Why Treat the Liver Directly? How Interventional Oncology Targets Cancer Where It Lives

Cancer treatment often brings to mind therapies that travel throughout the entire body: chemotherapy, immunotherapy or medications taken by mouth.

But when cancer is concentrated in the liver, another question becomes possible:

What if we could take treatment directly to the tumor?

That’s one of the ideas behind liver-directed therapy, an important part of modern interventional oncology.

Rather than thinking only about cancer treatment as something delivered throughout the bloodstream, interventional radiologists can sometimes use the liver’s own blood vessels as a pathway to target tumors much more locally.

It’s precise. It’s image-guided. And for carefully selected patients, it can become an important part of a larger cancer treatment plan.

Why the Liver Is Different

The liver has an unusual blood supply.

Most normal liver tissue receives much of its blood through the portal vein.

Many liver tumors, particularly hepatocellular carcinoma (HCC), receive much of their blood supply from branches of the hepatic artery.

That difference creates an opportunity.

An interventional radiologist can navigate a tiny catheter through the arteries and selectively reach the vessels supplying a tumor.

The goal is not simply to “treat the liver.”

It’s to treat the cancer inside the liver as selectively as possible.

The National Cancer Institute describes this arterial blood-supply difference as a fundamental reason embolization works in liver cancer: blocking tumor-feeding arterial branches can deprive the tumor of blood flow while much of the surrounding liver continues receiving blood from the portal circulation.

What Does “Liver-Directed Therapy” Actually Mean?

Liver-directed therapy isn’t one procedure.
It’s a family of treatments that can be used depending on the type of cancer, tumor location, number of tumors, liver function and overall treatment strategy.
Some of the major approaches include:

Bland embolization

With transarterial embolization, an interventional radiologist guides a catheter into arteries supplying the tumor and delivers particles that reduce or block its blood flow.
Tumors need oxygen and nutrients just like every other tissue.
Take away much of that supply, and the cancer cells can be damaged.

Chemoembolization

Transarterial chemoembolization (TACE) combines embolization with chemotherapy.
Instead of simply reducing blood flow, chemotherapy is delivered directly into the tumor’s arterial supply along with materials that slow or block circulation.
That allows a concentrated treatment to be placed at the tumor rather than relying exclusively on chemotherapy circulating throughout the entire body.

Y-90 radioembolization

Radioembolization uses tiny microspheres containing the radioactive isotope yttrium-90, or Y-90.
These microspheres travel through the hepatic artery and lodge in and around tumor blood vessels, delivering radiation from inside the liver.
NCI describes Y-90 radioembolization as a method of placing radioactive microspheres into the arterial supply of liver tumors so radiation can be delivered locally to cancerous tissue.
Different tools. Same basic idea:
Bring treatment to the cancer rather than asking treatment to find the cancer from somewhere else in the body.

469-458-9800

Is Liver-Directed Therapy Only for Primary Liver Cancer?

No.

That’s an important distinction.

Some liver-directed therapies are used for primary liver cancers, meaning the cancer started in the liver.

But cancer from somewhere else in the body can also spread—or metastasize—to the liver.

Depending on the type of cancer and clinical situation, liver-directed treatments may be considered for certain metastatic tumors as well.

NCI, for example, describes embolization and radioembolization as treatments that may be used for tumors that have spread to the liver, including certain neuroendocrine cancers.

This doesn’t mean every liver metastasis should be treated with embolization.

Cancer care is far more individualized than that.

Interventional Oncology Doesn’t Replace the Oncology Team
This may be one of the most important things to understand.

Interventional oncology isn’t about choosing procedures instead of oncology.

It’s about adding another tool to the cancer-treatment toolbox.

A patient’s overall plan may involve some combination of:

• Medical oncology
• Surgical oncology
• Radiation oncology
• Interventional oncology
• Systemic chemotherapy
• Immunotherapy
• Targeted therapies
• Surgery
• Ablation or embolization

For some patients, liver-directed treatment may be used to control tumors that can’t be surgically removed.

For others, it may complement systemic therapy.

In certain situations, local therapy may even be used as part of a strategy intended to make another treatment possible later.

The right approach depends entirely on the cancer and the patient.

Why Precision Matters

The phrase “targeted treatment” gets used a lot in medicine.

With liver-directed therapies, the targeting is physical.

An interventional radiologist uses live imaging to navigate through blood vessels that may be only millimeters wide.

A catheter can be advanced into very specific arterial branches.

That allows treatment to be delivered where it’s needed while working to limit exposure to uninvolved tissue.

And before procedures such as Y-90, detailed mapping may be performed to understand blood flow and plan how treatment will reach the tumor. NCI notes that modern Y-90 planning can include measurements comparing tumor uptake with normal liver tissue to help personalize treatment delivery.

A Different Way to Think About Cancer Treatment

For patients, learning that cancer is in the liver can make everything suddenly feel bigger.
Interventional oncology offers a different way to look at part of that problem.

Sometimes the question isn’t only:
“What medicine treats this cancer?”

It can also be:
“Can we reach this tumor directly?”

That’s where liver-directed therapy becomes such an important part of the discussion.

At MTVIR in Dallas, Dr. Travis Van Meter provides advanced interventional oncology procedures and works as part of the broader cancer-care team to determine when image-guided therapies may be appropriate.
MTVIR is located in The Pyramids at 9101 N Central Expy, Suite 550, Dallas, TX 75225.
Call (469) 458-9800 to learn more about interventional oncology and liver-directed treatment options.

Looking for advanced liver-directed therapy in Dallas?

MTVIR offers a state-of-the-art interventional oncology center in North Dallas, where patients can receive expert consultations and minimally invasive liver-directed treatments in one convenient location.

Find us at:

9101 N Central Expy, Suite 550, Dallas, TX 75225
Call (469) 458-9800
Or contact us here to schedule a consultation.