Volume 1, Issue 10
November, 2007
Yttrium 90 Microspheres Education and Support
When The Improbable Is Possible
Welcome to the November YES newsletter! Thanksgiving has
come and gone and the holidays are quickly approaching. 2007
is melting rapidly into 2008. This is the tenth YES newsletter and
here you will find the latest updates in Yttrium 90 Microspheres
treatments as well as hope that you can enjoy throughout the
coming month. Your suggestions for stories, articles, and
questions are greatly appreciated. If you are in need of brochures
and information packets on YES, please let us know by email at
[email protected]
Dwayne Frazier
The Wichita Eagle
Dr. Steven Rose is a fellowship trained radiologist specializing in interventional
radiology at The University of California, San Diego. With great care and
compassion Dr. Rose offers hope to patients with inoperable liver tumors
through technology called selective internal radiation therapy, also known as
SIR-Spheres. SIR-Spheres utilize millions of microscopic beads to help destroy
tumors. Radioactive micro-spheres are inserted directly into the liver artery that
supplies the tumor using X-ray guidance. These tiny microspheres travel via the
blood stream and lodge in the tumors. Once SIR-Spheres are in the tumor, they
irradiate the tumor, leading to the destruction of the tumor. SIR-Spheres deliver
much more radiation directly to the tumor than is possible with conventional
external-beam radiation, and SIR-Spheres leave most of the normal liver tissue
unaffected. The procedure is usually an outpatient treatment performed under
local anesthesia. Though SIR-Spheres are generally not regarded as a cure, they
have been shown to shrink the tumors more than chemotherapy alone. For a
small number of patients, SIR-Spheres can cause significant shrinkage of the
liver tumor, allowing for surgical removal at a later date. Dr. Rose is pleased to
have the ability to provide a patient with advanced liver cancer the possibility of
additional time and quality of life.
Dr. Rose can be reached at (619) 543-7965.
Page 1
John Markham's fight with liver
cancer has its days. There are days
when he energetically hits balls to
his Goddard tennis players in
practice, and there are days when
he doesn't have the energy to leave
the house. He talks excitedly
about this weekend's Class 6A
girl s tennis tournament in
Overland Park, while continuing
to make preparations for hosting
the 6A boys tournament next May.
'It's good to stay busy,' he said. 'I
think that helps me get through
each day.'
Markham said he and his family
have been overwhelmed by
support since he was diagnosed
with his illness last November.
'My wife has been my No. 1
supporter throughout this,'
Markham said. 'But it's really been
amazing to hear from so many
people.'
Continued on Page 6
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Tiny Radioactive Spheres Effectively Treat Cancer That Has
Spread To The Liver
Source: Mayo Clinic
Date: Wed, 31 October 2007
Placing tiny radioactive spheres directly into the liver through its blood supply halted growth of tumors that had spread
to the organ in 71 per cent of patients tested in a small clinical trial, researchers from Mayo Clinic Jacksonville report.
They say that the technique appears to offer a treatment option for patients who develop multiple tumors in their liver
from cancer metastasis.
"Most of these patients don't have other effective treatment options, because surgery is not possible if there are
multiple tumors in their liver," says the study's lead investigator, Laura Vallow, M.D. "But with this radiotherapy, no
new tumors developed in patients who responded and we find this to be very encouraging."
Vallow presented results of the study at the annual meeting of the American Society for Therapeutic Radiation and
Oncology (ASTRO).
She says her report is one of the first to sum up an initial clinical experience with the therapy, known as SIR-Spheres
microspheres, which was approved for use by the federal Food and Drug Administration in 2002. "We are trying to
determine the clinical situations in which it is best to use these microspheres," Vallow says.
The therapy uses millions of tiny polymer beads - each one of which is about one-third the diameter of a human hair which contain the radioactive element yttrium-90. An interventional radiologist uses a catheter to infuse the
microspheres directly into the hepatic artery, which supplies all the blood to the liver. There the beads deliver radiation
directly to tumors for about 11 days.
