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Interventional Radiology: TheraSphere® A Radiation Treatment Option for Liver Cancer (6428)

Interventional Radiology: TheraSphere® A Radiation Treatment Option for Liver Cancer (6428) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Radiology - Invasive Procedures

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TheraSphere®
A Radiation Treatment Option for Liver Cancer

TheraSphere® (radioembolization) is a
treatment which is done in the Interventional
Radiology Department. If you have more
questions after reading this handout, call us
at (608) 263-9729, press 3 between 8:00am
-4:00pm, Monday through Friday.

What is a TheraSphere®
(radioembolization) treatment?

TheraSphere® is an outpatient radiation
treatment for unresectable hepatocellular
carcinoma, metastatic liver cancer, and
cholangiocarcinoma. This treatment is FDA
approved as a “Humanitarian Use Device”.
This means that your treatment will include
reviewing and signing a special consent
form and being included on a confidential
patient registry. Therasphere treatment is
safe and offers a likely benefit to patients
who are good candidates for the treatment.

The treatment involves injecting a large
number of tiny radioactive glass beads
(TheraSpheres®) into the liver arteries (the
blood vessels that bring oxygen to the liver).
The TheraSpheres® travel through the blood
vessels until they lodge into the smaller
blood vessels of the liver tumor. The beads
stay there and give off radiation that
destroys the cancer cells with little injury to
the healthy liver. After a few days, the
beads lose their radioactivity.

Who can get TheraSphere® treatment?

Patients who have your type of cancer that
cannot be removed with surgery, may be
able to receive this treatment. Your doctor,
the Interventional Radiology staff, and the
Radiation Oncology staff will review your
health history, recent scans, and your blood
work. They will meet with you in clinic
ahead of time to assess whether you are able
to endure the treatment. Also, to make sure
that you are a good candidate, 2 screening
tests need to be done before the treatment.

1. A mapping angiogram of the liver is a
test where x-ray dye is injected into the
liver blood vessels to see how the blood
flows through the liver. This test will
provide a “road map” to help plan for the
TheraSphere® treatment. Also, smaller
blood vessels may be found that could
carry some of the radioactive beads
away from the liver to your stomach and
intestine. These small blood vessels
may need to be plugged up (embolized)
to prevent the beads from going to your
stomach and intestine. If TheraSphere®
glass beads were to go to your stomach
or intestine, bleeding or an ulcer may
occur.

Before the angiogram, you will receive
IV pain medicine and a sedative. An
artery in your wrist or in your groin will
be chosen as the best artery to go into.
The area over the artery will be number
with lidocaine. Then, a small tube will
be placed in your artery and guided to
your liver blood vessels. Dye for an x-
ray is injected into the liver blood
vessels and pictures are taken. Small
blood vessels that go to the stomach or

bowel will be embolized. Your stomach
and intestines get blood from many other
blood vessels, so in most cases, it is not
a problem to block these small blood
vessels. After this test is complete, the
tube in your artery will be removed.
You will need to lie flat for 2-6 hours to
allow the artery puncture site to seal up.
You will not be able to drive or do heavy
lifting for 24 hours after this test. You
will be given additional instructions by
the nurse.

2. While you recover from the angiogram
of your liver, an MAA scan will be
done. This is also called a lung shunting
scan. This scan shows how much blood
flows around the liver tumors and to
your lungs. The amount of shunting will
determine whether you are a candidate
for TheraSphere® treatment. You will
be placed under a scanner for ½ hour.
After this test you will be taken to the
recovery area until you are ready to go
home.

If these tests show that it is safe for you to
have TheraSphere® treatment, you will be
set up for the first treatment within the next
few weeks. The first treatment will treat
liver tumors on one side of your liver. You
may need a second treatment if you also
have tumors on the other side of you liver or
if your tumor is getting blood supply from
multiple areas. Your treatment team will
review this with you.

What can I expect during the
TheraSphere® treatment?

Getting ready is the same as for the
angiogram test. An IV will be placed in
your hand or arm to be used for IV pain and
sedative medicine. The Interventional
Radiologist will place a small tube into your
groin or wrist artery. The Interventional
Radiologist will place a small tube into your
groin or wrist artery and guided to your liver
blood vessels. The Interventional
Radiologist will use the mapping angiogram
as a guide to place the tube in the correct
vessels to direct the treatment to the
tumor(s) in the liver. X-ray dye is used to
make sure the tube is in the correct place.
Then the Radiologist will inject the
TheraSphere® beads. Once this is done, the
tube will be removed from the artery, and
you will be sent to the recovery area.

