Y-90 Treatment Provides Option for Cancer Patients
Thomas Souders of Fleetwood treasures every moment he gets with his beloved, 18-month-old granddaughter, Regan Lynn. Without the team of health care providers at Penn State Health St. Joseph that has been treating him for cancer since 2013, Souders fears he would have never had the opportunity to know her.
“I don’t think anybody expected me to be around for this long, but thank God I am,” Souders said. “Being with my granddaughter is just awesome. It’s a really good thing.”
Souders, who after experiencing severe abdominal pain was diagnosed with a type of pancreatic cancer that had spread to his liver, will hopefully have much more time with Regan.
He recently became the first patient at St. Joseph to receive a promising treatment for patients suffering from liver cancer.
The treatment, called Selective Internal Radiation Therapy, or SIRT, targets tumors in the liver with precise, high doses of radiation while sparing as much normal tissue as possible.
Radiation is delivered with Yttriun-90 (Y-90) microspheres that are delivered through tiny catheters threaded through a patient’s arteries.
“It’s a very exciting treatment because it’s proven safe and it increases the amount of time that patients are without liver disease,” said Dr. Navesh K. Sharma, a Board Certified radiation oncologist who recently joined Penn State Health St. Joseph.
Sharma is nationally and internationally recognized as an expert in liver-directed radiation therapy, and was the principal U.S. investigator of a recent trial to test the effects of SIRT. He came to Penn State St. Joseph in September from the University of Maryland, a National Cancer Institute-designated cancer center that was the first in the country to offer the treatment. Sharma said it can provide hope for patients with advanced liver disease because it specifically targets tumors while sparing the rest of the liver from damage from radiation.
“In the majority of cases it will shrink, and in some cases completely eliminate the tumor,” Sharma said. He works with medical oncologists, interventional radiologists and others to treat patients who are candidates for this innovative treatment. Souders was referred to Sharma by Dr. Marc A. Rovito, a Board Certified medical oncologist at St. Joseph who has been treating Souders since his diagnosis.
The patient was having trouble tolerating an oral cancer drug he had been taking for several years, and Rovito was looking for another option. “The medicine was effective for him, but long durations of these drugs can have toxicity,” Rovito explained. “This treatment allows us to get him off that drug, which will improve his quality of life.”
Once it was determined that Souders was a candidate for the Y-90 treatment, Sharma worked with Dr. Kartik Shah, an interventional radiologist, to get imaging that let them examine the blood flow to the tumor and determine how much radiation to administer.
“No two patients are alike,” Shah explained. “We have to look closely at this imaging ahead of time so we know what we’re looking at.” On the day of the procedure, a catheter was inserted in the patient’s groin, through which the radiation was delivered to the tumor. Shah and Sharma work together to make sure the catheter is precisely placed, and the spheres delivered directly to the tumor. “The thing is, you’ve got two people doing their thing in concert,” Rovito observed. “It truly is a team effort.”
The treatment, which has been shown to reduce the risk of continued growth of a tumor in the liver by more than 30 percent, often is used to treat patients with colorectal cancer that has spread to the liver. Colorectal cancer is the third most common cancer in the United States and, if not found early, tends to spread to the liver.
The Y-90 procedure is done on an out-patient basis, and can be administered in conjunction with chemotherapy. Unlike some other cancer treatments, it does not have to be repeated.
Souder has undergone treatment for the right lobe of his liver and is scheduled for an additional treatment that will address the left lobe. The results of the treatment should be long lasting, and side effects, which include fatigue, flu-like symptoms and abdominal pain, usually last for only one to two weeks.
“I was pretty tired and needed to rest a lot for a week or two, but I’m feeling better now,” Souders reported. He praised his healthcare providers and expressed gratitude for an option to his former treatment.
“I knew the pill wasn’t going to work for me forever,” Souders said. “To have Dr. Rovito explain the Y-90 treatment to me, and then work with Dr. Sharma and Dr. Shah to get it set up was amazing. All the doctors and nurses at St. Joe’s are so caring. They’re just great.” While the procedure is not for every patient who has liver cancer, it is an important and exciting treatment with definite benefits for some.
“This is not a treatment for everyone, but there are many people who could benefit from it who don’t even know about it,” Sharma said. “We want to get the word out to patients, family members and other physicians that this treatment is available now at Penn State St. Joseph.” Meanwhile, Souders will take one day at a time, delighting in watching Regan grow up.
“She gives me a reason to want to go on,” he said. “I intend to be around when she brings home her first boyfriend so that I can set him straight.”