In this study, data from 20 patient procedures using microspheres at Mayo Clinic Jacksonville were analyzed. The
entire liver was treated in 75 per cent of the cases, and in the remaining 25 per cent, either the left or right lobe of
the liver was selectively targeted. Four weeks after treatment, researchers used CT scans to assess response of
tumors, and found that in 71 per cent, tumors decreased in size. "The tumors were smaller or less active with less
contrast uptake on follow-up CT scans," Vallow says.
The majority of patients had minimal side effects from the treatment, she says. Cancer progressed in two patients and
they died within three months. But for the patients who responded, by the end of a ten-month follow-up period, no
new tumors were detected, Vallow says. "Liver function tests in the responding patients have become normal or have
stabilized."
The researchers say the treatment works best in patients that have good blood flow to their tumors. "Further
evaluation with longer follow-up will help clarify the benefit of this novel treatment," Vallow says.
From Hospice To Sir-Spheres, From Sir-Spheres Back To The Golf Course,
From The Golf Course To A Long Awaited Liver Resection
Sir-Spheres Brings Hope To The Future
Mark Spague
Page 2
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Hope is what life is all about!
Interventional Radiological Approaches to
Improving Outcomes of Selective Internal
Radiation Therapy
L. Bester1; M. Richardson2
1St. Vincent s Public Hospital, Sydney, Australia
2University of New South Wales, Australia
By Tami Thennis
Dreams are renewable. No matter what our
age or condition, there are still untapped
possibilities within us and new beauty waiting
to be born.
Dale E. Turner
The future belongs to people who see
possibilities before they become obvious.
Anonymous
Probable impossibilities are to be preferred to
improbable possibilities.
Aristotle
We all have possibilities we don't know about.
We can do things we don't even dream we can
do.
Dale Carnegie
Every day we live is a priceless gift of God,
loaded with possibilities to learn something
new, to gain fresh insights into His great
truths.
Dale Evans
I am where I am because I believe in all
possibilities.
Whoopi Goldberg
At the height of laughter, the universe is flung
into a kaleidoscope of new possibilities.
Jean Houston
It seems everything is so full of possibilities one
can hardly take it all in.
Kenneth Koch
Our thoughts and imagination are the only
real limits to our possibilities.
Orison Swett Marden
It is reality that awakens possibilities, and
nothing would be more perverse than to deny
it.
Robert Musil
Page 3
Purpose: The ability of liver tumours to preferentially
parasitise hepatic arterial vascularity has created a
vulnerability that Selective Internal Radiation
Therapy (SIRT) can exploit. This form of intraarterial brachytherapy implants radiolabelled
microspheres into hepatic tumours via a femoral
catheter inserted into the hepatic artery. Effective
implantation depends on characterisation of hepatic
arterial anatomy, which is highly variable, and
detection of arteriohepatovenous shunts.
Inappropriate implantation results in potentially lifethreatening complications, e.g. gastric ulceration and
radiation pneumonitis.
Methodology: All patients implanted with SIRT
undergo a hepatic angiogram followed by CTHA and
technetium-99 MAA nuclear scan. Hepatic
angiography allows for characterisation and treatment
of problematic vessels while the MAA scan will detect
arterio-hepatovenous shunts. Following this scrutiny of
the arterial bed, the radiolabelled microspheres can be
implanted.
Results: Diagnostic angiography detected variant
arterial anatomy in 58% of 167 patients treated.
Arterial connections between liver and bowel
identified during workup were occluded by coil
embolisation to prevent inappropriate implantation.
Arterio-hepatovenous shunts occurred in 3% of 167
patients implanted and were treated by occlusion of
the venous outflow with angiographic balloons.
Conclusion: An effective patient work up will serve to
improve the safety and efficiency of SIRT. Aberrant
vessels can be embolised, preventing major
complication while arterio-hepatovenous shunts were
effectively dealt with to prevent inappropriate
targeting of the lungs by the microspheres. Successful
preparation leads to decreased complications and
improved therapeutic outcomes.
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Liver Function Tests
What Is A Liver Function Test?
Liver function tests,sometimes called LFT's, include tests for bilirubin and ammonia. LFTs often include tests to measure levels of several
enzymes, which are special proteins that help the body break down and use other substances. Enzymes that are often measured in LFTs
include GGT, ALT or SGPT, AST or SGOT, and ALP. LFTs may also include prothombin time (PT), a measure of how long it takes for
the blood to clot.
