Tiny beads block the blood vessels supplying the tumour. Selective internal radiation therapy (SIRT) is a novel treatment for liver metastases. It involves millions of very tiny ‘beads’ (microspheres) being injected into the major blood vessel that supplies the liver with oxygen and nutrients. Each bead is small enough to reach the tiny blood vessels in and around the active tumours, where they give out concentrated doses of direct radiation specifically to these tumour cells. The treatment is then active within the liver for about two weeks of continuous treatment.
SIRT is suitable for patients where the liver is either the only site of disease or the major site of disease. There are a number of other factors that have to be considered before it can be offered as a treatment option. Most importantly, your liver needs to be otherwise in good condition and working properly. This is usually determined by simple blood tests. SIRT is not used routinely in the first-line treatment of advanced bowel cancer: chemotherapy and biological therapy are the current treatments of choice.
In June 2013 NHS England agreed to fund 600 NHS patients in England who had failed or were intolerant to chemotherapy to receive selective Internal Radiation Therapy (SIRT) for the treatment of liver metastases from bowel cancer in 10 NHS hospitals in England. The funding was provided through the Commissioning through Evaluation (CtE) process.
NHS England decided to stop funding SIRT at the end of March 2017 with an estimated 400 patients funded. The data will now be assessed to establish whether SIRT should be provided routinely on the NHS – a process that NHS England admits could take up to 12 months or more. This gap in the provision of treatment leaves new NHS patients with no way of accessing promising treatments until NHS England decides that they have assessed the procedure. We believe this decision is unfair to patients and potentially unethical, especially when the procedure is freely available to patients throughout Europe.
If you have been told that SIRT would be a suitable treatment for you but it is not available, please email us.
Selective internal radiation therapy is done in two stages. The first step is to prepare the liver for the treatment and involves having a fine tube (catheter) inserted into a blood vessel in your groin and passed up to the blood vessel which carries blood to the liver.
Tiny beads are infused into a major blood vessel in your groin. You would also receive a small amount of radioactive dye to check the blood flow between your liver and lungs. Vessels in your liver will be blocked to stop the microspheres travelling elsewhere in your body. The second step, usually one to two weeks later, involves receiving the microspheres via a tube in your groin area. This treatment involves staying in hospital for one to four days.
Side-effects of treatment include abdominal pain and / or nausea which will normally ease after a short time with or without medication. You may also develop a mild fever for up to a week, and feel tired for several weeks after having the infusion. You may need to take painkillers or other medicines to prevent or reduce these side-effects.
For more information on SIRT, please click here.