You will need to lie flat for 2-6 hours to
make sure your artery puncture site seals up.
You will not be able to drive or do heavy
lifting for 24 hours. You will be allowed to
go home if you live within about 2 hours of
Madison. If you live further than 2 hours
away we will help you arrange a hotel room
for you to stay that night. The next morning
you will come to see us in clinic. Prior to
that visit, you will undergo a brief scan to
assess the location of the radioactive
particles. After this scan you will go to the

Interventional Radiology Clinic for a final
check before you go home.

What side effects can I expect after the
TheraSphere® treatment?

For 2-3 weeks after TheraSphere®
treatment, most patients feel tired, have a
decreased appetite, and may have a low
grade fever. Rarely, patients have mild pain
for a short time. If you are having pain you
will be given pain medicine to control this.

When will I receive my next treatment?

If you need an additional treatment it will be
scheduled for 4-8 weeks after your first
treatment. We’ll want to be sure that you
are not too tired and that your liver function
tests are good. Most of the time, it is not
necessary to repeat the “mapping
angiogram” before your next treatment.

How can TheraSphere® treatment help
me?

Since each patient is different, it is hard to
predict how much you may be helped by
TheraSphere® treatment. It depends on the
size, number and location of your tumors.
We will review that with you when we meet
you in our clinic prior to the treatment. It
has been found to be most helpful to patients
who are good candidates for the treatment.
Home Care After TheraSphere®

Please look at the list below to avoid
problems after your procedure.

Diet:
ξ Drink plenty of fluids - Drink at
least eight-8 oz glasses of water,
juice, or soda over the next 24 hours
after treatment.
ξ You may eat whatever you like.
Patients often tolerate smaller
amounts of food eaten more often
during the first few days after
treatment.
ξ Do not drink any alcoholic beverages
for 4 weeks after your SIRT
treatment. This will give your liver
the best chance of healing.

Medicine:
ξ You may restart your scheduled
medicine as prescribed.
ξ You may already be on an anti-ulcer
medicine or have been prescribed
medicine for this as part of the
procedure. Be sure to take this
medicine for 4 weeks after the
procedure.

Site Care:
ξ You may remove the dressing over
the artery after 24 hours.
ξ Do not take a hot bath or shower for
at least 24 hours.
ξ Look at the puncture site daily for 5
days.

Activity: No strenuous physical activity
of any kind.
ξ Do not bend the leg that was used for
the procedure more than needed for
the next 24 hours after procedure.
ξ Do not lift greater than 10 pounds for
48 hours.
ξ Avoid sports, heavy cleaning, and
stair climbing for 48 hours.
ξ No driving for 24 hours, or while
taking pain medicine.

Radiation Precautions:
ξ The spheres used for this procedure
contain a radioactive substance that
takes time to become inactive. This
means that for 3 days (72 hours)
after your procedure, other people
that you are around may be exposed

to radiation from your body. Please
follow these simple guidelines:

1. NO VISITORS WHO ARE
PREGNANT.
2. NO PHYSICAL CONTACT OR
EXTENDED TRAVEL WITH
OTHERS FOR LONGER THAN 2
HOURS.
3. SLEEP IN BED ALONE.
4. DO NOT ALLOW CHILDREN OR
PETS TO SIT ON YOUR LAP.
5. THERE IS NO NEED TO MAKE
SPECIAL PLANS FOR HANDLING
BODILY FLUIDS SUCH AS URINE,
STOOL, BLOOD, OR VOMIT.

ξ If you seek medical care somewhere
else within 3 months of treatment,
please inform your provider that you
have undergone treatment with a
radioactive substance. In addition,
we suggest that you not undergo an
open abdominal surgery within 3
months after treatment.





When to Call the Doctor

ξ You notice redness, swelling, or
drainage at the groin site. Some
bruising at the puncture site is
normal and will go away in a couple
days.
ξ You feel increased pain, numbness,
coolness, or see blue bruising of the
leg or hand where the puncture site is
located.
ξ You have stomach pain that gets
worse over time.
ξ You notice bleeding at the puncture
site. Put pressure on the site to stop
the bleeding and then call the phone
number below.
ξ You have nausea and vomiting that
that you cannot control by medicine
or lasts for more than 24 hours.
ξ You may have a fever for the first
several days after the procedure.
This can be relieved by taking
acetaminophen (Tylenol ) 325 mg,
1-2 tablets every 4 hours; or,
ibuprofen (Advil ) 200mg, 1-2
tablets, every 6 hours. Call if fever
is more than 101 θF for two readings
taken 4 hours apart

Phone Numbers
Interventional Radiology Department: Mon-Fri. 8:00 am-4:00 pm. (608) 263-9729, prompt 3 or
1-800-323-8924.
After hours, weekends and holidays, this number will give you the hospital paging operator. Ask
for Interventional Radiology Resident on call. Give your name and phone number with the area
code. The doctor will call you back.




Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright 6/2017. University of Wisconsin Hospitals and
Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6428