What Does It Determine?
Liver function tests are used to determine if the liver has been damaged or its function impaired. Elevations of certain liver tests in
relation to others aids in that determination. For example, aminotransferases are notably elevated in liver damage caused by liver cell
disease (hepatocellular disease). However, in intrahepatic obstructive disease which may be caused by some drugs or biliary cirrhosis
the alkaline phosphatases are most abnormal.
Alanine aminotransferase (ALT) ,previously called serum glutamate pyruvate transaminase, or SGPT, is an enzyme that is needed for
energy production. It is present in a number of tissues, including the liver, heart, and skeletal muscles, but is found in the highest
concentration in the liver. Because of this, it is used in conjunction with other liver enzymes to detect liver disease, especially hepatitis or
cirrhosis without jauncide. Additionally, in conjunction with the AST, it helps to distinguish between heart damage and liver tissue
damage.
Aspartate aminotransferase (AST), previously called serum glutamic-oxaloacetic transaminase, or SGOT, is another enzyme necessary
for energy production. It, too, may be elevated in liver and heart disease. In liver disease, the AST increase is usually less than the ALT
increase. However, in liver disease caused by alcohol use, the AST increase may be two or three times greater than the ALT increase.
Alkaline phosphatase (ALP) levels usually include two similar enzymes (isoenzymes) that primarily come from the liver and bone and
from the placenta in pregnant women. In some cases, doctors may order a test to differentiate between the alkaline phosphatase that
originates in the liver and the alkaline phosphatase originating in bone. If a person has elevated ALP, does not have bone disease and is
not pregnant, he or she may have a problem with the biliary tract, the system that makes and stores bile. (Bile is made in the liver, then
passes through ducts to the gall bladder, where it is stored.)
Gamma-glutamyl transferase (GGT), sometimes called gamma-glutamyl transpeptidase (GGPT), is an enzyme that is compared with
ALP levels to distinguish between skeletal disease and liver disease. Because GGT is not increased in bone disorders, as is ALP, a normal
GGT with an elevated ALP would indicate bone disease. Conversely, because the GGT is more specifically related to the liver, an
elevated GGT with an elevated ALP would strengthen the diagnosis of liver or bile-duct disease. The GGT has also been used as an
indicator of heavy and chronic alcohol use, but its value in these situations has been questioned recently.
Bilirubin, a breakdown product of hemoglobin, is the predominant pigment in a substance produced by the liver called bile. Excess
bilirubin causes yellowing of body tissues (jaundice). There are two tests for bilirubin: direct-reacting (conjugated) and indirect-reacting
(unconjugated). Distinguishing between the two is important diagnostically, as elevated levels of indirect bilirubin are usually caused by
liver cell dysfunction (e.g. hepatitis), while elevations of direct bilirubin typically result from obstruction either within the liver
(intrahepatic) or a source outside the liver (e.g. gallstones or a tumor blocking the bile ducts).
Ammonia Analysis of blood ammonia aids in the diagnosis of severe liver diseases and helps to monitor the course of these
diseases. Ammonia levels are also helpful in the diagnosis and treatment of hepatic encephalopathy, a serious brain condition caused by
the accumulated toxins that result from liver disease and liver failure.
WHAT DO THE RESULTS MEAN?
Reference ranges vary from laboratory to laboratory and also depend upon the method used. However, normal values are generally
framed by the ranges shown below. Values for enzymes are based upon measurement at 37°C.ALT: 5 35 IU/L. (Values for the elderly
may be slightly higher, and values also may be higher in men and in African-Americans.)
Continued on Page 8
Nell and I can t believe how easy Sir-spheres have been compared to all of her chemotherapy
treatments. Now that all of those have failed her, we have discovered a renewed sense of hope
with these little magic beads when not long ago we believed that hope was all but gone.
