Y-90: Innovation in Cancer Treatment

In Newsletter, Statler, Volume 10 Issue 1 by Addison Clark

In collaboration with Mary Washington Healthcare, Hematology Oncology Associates of Fredericksburg, Northern Virginia Hematology & Oncology Associates, and Virginia Oncology Care, PC, Radiologic Associates of Fredericksburg is pleased to be involved with the latest services in the treatment of cancer performed by physicians from Virginia Interventional and Vascular Associates (VIVA). The outpatient Interventional Radiology services at Mary Washington Hospital will now include radioembolization, known as Y-90 therapy. Only fifteen years ago, this treatment was not readily available. Now, the Board Certified, Fellowship Trained Physicians of Radiologic Associates of Fredericksburg (RAF) offer this important service for our region.

According to Dr. John D. Statler, Interventional Radiologist at Radiologic Associates of Fredericksburg, “Embolization represents an entirely different way of delivering therapy. Rather than focusing radiation from an external source, the Interventional Radiologist treats the tumor by inserting radioactive beads inside the body, through the hepatic artery. In the past, patients needed to be admitted to the hospital. This procedure, performed at Mary Washington Hospital, will be provided on an outpatient basis.”

Radioembolization combines embolization and radiation therapy to treat both primary liver tumors and tumors metastatic to the liver. Radioactive isotope yttrium Y-90, encapsulated in resin beads called “microspheres”, is delivered through the hepatic artery directly into the blood flow leading to the tumor. Healthy tissue is spared as localized; high-dose radiation is released directly into the tumor. Radioembolization offers a direct and effective approach for patients with inoperable liver tumors, improving their long-term survival rates and quality of life compared with supportive care. The destruction of tumor cells and shrinking that may occur through Y-90 therapy can provide successful treatment of previously untreatable tumors.

“Radioembolization is a safe, effective, minimally invasive procedure that has much fewer side effects than the traditional treatments,” said Dr. Statler.

Ranging from 20 to 60 microns in diameter, the microspheres of Y-90 are smaller than the width of a human hair. Through clinical collaboration, the Interventional Radiologist introduces an appropriate number of microspheres into the tumor’s blood supply. Once inserted, the encapsulated radiation is carried directly to the blood vessels within and around the tumor. The physical properties of Y-90 allow it to treat the targeted tumor while sparing normal surrounding liver tissue.

Traditional methods of external beam radiation therapy have been unsuccessful in the treatment of liver tumors. Delivering an external dose of radiation sufficient to treat a liver tumor would often result in unacceptable damage to the liver itself. In contrast, radioembolization maximizes tumor dose while minimizing collateral damage. Y-90 microspheres are “bioinert”, and have no systemic effect.

The majority of the radiation dose is delivered within the first ten days following implantation, with all radiation decayed by four weeks. Treated patients have minimal limitations on their daily activities and minimal restrictions on close contact with loved ones. Common side effects include nausea, fever, and upper abdominal pain, all of which are self-limited and easily treated with medication. Y-90 radioembolization is an exciting therapy for the treatment of certain kinds of liver cancer. VIVA physicians are proud to offer this therapy to our community.