Radioembolization (Y-90) Offers Hope to Patients with Primary Liver Cancer

Riccky Friloux knows overcoming challenges in life takes patience, perseverance and a positive attitude. This mindset helped Friloux, a 67-year-old grandfather, stay strong when faced with circumstances that tested his strength. Friloux, a two-time cancer survivor, beat throat cancer in 2004, and two years ago, he survived primary liver cancer. 

“I felt that something just wasn’t right with my body,” said Friloux. “In July 2020, I went to my primary care physician because I was losing a lot of weight. After running several tests on me, he told me I should see a cardiologist. When I saw my cardiologist, he noticed a suspicious mass in my liver. He referred me to an oncologist at Memorial Hermann. When I met my oncologist, Dr. Anish Meerasahib, I had a biopsy and underwent scans. It didn’t take long for him to confirm that I had primary liver cancer. Since I beat cancer once before, I told my oncologist, ‘I’m ready to fight this again.’” 

Friloux was diagnosed with hepatocellular carcinoma, the most common type of primary liver cancer. He had only two hepatocellular carcinoma lesions on his liver, which made him an ideal candidate for Y-90 radioembolization treatment, a minimally invasive, outpatient procedure that delivers targeted treatment to malignant tumors in the liver. Tiny glass or resin beads filled with the radioactive isotope yttrium-90 are placed inside the blood vessels that feed a tumor. The beads “embolize,” meaning they block the supply of blood to the cancer cells, delivering a high dose of radiation directly to the tumor while sparing healthy liver tissue.

“There are different ways to treat primary liver cancer,” said Rachael Munster, a physician assistant who was a member of Friloux’s care team. “We follow certain criteria to determine the best individualized treatment plan for each patient and work closely with the oncologists. In Friloux’s case, selective Y-90 radioembolization treatment was the best curative approach to treat these two hepatic lesions.”

Dr. Sasidhar Yallampalli, an interventional radiologist, performed Y-90 on Friloux to treat his two lesions separately. Friloux had his first Y-90 treatment in October 2020. He had his second Y-90 treatment one month later. Using X-ray imaging and a contrast material to visualize the blood vessels feeding the two tumors, Yallampalli inserted a catheter in the groin to access the femoral artery to the liver. The radioactive Y-90 beads were fed through the catheter and travelled to the blood vessels that supply the tumor in the liver. Once released at the tumor site, the beads delivered radiation directly to the cancer cells. Patients with primary liver cancer are prone to potentially developing more liver masses, which it is why it is important to continue following up with the interventional radiologist who performs the procedure.

“My Y-90 experience wasn’t bad at all,” said Friloux. “I felt comfortable, and I didn’t feel any pain. They numbed the area before the catheter was inserted, and I was awake during the entire procedure. I didn’t experience any bad side effects. Within the next day or two, I was able to go back to work and resume my normal activities. My last CT scan showed there were no viable tumors on my liver.”

Memorial Hermann has offered Y-90 treatment for several years, and it has been revolutionary for treating patients with primary liver cancer. Unlike standard radiation therapy, Y-90 radioembolization delivers a higher dose of radiation directly to the tumor and produces fewer side effects. No surgical incision is necessary – only a small nick in the skin that doesn’t require stitches. This treatment also attacks the tumor without damaging surrounding healthy tissue. Often, one or two treatments are all that are required versus going through several weeks of traditional radiation therapy. 

“With Y-90, these treatments can extend the lives of these patients and improve their quality of life,” said Munster. “In some cases, it may also allow patients to become a candidate for surgical resection or liver transplantation. Before Y-90 for primary liver cancer, patients relied on systemic therapy such as chemotherapy or immunotherapy, which is usually refractory to such treatments. Even so, immunotherapy and chemotherapy can be given in conjunction with Y-90. We have seen great outcomes with Y-90.”

“I have a lot more living to do,” said Friloux, who completed his Y-90 treatments two years ago. “I have seven grown children – four boys and three girls – and lots of grandchildren that I love spending time and creating memories with. I am grateful for this second chance at life, and I am glad I was a good candidate for Y-90 – it saved my life.”

To learn more about liver cancer and our treatment options at Memorial Hermann, please visit: https://memorialhermann.org/services/conditions/liver-cancer

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Ali Vise