~Tom and Nell Mast~
Page 4
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OCULAR MELANOMA LINKS
BREAST CANCER LINKS
ACOR List-serv for Breast Cancer
http://listserv.acor.org/archives/breast-onc.html
Breastcancer.org
www.breastcancer.org
Susan G. Komen Breast Cancer Foundation
www.komen.org
1-888-IM AWARE
Y-ME National Breast Cancer Organization
www.y-me.org
1-800-221-2141 (English)
1-800-986-9505 (Spanish)
CancerLink
http://www.cancerlinks.com/melanoma.html
Mike s Page
http://www.tustison.com/interests1.shtml
Ocu-Mel List Serv
OCU-MEL-subscribe-request@LISTSERV
PANCREATIC CANCER LINKS
ACOR List-serv for Pancreatic Cancer
http://listserv.acor.org/archives/pancreasonc.html
PANCAN
www.pancan.org
1-877-272-6226
CARCINOID LINKS
PROSTATE CANCER LINKS
ACOR List-serv for Carcinoid
http://listserv.acor.org/archives/carcinoid.html
Caring For Carcinoid
www.caringforcarcinoid.org
1-857-222-5492
The Metro New York Carcinoid Support Group
www.carcinoid.us
The Carcinoid Foundation, Inc.
www.carcionid.org
1-888-722-3132
Prostate Cancer Foundation
www.prostatecancerfoundation.org
800-757-CURE
Us Too International Prostate Cancer Education and
Support Network
www.ustoo.org
800-808-7866
COLORECTAL CANCER LINKS
American Cancer Society
www.cancer.org
1-800-ACS-2345
Cancer Care
www.cancercare.org
1-800-813-4673
Lance Armstrong Foundation
www.laf.org
512.236.8820
Patient Advocate Foundation
www.patientadvocate.org
1-800-532-5274
ACOR List-serv for Colorectal Cancer
http://listserv.acor.org/archives/colon.html
Colorectal Cancer Network
www.colorectalcancer.org
800-227-2732
Colorectal Cancer Coalition
www.fightcolorectalcancer.org
National Colorectal Cancer Research Alliance
www.eifoundation.org
818-760-7722
ESOPHAGEAL CANCER LINKS
ACOR List-serv for Esophageal Cancer
http://listserv.acor.org/archives/ec-group.html
Esophageal Cancer Awareness Association
www.ecaware.org
1-866-370-3222
Esophageal Cancer Café
www.eccafe.org
General Resources
MDS Nordion
www.therasphere.com
Sirtex
HEPATOCELLULAR (LIVER) CARCINOMA
www.sirtex.com
About Liver Tumors
www.aboutlivertumors.org
ACOR List-serv
http://listserv.acor.org/archives/liver-onc.html
Page 5
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Y90 Microspheres Education and Support
www.y90support.org
877-937-7478
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Gastroduodenal Injury After
Radioembolization of
Hepatic Tumors
Cristina Carretero, M.D., Miguel MunozNavas, M.D., Ph.D., Maite Betes, M.D., Ph.D.,
Ramon Angos, M.D., Ph.D., Jose C. Subtil,
M.D., Ph.D., Ignacio Fernandez-Urien, M.D.,
Susana De la Riva, M.D., Ph.D., Josu Sola,
M.D., Ph.D., Jose I. Bilbao, M.D., Ph.D.,
Esther de Luis, M.D., and Bruno Sangro,
M.D., Ph.D
Markham Continued
The last few months have been good. Markham is
no longer undergoing the rounds of chemotherapy
that left him sick and weak throughout the spring.
Last month, he underwent a therasphere procedure
in Omaha, which injects radiation directly into the
tumor on his liver.
'My energy is a lot better now,' he said. 'I haven't
missed work, and I'm able to feed more balls at
practice.'
Markham returns to Omaha on Tuesday for a CT
scan, which will reveal the results of the procedure.
(Am J Gastroenterol 2007;102:1 5)
'My ultimate hope is that it (the tumor) is gone,' he
said. 'Realistically, we hope to have the size
reduced for surgery.'
Abstract
One of the best parts of Markham's day is tennis.
It's a sport he has loved most of his life.
BACKGROUND: Radioembolization is a new
tool for the treatment of hepatic tumors that
consists in the injection of biocompatible
microspheres carrying radioisotopes into the
hepatic artery or its branches.
