When a doctor tells you or someone you know has liver cancer and says that surgery is not possible, it's normal to feel a lot of fear and anxiety. You may be wondering, "What do I do now?" However, with the advancements in modern medicine, there are treatments that can bring us great relief and hope even in such cases. Today, we are going to talk about one such special, advanced treatment. That is the Y-90 treatment.
Okay, so what is this Y-90 treatment?
Simply put, Y-90 therapy is a type of radiation therapy that is specifically targeted for liver cancer. "Y-90" here is the short name for the radioactive substance "Yttrium-90".
Think of a cancer tumor as a camp for an evil enemy. The blood vessels that supply blood to that camp are like the roads that carry food and drink to that camp. In this treatment, doctors inject millions of microscopic beads containing a radioactive substance called Y-90, which are so small that they cannot even be seen with the naked eye, into the main blood vessel that supplies blood to the cancer tumor.
These tiny particles travel through the bloodstream and lodge in the tiny blood vessels inside the tumor. Once lodged there, they deliver a high dose of radiation directly to the cancer cells. The best part is that this radiation is focused on a very small area, so there is little or no damage to the healthy liver tissue surrounding the tumor.
The important thing is that Y-90 treatment may not completely cure liver cancer. However, it can shrink tumors , control the disease, and give the patient a better chance of living longer without symptoms and with a good quality of life.
This treatment is known by several other names, for example, ``Transarterial Radioembolization - TARE'' and ``Selective Internal Radiation Therapy - SIRT'', which your doctor may use.
Who is this treatment best suited for?
Your doctor will decide whether this treatment is right for you. Typically, Y-90 treatment is recommended in the following cases:
- For those with cancer that originated in the liver (primary cancer).
- For those who have cancer that has spread to the liver (metastatic cancer) from another location.
- It is also used for some types of bile duct cancer.
This treatment is often considered when surgery is not possible to remove the cancer . Sometimes, the cancer is too close to major blood vessels, and surgery could cause significant damage to the liver. In such cases, Y-90 therapy can control the growth of the cancer and preserve liver function.
Another important thing is that for some people, after the initial Y-90 treatment shrinks the tumor, they may be able to undergo surgery or a liver transplant later. This can be an important step on the path to recovery.
How do you prepare before treatment?
Before treatment, your doctor will carefully examine you to make sure you are physically fit. This usually involves:
- A physical examination
- Blood tests
- Liver function tests
In addition, your doctor will clearly discuss these things with you before treatment:
- Your complete medical history, any allergies you have, and whether you are pregnant.
- What medications you are currently taking and which medications you need to stop taking before treatment.
- You need to arrange for someone to take you home after treatment.
- Before treatment, it is time to stop eating and drinking.
- About the entire process of treatment.
This is the best time to ask the doctor any questions or doubts you may have.
Shall we talk about how the treatment works?
The Y-90 treatment consists of two main steps. These two are usually performed about two weeks apart. This process is led by a specialist physician.
| Steps | What is happening? |
|---|---|
| Step 1: Mapping Angiogram | This is like a rehearsal for the actual treatment. Here, a very small incision is made in your groin or wrist, and a very thin tube (catheter) is inserted through it along the blood vessels that supply blood to the cancer. Then, a special dye is injected, and the blood vessels that supply blood to the cancer are precisely mapped. This is used to choose the exact route to send the Y-90 particles. This can take about 2-4 hours. |
| Step 2: Y-90 Infusion | This is the real treatment. As before, the catheter is inserted, and millions of radioactive Y-90 particles are injected along the mapped path. These particles get stuck inside the tumor and start emitting radiation. This process usually takes an hour or two. 90% of the radiation from these particles is released within 10 days. The particles then remain harmless in the body. |
What are the benefits of Y-90 treatment?
Y-90 therapy has several advantages over traditional radiation therapy (EBRT).
- Targeted therapy: Because the radiation goes directly to the cancer, there is very little damage to healthy tissue. Therefore, there are fewer side effects.
- Minimally invasive: There are no large surgical incisions. It is done through a very small incision, like inserting a needle. Therefore, the healing time is short and there is almost no scarring.
- Quick recovery: You can return to normal life more quickly than with major surgery.
Are there any side effects or risks?
As with any medical treatment, there are potential for minor side effects and very rare complications.
Commonly seen conditions
It is normal to feel tired for a week or two after treatment. Some people may experience a condition called post-embolization syndrome (PES) . This includes:
- Nausea and vomiting
- Appetite
- Stomach pain
- Feeling feverish
These symptoms usually start after about three days and subside within a week. If you experience these symptoms, tell your doctor so that he or she can prescribe the necessary medication.
Rare complications
- Infection: An infection may develop at the site of the catheter insertion. This may require antibiotics.
- Allergies: It's possible to have an allergy to something like the dye used. That's why the doctor will ask about your allergies beforehand.
- Stomach ulcers: Very rarely, this can happen if the Y-90 particles get into the stomach or small intestine. However, this risk is very low because the doctor blocks the blood vessels in those areas during the mapping angiogram.
What should I be careful about after treatment?
Rest well for a few days after treatment. Follow your doctor's instructions carefully, especially any restrictions on driving and exercising.
Another important thing is about radioactivity. Even after you go home from the hospital, a small amount of radiation from the Y-90 particles will be released for a few days. So your doctor may give you some advice like this:
- Avoid sleeping in the same bed with your partner for a few days.
- Avoid sitting close to someone for long periods of time.
- Limit close contact with pregnant women and those with weakened immune systems.
But don't worry. Because Y-90 is a targeted treatment, most of the radiation is absorbed by the cancer itself. So the risk to others from you is very low.
If you have a fever, feel chills, have swelling, redness, or warmth where the catheter was inserted, have severe stomach pain, or numbness in your legs, notify your doctor immediately .
It's normal to feel scared when you think about putting a radioactive substance into your body. However, Y-90 therapy is a very safe and effective treatment for liver cancer. It can also give you the strength to live longer without symptoms of cancer. So, if your doctor recommends this treatment for you, talk to him/her carefully and ask all your questions.
Take-Home Message
- Y-90 is a special treatment method that sends radioactive particles directly to target liver tumors.
- Although this does not cure the cancer completely, it can shrink the tumor, control the disease, extend life, and improve the quality of life.
- This is not a major surgery. Because it is done through a small incision, the recovery time is short and the side effects are minimal.
- It is important to follow the instructions given to protect yourself from radiation for a few days after treatment.
- If you have any questions about this treatment, don't be afraid to ask your doctor.
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