Vascular oncology is a term used to describe treating tumours via their own blood supplies. The blood supply of a tumour may be blocked (embolisation) and/or therapy may be given directly into the tumour itself, reducing the harm to the rest of the body.
Embolisation
This is carried out by inserting a small tube (or catheter) into the groin blood vessels. The tube is then passed up to the organ that contains the tumour, where particles, metal coils or gel may be delivered directly.
Embolisation may be used to shrink tumours before surgery or if they are causing pressure from their size. It is also very important to stop bleeding that may either start spontaneously or after surgery. Uterine fibroids are benign tumours of the uterus which may be targeted if they cause symptoms such as heavy bleeding during periods.
Embolisation with chemotherapy (DEB-TACE)
Drug-eluting bead transarterial chemoembolization (DEB-TACE) combines the technique of blocking off blood vessels with the delivery of high concentrations of chemotherapy to the target tumours. The tiny particles used to block the tumour blood vessels are soaked in chemotherapy before treatment; once they are lodged in the tumour blood vessels they are able to release the chemotherapy directly. This is a novel technique recently introduced for the treatment of cancer that has spread to the liver and cannot be dealt with by surgery or direct ablation. Clinical trials have proven DEB-TACE to be more effective than chemotherapy given via a vein in patients who have already had standard chemotherapy for this kind of cancer.
Please click here to view our patient leaflet for DEB_TACE Treatment.
Embolisation with radiation therapy (Radio-embolisation or SIRT)
Particles used for embolisation (see above) may be pre-treated with yttrium-90 – a source of very localised radiation. This is also known as Selective Internal Radiation Therapy (or SIRT). This is a treatment that is approved for the treatment of liver tumours that cannot be removed by surgery. These may be cancers that start in the liver (primary liver cancer), or they may be tumours that have spread to the liver from another part of the body (secondary liver cancer or metastases). SIRT provides a very localised delivery of radiation to the tumour, and has been approved nationally for the treatment of liver tumours.
It is a two stage procedure, usually 1 to 3 weeks apart. The 1st stage involves an angiogram and embolisation to ensure that any blood vessels that are not directly feeding the tumour are blocked off. During the 2nd stage, the treatment is delivered using tiny resin or glass beads – less than the width of a human hair – containing a radioactive element (Yttrium-90 (Y90) to treat the liver tumours directly. The microspheres tend to lodge in the small vessels within the tumour and deliver their dose of radiation for a period of approximately two weeks.
Please click here to view our patient leaflet on SIRT therapy.
Hepatic chemosaturation
The concept of chemosaturation therapy is to temporarily isolate the liver from the body’s blood circulation and deliver concentrated doses of an anti-cancer drug directly to the liver, “saturating” the entire organ. Blood leaving the liver is directed outside of the body to filters that remove most of the anti-cancer drug before returning it to the body. Because the liver is isolated from the rest of the body, the anti-cancer drug can be given at higher concentration levels than is possible in systemic chemotherapy. By delivering this drug to the entire liver, treatment is administered to potentially both visible tumours and undetected microtumours.
Chemosaturation has 3 steps: Isolation – your doctor will put a catheter with 2 small balloons around your liver. The balloons will “seal off” the blood in your liver from the rest of your body. Saturation – next, your doctor will give you a powerful anti-cancer drug. The drug will go directly to your liver. The balloons will keep the drug from spreading to other parts of your body. Filtration – after the anti-cancer drug has been delivered to your liver, the filter will remove most of the drug from your blood. This is an important step because it can help reduce side effects after your procedure to a level that you can manage better.
Please click here to view our patient leaflet for Chemosaturation Treatment.
Please click here to read the Chemosaturation leaflet from Delcath Systems Ltd.
Please click here to read the Delcath Leaflet “Against the odds”
Press below to view our videos for more information on Chemosaturation from our Clinicians and The Harley Street Clinic Team.
Click here for more information regarding The Harley Street Clinic, where our team delivers Chemosaturation Therapy.
Click here for more information from DELCATH Systems Ltd, who provide the technology for Chemosaturation Therapy.