METHODS: We have performed
radioembolization in 78 patients with hepatic
tumors using resin-based microspheres loaded
with yttrium-90. All patients were previously
evaluated to minimize the risk of hazardous
irradiation to nontarget organs and to obtain
the data needed for dose calculation.
RESULTS: We report a complication found in
three cases (3.8%) that consists of abdominal
pain resulting from gastroduodenal lesions and
that had a chronic, insidious course.
Microscopically, microspheres were detected
in the specimens obtained from all affected
gastric areas. Since these gastroduodenal
lesions do not appear when nonradiating
microspheres are injected in animals, lesions
are likely to be due to radiation and not to an
ischemic effect of vascular occlusion by
spheres.
He has coached tennis at Goddard for 23 years,
leading the Lions to state boys titles in 2001 and
2002.
Last year, the school completed construction of its
$700,000 tennis facility, which features 10 courts
and spacious areas for grandstands and lawn
chairs.
Markham, who helped plan the facility, looks
forward to the school's first opportunity to host a
state tournament next spring.
'Along with his faith and family, I think tennis has
been a real salvation for John,' said Dan Buchanan,
who has assisted Markham for seven years. 'We all
need something to keep us going, and I think he
looks forward to that every day.'
Continued on page 7.
CONCLUSIONS: We believe that a
pretreatment evaluation that includes a more
thorough scrutiny of the hepatic
vascularization in search of small collaterals
connecting to the gastroduodenal tract can help
prevent this awkward complication.
Page 6
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make a donation
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Healing Patient Partnerships in
Cancer Care
A web-based listserv for Y90 related support,
questions, and concerns is available for YES
members. The list can be received in either digest or
email form. To sign up, simply write to
[email protected] or call 877-937-7478 for
assistance. Web-messaging is a valuable way to meet
others and discuss experiences.
Markham continued
Earlynn Lauer, a senior tennis player for Goddard,
said Markham's illness has never affected his
attitude.' He's always really positive,' Lauer said.
'Every day, he's trying to pump us up and get us to
do our best. He's been an inspiration to all of us.'
Lauer, a singles player, is one of four Goddard
players Markham is taking to state.
For Markham, the Kansas City trip is an
opportunity to see his son along with watching his
top players compete at state.
'I'm enjoying myself,' he said. 'All you can do is
take one day at a time and count your blessings.
It's a whole lot better than sitting around and
dwelling on the negatives.' He hasn't missed any
school since that time and will have a scan in
January to see how The October scan showed that
it was doing what it was reacting as it should.
TIPS TO CONTROL NAUSEA AND VOMITING:
Smells can contribute to nausea. Some people find that
sliced lemons or lavender can mask other odors. Do
not wear perfumes or strong scented lotions during
treatment.
Walking may help to decrease nausea.
Peppermint, lemon drops, or ginger candies may be
helpful.
If the medications prescribed for you don't relieve your
nausea and vomiting, then make sure that your
treatment team is aware. There are a number of
medications available and it may take time to find the
right combination to relieve your symptoms. Don't give
up.
Page 7
J.K. Reyes, P.S. Gable, J.A. Ellizy, J.I. Dryment,
J.B. Fitzpatrick, T.E. Johnson, A.D. Chan,
S.M. Gharabaghli
Background: Navigating complex health systems
when a patient is well is challenging enough, but
when faced with a diagnosis such as cancer, it is
easy for someone to become overwhelmed. We
identified that many of our cancer patients were not
consistently receiving vital information to make
informed decisions about their care. Clinicians were
often reticent to discuss emotionally charged topics.
Therefore, patients who could benefit from
supportive services were often referred late or not at
all. The communication gap presented opportunities
for improvement in care coordination. We created a
unique 90 minute Cancer 101 course, offered bimonthly, where patients and family received
valuable information from an oncology social
worker, registered nurse, cancer counselor,
registered dietician, and chaplain on a variety of
topics.
Methods: We designed a curriculum of Cancer
101 which introduced various support services that
assisted patients at an appropriate level and a selfreferral form for use after Cancer 101, enabling
the patient to self-identify services needed from a
multitude of professional disciplines.
