Liver cancer is a serious and challenging disease that affects millions of people worldwide. Among the various treatment options available, Transarterial Radioembolization (TARE), also known as Selective Internal Radiation Therapy (SIRT), has emerged as a promising intervention for managing certain types of liver cancer. TARE involves the targeted delivery of radioactive microspheres into the tumour-feeding blood vessels, effectively delivering radiation directly to the cancerous cells while minimising damage to healthy liver tissue. This article provides an in-depth review of TARE, including its symptoms, causes, diagnosis, treatment, cost in India, and concludes with an assessment of its potential impact on liver cancer patients.
Symptoms of Liver Cancer:
Liver cancer, particularly hepatocellular carcinoma (HCC), often presents with nonspecific symptoms, especially in the early stages, making it challenging to diagnose. Some common symptoms of liver cancer include:
1. Persistent Abdominal Pain: Patients may experience continuous pain or discomfort in the upper right abdomen, caused by the growing tumour and its effect on surrounding tissues.
2. Unexplained Weight Loss: Rapid and unintentional weight loss may occur due to the metabolic changes caused by the cancer.
3. Loss of Appetite: Liver cancer can lead to a decreased appetite, causing patients to eat less than usual.
4. Fatigue: Persistent tiredness and a lack of energy are common in liver cancer patients, as the disease progresses.
5. Jaundice: Yellowing of the skin and eyes (jaundice) may occur due to the tumour obstructing the bile ducts and affecting liver function.
6. Palpable Mass in the Abdomen: In advanced stages, a palpable mass or enlargement of the liver can be felt during a physical examination.
Causes and Risk Factors:
The development of liver cancer is often associated with chronic liver damage. Several risk factors contribute to the onset of liver cancer, including:
1. Chronic Viral Infections: Chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) is one of the primary risk factors for liver cancer.
2. Cirrhosis: Cirrhosis, a condition characterised by scarring of the liver due to various causes, increases the risk of liver cancer.
3. Chronic Alcohol Consumption: Long-term alcohol abuse can lead to liver damage and an increased likelihood of liver cancer.
4. Non-Alcoholic Fatty Liver Disease (NAFLD): Accumulation of fat in the liver in the absence of alcohol consumption can progress to NAFLD, a risk factor for liver cancer.
5. Exposure to Aflatoxins: Aflatoxins are harmful substances produced by certain molds found in contaminated food products. Long-term exposure can increase the risk of liver cancer.
6. Genetic Factors: Inherited conditions such as hemochromatosis and Wilson's disease can also elevate the risk of liver cancer.
Diagnosis of Liver Cancer:
Early diagnosis of liver cancer is crucial for successful treatment. The diagnostic process typically involves the following steps:
1. Medical History and Physical Examination: The healthcare provider reviews the patient's medical history, including risk factors, and conducts a physical examination to assess any signs or symptoms of liver cancer.
2. Blood Tests: Blood tests, including alpha-fetoprotein (AFP) levels, liver function tests, and other tumour markers, are performed to assess liver health and detect any abnormalities associated with liver cancer.
3. Imaging Studies: Advanced imaging techniques such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans help visualise the liver and detect any suspicious masses or lesions.
4. Liver Biopsy: If a tumour is suspected, a liver biopsy may be performed to confirm the diagnosis and determine the type and stage of liver cancer.
Treatment Options and TARE Procedure: The choice of treatment for liver cancer depends on various factors, including the type and stage of cancer, the extent of tumour involvement, and the patient's overall health. TARE is primarily used in cases where surgical resection is not feasible or when the tumour is unrespectable. The TARE procedure involves the following steps:
1. Pre-Procedure Evaluation: Before undergoing TARE, patients undergo a thorough evaluation to assess their overall health, liver function, and suitability for the procedure. This includes imaging studies, blood tests, and other diagnostic tests.
2. Angiography and Microsphere Delivery: The TARE procedure is performed by interventional radiologists in a specialised angiography suite. A catheter is inserted through the patient's groyne or wrist and navigated to the blood vessels supplying the liver tumour. Radioactive microspheres, containing either yttrium-90 or holmium-166, are then precisely delivered through the catheter and into the tumour's blood vessels.
3. Targeted Radiation: Once in place, the radioactive microspheres lodge in the tumour's vasculature and emit targeted radiation to destroy the cancer cells. The radiation is delivered over a specific period, effectively treating the tumour while sparing healthy liver tissue.
4. Post-Procedure Care: After the TARE procedure, patients are closely monitored by their medical team to manage any potential side effects and ensure the best possible recovery.
TARE Treatment Cost in India:
The cost of Transarterial Radioembolization (TARE) in India can vary depending on several factors, such as the hospital's reputation, location, the experience of the medical team, and the specific type of radioactive microspheres used. On average, the cost of a single TARE procedure in India can range from XXXX to XXXX rupees. It is essential for patients to discuss the treatment's overall cost with their healthcare provider, as it may include pre-procedure evaluations, follow-up visits, and post-procedure care.
Transarterial Radioembolization (TARE) has emerged as a promising treatment option for managing liver cancer, particularly hepatocellular carcinoma (HCC) and metastatic liver tumours. By delivering targeted radiation directly to the tumour site, TARE offers a minimally invasive and effective approach to treat unrespectable tumours and improve patient outcomes. However, like any medical intervention, TARE requires careful patient selection, thorough evaluation, and comprehensive treatment planning to achieve optimal results. As research and technology continue to advance, TARE's role in liver cancer management will likely expand, further improving the quality of life and prognosis for liver cancer patients in India and beyond.
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