Q1. Why liver cancers are often diagnosed at late stage?
Tumour is smaller in early-stage liver cancer. Symptoms are not obvious and hard to notice. In mid- or late-stage, patients may start to feel pain as the tumour grows larger. People with high risk factors, e.g. carriers of hepatitis virus, are often advised to have regular check-ups. The cure rate of liver cancer is higher if it is detected before symptoms appear.
Q2. If the liver tumour is too large and inoperable, are there any other treatment options?
You don’t need to worry as there are still many treatment options. When radical surgery is not feasible, other treatments such as immunotherapy, targeted therapy or interventional therapy can keep liver cancer under control, prolong lifespan and even reduce cancer stage, thereby making patients amenable to surgery and increasing cure rate.
Q3. What are the treatment options for late-stage metastatic liver cancer?
Liver cancer is mostly in late stage if no longer operable. Interventional therapy is considered if the tumour has not spread to other organs, e.g. Yittrium-90 internal radiation therapy and transarterial chemoembolisation. They are all effective in controlling disease progression.
Q4. What is Yittrium-90 (90Y) therapy? Who can receive the treatment? What are the outcomes?
Yittrium-90 (90Y) therapy is a minimally invasive and interventional therapy that directly injects a radioactive isotope yttrium 90Y into the hepatic artery to control liver cancer progression. It is suitable for patients with tumours that are not yet metastatic but inoperable. The treatment is very effective in treating a single tumour or those that have not spread to the other side of the liver with up to 90% efficacy. It can also attain an average survival of two years or longer, and have fewer side effects.
Q5. How is Yittrium-90 (90Y) therapy conducted?
PET scan is first performed to assess the tumour’s biological characteristics and make an initial dose calculation. An interventional assessment of radioactivity is then conducted to calculate the ratio of radiation absorbed by the tumour and confirm the required dose. With medications purchased overseas after assessment, a minimally invasive procedure is performed to directly inject a radioactive isotope into the hepatic artery that supplies blood to the liver. The injected radioactive microspheres then enter the tumour and destroy the cancer cells inside.
Q6. What should patients expect after Yittrium-90 (90Y) therapy?
The side effects of Yittrium-90 (90Y) therapy are minimal. There is no need to make changes in lifestyle after treatment. It also does not compromise one’s immunity. Patients can lead a normal life without isolation and avoiding certain activities or foods.
Check out YouTube videos [1] from HKSH Medical Group for more health information.
