September 27, 2012

Chemotherapy Systemic (whole body)


Systemic chemotherapeutic agents most commonly used are doxorubicin (Adriamycin) and 5-fluorouracil (5 FU). These drugs are used together or in combination with new agents that are experimental. These drugs are highly toxic and the results have been disappointing. Some studies suggest some benefit with tamoxifen (Nolvadex) but studies that showed no benefit
. Octreotide (Sandostatin) is given as an injection is shown in a study of slow progression of liver cancer tumors are large, but so far, no other studies have confirmed these benefits.


Hepatic Arterial Infusion Chemotherapy

Normal liver gets its blood supply from two sources: the portal vein (approximately 70%) and hepatic artery (30%). However, liver cancer gets its blood exclusively from the hepatic artery. Utilizing this fact, investigators have delivered chemotherapy agents selectively through the hepatic artery directly to the tumor. The advantage is that the theoretically-concentrations have higher concentrations of these agents can be delivered to tumors without treating patients in the systemic toxicity of these agents.

In reality, however, many of the chemotherapeutic agents end up on the entire body. Therefore, intra-arterial chemotherapy selectively may cause side effects of systemic (whole body) are common. In addition, this treatment can result in some regional side effects, such as inflammation of the gallbladder (cholecystitis), stomach ulcers and stomach, and inflammation of the pancreas (pancreatitis). Liver cancer patients with advanced cirrhosis may develop liver failure after this treatment. Good and what are the benefits of intra-arterial chemotherapy? The bottom line is that fewer than 50% of patients will experience a reduction in tumor size.
An interventional radiologist (someone who does therapeutic procedures) usually perform this procedure. The radiologist must work closely with an oncologist (cancer specialist), which determines the amount of chemotherapy received by patients at each session. Some patients may undergo repeat sessions at intervals of 6 to 12 weeks. This procedure is performed with the aid of fluoroscopy (a type of x-ray) imaging. A catheter is inserted into the femoral artery in the groin (groin) and threaded / infiltrated into the aorta (main artery of the body). From the aorta, the catheter advanced into the hepatic artery. Once the branches of the hepatic artery that feed the liver cancer were identified, at-infusion chemotherapy. The whole procedure takes one to two hours, and then the catheter is removed.

Patients generally stay in the hospital overnight for observation. A sand bag is placed over the groin area where the thigh to push the catheter is inserted into the femoral artery. The nurses periodically check for signs of bleeding from the femoral artery puncture. They also check the pulse on the revenue side of the foot in the catheter to ensure that the femoral arteries are not blocked as a result of the procedure. Obstacles / barriers will be marked by the absence of a pulse.

Generally, the liver tests increase (worsening) for two to three days after the procedure. Worsening of liver tests is actually caused by the death of tumor cells (and some non-tumorous cells). Patients may experience some abdominal pain and low-grade fever after the procedure. However, abdominal pain and severe nausea suggest that a more serious complication has developed. Liver imaging studies repeated in 6 to 12 weeks to access the tumor size in response to treatment.
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Chemotherapy Systemic (whole body)


Systemic chemotherapeutic agents most commonly used are doxorubicin (Adriamycin) and 5-fluorouracil (5 FU). These drugs are used together or in combination with new agents that are experimental. These drugs are highly toxic and the results have been disappointing. Some studies suggest some benefit with tamoxifen (Nolvadex) but studies that showed no benefit
. Octreotide (Sandostatin) is given as an injection is shown in a study of slow progression of liver cancer tumors are large, but so far, no other studies have confirmed these benefits.


Hepatic Arterial Infusion Chemotherapy

Normal liver gets its blood supply from two sources: the portal vein (approximately 70%) and hepatic artery (30%). However, liver cancer gets its blood exclusively from the hepatic artery. Utilizing this fact, investigators have delivered chemotherapy agents selectively through the hepatic artery directly to the tumor. The advantage is that the theoretically-concentrations have higher concentrations of these agents can be delivered to tumors without treating patients in the systemic toxicity of these agents.

In reality, however, many of the chemotherapeutic agents end up on the entire body. Therefore, intra-arterial chemotherapy selectively may cause side effects of systemic (whole body) are common. In addition, this treatment can result in some regional side effects, such as inflammation of the gallbladder (cholecystitis), stomach ulcers and stomach, and inflammation of the pancreas (pancreatitis). Liver cancer patients with advanced cirrhosis may develop liver failure after this treatment. Good and what are the benefits of intra-arterial chemotherapy? The bottom line is that fewer than 50% of patients will experience a reduction in tumor size.
An interventional radiologist (someone who does therapeutic procedures) usually perform this procedure. The radiologist must work closely with an oncologist (cancer specialist), which determines the amount of chemotherapy received by patients at each session. Some patients may undergo repeat sessions at intervals of 6 to 12 weeks. This procedure is performed with the aid of fluoroscopy (a type of x-ray) imaging. A catheter is inserted into the femoral artery in the groin (groin) and threaded / infiltrated into the aorta (main artery of the body). From the aorta, the catheter advanced into the hepatic artery. Once the branches of the hepatic artery that feed the liver cancer were identified, at-infusion chemotherapy. The whole procedure takes one to two hours, and then the catheter is removed.

Patients generally stay in the hospital overnight for observation. A sand bag is placed over the groin area where the thigh to push the catheter is inserted into the femoral artery. The nurses periodically check for signs of bleeding from the femoral artery puncture. They also check the pulse on the revenue side of the foot in the catheter to ensure that the femoral arteries are not blocked as a result of the procedure. Obstacles / barriers will be marked by the absence of a pulse.

Generally, the liver tests increase (worsening) for two to three days after the procedure. Worsening of liver tests is actually caused by the death of tumor cells (and some non-tumorous cells). Patients may experience some abdominal pain and low-grade fever after the procedure. However, abdominal pain and severe nausea suggest that a more serious complication has developed. Liver imaging studies repeated in 6 to 12 weeks to access the tumor size in response to treatment.