Results: Since July 2006, over 300 participants
have attended Cancer 101 , resulting in improved
patient and family satisfaction as measured by postclass evaluations; the experience also proved to be
rewarding for members of the health-care team.
Discussion: We wanted to make a difference in our
patients lives. Patients perceive greater control and
are more engaged in their care as a result of this new
partnership with their multidisciplinary health-care
team. We improved coordination of care and
services and thereby the quality of care for our
cancer patients.
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LFT s continued
•
•
•
•
•
•
NEW INTERNATIONAL COLORECTAL CANCER
STUDY USING TARGETED RADIOTHERAPY
ALP: 30 120 IU/LALP is higher in children, older adults and
pregnant females.
GGT: males 2 30 U/L; females 1 24 U/L.
LDH: 0 4 days old: 290 775 U/L; 4 10 days: 545 2000 U/L;
10 days 24 months: 180 430 U/L; 24 months 12 years: 110
295 U/L; 12 60 years: 100 190 U/L; 60 years: >110 210 U/L.
Bilirubin: (Adult, elderly, and child) Total bilirubin: 0.1 1.0
mg/dL; indirect bilirubin: 0.2 0.8 mg/dL; direct bilirubin: 0.0
0.3 mg/dL.
Ammonia: 10 70 micrograms per dL (heparinized plasma).
Normal values for this test vary widely, depending upon the
age of the patient and the type of specimen.
Alblumin: 3.2-5.4 g/L.
ABNORMAL RESULTS
ALT: Values are significantly increased in cases of hepatitis, and
moderately increased in cirrhosis, liver tumors, obstructive jaundice,
and severe burns. Values are mildly increased in pancreatitis, heart
attack, infectious mononucleosis, and shock. Most useful when
compared with ALP levels.
AST: High levels may indicate liver cell damage, hepatitis, heart attack,
heart failure, or gall stones.
ALP: Elevated levels occur in diseases that impair bile formation
(cholestasis). ALP may also be elevated in many other liver disorders,
as well as some lung cancers and Hodgkin's lymphoma. However,
elevated ALP levels may also occur in otherwise healthy people,
especially among older people.
GGT: Increased levels are diagnostic of hepatitis, cirrhosis, liver tumor
or metastasis as well as injury from drugs toxic to the liver. GGT levels
may increase with alcohol ingestion, heart attack, pancreatitis, infectious
mononucleosis, and Reye's syndrome.
LDH: Elevated LDH is seen with heart attack, kidney disease,
hemolysis, viral hepatitis, infectious mononucleosis, Hodgkin's disease,
abdominal and lung cancers, germ cell tumors, progressive muscular
distrophy, and pulmonary embolism. LD is not normally elevated in
cirrhosis.
Bilirubin: Increased indirect or total bilirubin levels can indicate
various serious anemias. Increased direct bilirubin levels can be
diagnostic of bile duct obstruction, gallstones, cirrhosis, or hepatitis
Ammonia: Increased levels are seen in primary liver cell disease,
Reye's syndrome, severe heart failure, hemolytic disease of the
newborn, and hepatic encephalopathy..
Albumin: Albumin levels are increased due to dehydration. They are
decreased due to a decrease in synthesis of the protein which is seen in
severe liver failure and in conditions such as burns or renal disease that
cause loss of albumin from the blood.
Be sure to speak with your treatment team about any abnormal results
and get an informed explanation of how these values reflect the status
of your own health. It is important to have guidance and direction from
your medical care provider.
Page 8
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Doctors anticipate a new international research study into
advanced colorectal cancer will determine the best first-line
treatment to prolong and improve the lives of patients with
disease that has spread to their liver, and may change standard
colorectal cancer treatment practices worldwide
The largest of its kind in the world, the SIRFLOX study has
now started in twelve Australian hospitals and will compare
two of the latest treatments for secondary liver cancer: an
innovative Australian-developed radiation therapy that targets
liver tumours, and three systemic chemotherapy drugs.
The randomised controlled trial will involve hospitals in
Australia, New Zealand, the US and Europe, with patients
accepted into the study until December 2008. It will involve
320 patients, with progression-free survival as the primary endpoint.
