization material or particles becoming lodged in the wrong place and depriving normal tissue in your body of its blood supply
- Allergic reaction to the contrast dye used for the X-ray
- Kidney damage for those with diabetes or pre-existing kidney disease
* Potential effects vary for every patient. Medications are given to help prevent or relieve most of these side effects. In addition, steps can be taken to prevent allergic reactions to contrast dye and lessen the chance of kidney damage for those at risk.
Radioembolization (Selective Internal Radiation Therapy) - SIRT
If you have primary liver cancer, or liver cancer that has metastasized from elsewhere in your body, radioembolization may be part of your treatment. we work closely with your referring physician to ensure you receive the best treatment to meet your needs. In addition, our clinical nurse coordinators assist you in planning, scheduling and following up after your treatment.
What is radioembolization?
Radioembolization is a minimally invasive treatment that uses tiny radioactive beads, called microspheres, to deliver radiation directly to cancerous tumors in your liver. The beads are extremely small, measuring about one-third the diameter of a human hair, and are placed directly inside the tumor. Over a period of 10 to 12 days, the beads emit high radiation, causing the tumor to shrink. Radioembolization may also be called intra-arterial brachytherapy, selective internal radiation therapy or Y-90. Radioembolization is a palliative treatment used to treat liver cancer that cannot be removed with surgery. Radioembolization has the potential to shrink tumors or downstage them, so you are eligible for other treatments, surgery or a liver transplant. Radioembolization has been shown to help you live longer and improve your quality of life.
Initial evaluation
Your physician will discuss all your treatment options with you before scheduling you for a treatment. You will meet with us. we will review your health history, current list of medications, labs, CT scans, MRI or PET scans. You may not be a candidate for radioembolization for several reasons:
- Abnormal liver function
- Abnormal or no arteries near your liver tumors
- A very large portion of your liver is covered by tumors
- Your bilirubin, albumin or other lab values are out of normal range
If you are not a candidate for the treatment, your physician will work with your medical oncologist to help you choose the best options for you.
Benefits
- Minimal injury to the surrounding healthy liver tissue.
- Decreased side effects from the radiation.
- Once you have received the radioactive microspheres, the external radiation exposure to other individuals is very low and highly unlikely to cause harm. To be cautious, minimize contact (within a yard) with children under the age of 10 and pregnant women for three days following therapy.
- Radioembolization is the only treatment approved in the United States to treat primary liver cancer in patients with portal vein thrombosis.
- The recovery period after radioembolization is generally short.
Risks
- Fatigue (usually lasts 10 to 12 days)
- Mild abdominal discomfort and bloating
- Due to sedation medications, nausea and vomiting may occur one to two days following your procedure
- Fever (10 percent of patients)
- Infection or bleeding
- Allergic reaction to the contrast dye used for the X-ray
- Kidney damage for those with diabetes or pre-existing kidney disease
Even after a safety planning session, there is a very small risk (less than one percent) that radiation could be delivered to your lungs and/or digestive tract. Lung damage might occur causing swelling, scarring or shortness of breath. Irritation of the gastrointestinal tract could result in chronic pain, nausea, vomiting, ulcers, bleeding or pancreatitis. Side effects vary for every patient. Medicines are given to help prevent or relieve most of these side effects. Also, steps can be taken to prevent allergic reactions to contrast dye and lessen the chance of kidney damage for those at risk. If you have any questions on these risks, discuss them with your physician.