The study will be led in Australia by medical oncologists Dr
Guy van Hazel from Mount Hospital, Perth, and Associate
Professor Peter Gibbs from Royal Melbourne Hospital, who
announced the study in Melbourne today at the annual AGITG
Scientific Meeting. (The Australasian Gastro Intestinal Trials
Group (AGITG) is an independent trials group committed to
addressing unanswered clinical questions through clinical trials
research.) In this instance, the SIRFLOX study will be
sponsored and conducted independently by biotechnology
company Sirtex Medical Limited (Sirtex).
Dr van Hazel said the SIRFLOX study was vital because more
than 30 per cent of patients diagnosed with colorectal cancer
each year develop liver metastases1,2, which are usually
inoperable and difficult to treat.
"We're hoping the study will provide definitive evidence of the
best first-line treatment to control patients' liver tumours and
prolong patients' lives by months or even years without
compromising their quality of life," Dr van Hazel said.
"The study is designed to discover whether selective internal
radiation therapy (SIRT) in combination with gold-standard
FOLFOX chemotherapy is more effective than chemotherapy
alone for the one in three colorectal cancer patients who have
inoperable liver tumours."
Assoc Prof Gibbs said the study could have a major impact
worldwide on the treatment of advanced colorectal cancer if
the results demonstrate a significant survival benefit when
patients receive SIRT plus FOLFOX chemotherapy as their
first directed therapy.
1 McLoughlin J et al, Resection of Colorectal Liver
Metastases: Current Perspectives. Cancer Control 2006;
13(1):32-41
2 Australian Institute of Health & Welfare, Australian
Association of Cancer Research; Cancer in Australia 2003 and
Cancer in NSW: Incidence and Mortality 2003.
Continued on page 9
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Study continued
NEWS TO USE
"The first treatment a patient receives often
determines his or her long term prognosis
because tumours can grow quickly and become
resistant over time, particularly with an
aggressive disease like liver cancer," Assoc
Prof Gibbs said.
"The results of this Australian-led study could
see a big leap forward in the treatment of
colorectal cancer that spreads to the liver, and
offer new hope to thousands of people.
"Australia is leading the way in developing an
effective targeted treatment for secondary liver
cancer, which is the ultimate cause of death for
one in three of all cancer patients, particularly
those with colorectal cancer."
Toll Free SURVIVOR Line:
Our toll free Survivor Line provides an outlet for patients and concerned others. It is a
place to access resources, advocacy, and support regarding treatment options with Yttrium
90 based therapies for liver metastases or primary hepatocellular (liver) carcinoma. You
can also receive information on how to become a part of our survivor support program,
"FRIENDS for the Journey."
Call 1-877-937-7478
Assoc Prof Gibbs said only 10-20 per cent of
patients are able to have surgery or ablation
because of the number, size or location of their
liver tumours, however, it is hoped that more
patients will be able to undergo potentially
curative surgery after their tumours are reduced
in size following SIRT treatment.
All patients in the study will receive a
chemotherapy regimen called FOLFOX (folinic
acid, fluorouracil and oxaliplatin), which is the
gold-standard treatment of choice for
secondary liver cancer from primary colorectal
cancer.
Half the patients will also receive selective
internal radiation therapy or SIRT, which is a
targeted internal form of radiotherapy designed
to destroy liver tumours that cannot be
removed by surgery.
Survivor Support Program:
We offer a unique survivor mentoring program called "FRIENDS for the Journey" that
matches survivors, caregivers, family and friends who have experienced treatment with a
Y-90 based procedure. Comparing options is a vital way to maintain a positive
outlook. FRIENDS can communicate via phone, email, snail mail, or in person.
791 Arnold Paul
Canton, Texas 75103
877-937-7478
[email protected]
www.y90support.org
Microscopic radioactive particles are injected
into the bloodstream of the liver, where they
target tumours with a single, high dose of
radiation while sparing healthy tissue.
Using SIRT enables doctors to deliver up to 40
times more radiation to the liver tumours than
conventional radiotherapy, which can only be
applied in small doses to limited areas of the
body and may adversely affect nearby tissues.
For more information, contact Carol Moore at:
[email protected]
© 2007 Yttrium 90 Microspheres Education and Support
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