Understanding Yttrium 90 Radioembolization (2024)

Yttrium 90 (Y90) radioembolization is a minimally invasive treatment for cancer in the liver. It can be used for cancer that starts in the liver (hepatocellular carcinoma). And it can be used for cancer that has spread to the liver from another part of the body (liver metastases).

This treatment is often done when other treatments for liver cancer aren’t an option. For example, your tumor may be too big to take out with surgery. Or you may not be able to have a liver transplant.

Y90 radioembolization does not cure liver cancer. But it may ease your symptoms or slow the growth of the cancer.

How to say it

IH-tree-ehm

NYN-tee

RAY-dee-oh-ehm-boh-lih-ZAY-shuhn

How is Y90 radioembolization done?

It combines embolization and radiation therapy. Embolization is when a blood vessel is blocked to stop blood flow. Radiation therapy uses beams of high-energy X-rays or other particles to kill cancer cells and shrink tumors. Radioembolization is a type of internal radiation therapy. That means the radiation source is put inside your body.

How does it work?

This treatment uses the radioactive isotope Y90 to kill cancer cells. Small beads (microspheres) with Y90 in them are put through a catheter into the hepatic artery. This is one of the liver's main blood vessels. Tumors in the liver get much of their blood supply from the hepatic artery.

The beads do 2 things. First, they block blood flow to the tumor. This starves it of the oxygen and nutrients it needs to grow. They also send cancer-killing doses of radiation directly to the cancer cells over a couple of weeks. Because the liver has 2 main blood vessels, the healthy liver cells can live off the unblocked vessel (portal vein).

Risks of Y90 radioembolization

  • Infection
  • Blood clots
  • Allergic reaction to the contrast dye
  • Stomach ulcer
  • Liver damage or failure

Getting ready for treatment

Before you have this treatment, you will need blood tests and an angiogram. An angiogram is a type of imaging test. X-ray visible dye is injected into the bloodstream. Your healthcare provider can then see the condition of the blood vessels sending blood to your liver.

Your healthcare provider may tell you to not eat or drink for some time before Y90 radioembolization.

Tell your healthcare provider:

  • All prescription and over-the-counter medicines you take
  • All vitamins and herbal supplements you take
  • If you have any allergies
  • If you may be pregnant or are breastfeeding

You may have to stop taking certain medicines before the procedure.

Talk with your provider if you have any questions or concerns.

On the day of treatment

Y90 radioembolization is often done in a hospital outpatient setting. An interventional radiologist will do the procedure. It takes about 1 hour. During the treatment:

  • You will be given a hospital gown to wear. You will lie down on your back on a table. You will be given medicine through an intravenous line (IV) in your hand or arm. It will help you relax and not feel pain.
  • A special contrast dye will be put into your blood. X-ray images are taken and sent to a video screen. The images help the healthcare provider see your blood vessels during the treatment.
  • The healthcare provider will clean the area of skin and numb it with a local anesthetic. They will make a small cut (incision) in your inner thigh to reach a blood vessel. They will then put a thin, flexible tube (catheter) into the blood vessel.
  • Using the images on the video screen, the healthcare provider will move the catheter up the blood vessel to the hepatic artery.
  • Once there, the healthcare provider will use the catheter to place the radioactive Y90 beads near the tumor. The beads will start to give off a steady dose of radiation into nearby tissue.
  • The healthcare provider will take out the catheter. They will put pressure on the spot to stop any bleeding. They will cover the small cut in your thigh with a bandage. Your IV will be taken out before you go home.

After treatment

After the treatment, you will stay in the hospital for a few hours. You will likely not have to stay overnight. Plan to have an adult there to drive you home. Ask how to take care of the incision site and change the bandage.

Once you are home, you may have nausea, vomiting, a slight fever, and belly (abdominal) pain. You may also feel very tired. Ask your healthcare team how to manage these symptoms. Also ask when to call if your symptoms don't get better or get worse.

It may take several weeks to fully recover. Ask your healthcare provider when you can go back to your normal activities.

It takes about 30 days for the radiation to clear from your body. During the first week, you should limit your contact with other people. Talk with your healthcare provider about steps you need to take to protect others from the radiation. This may mean limiting close contact with children and pregnant people and not sharing a bed with a partner.

Make sure you go to all follow-up visits with your healthcare provider. You will have other tests to see how the cancer has reacted to the treatment. The beads will be left in place to block the blood supply to the cancer. They will not cause any problems.

Understanding Yttrium 90 Radioembolization (2024)

FAQs

How long can you live with Y-90 with liver cancer? ›

In the SARAH trial , half the people who received Y90 radioembolization with locally advanced or intermediate stage liver cancer after unsuccessful treatment with TACE survived at least 8 months. Half of those who received sorafenib lived for 9.9 months.

How effective is Y-90 radioembolization? ›

After the Y90 radioembolization, 9 of 32 (28.1%) patients received subsequent surgery including LT and surgical resection with 2-year OS, 1-year and 2-year disease-free survival being 100%, 96.9% and 93.8%, respectively (median follow-up time 20.6 months).

Can Y-90 cause liver damage? ›

In patients receiving gemcitabine, Y90 can lead to radioembolization-induced liver disease.

What is Yttrium-90 radioembolization? ›

Yttrium-90 radioembolization

This therapy is used to treat both primary and metastatic liver tumors. This treatment involves injection of plastic or glass microspheres incorporating the radioactive isotope Yttrium-90 directly into the tumor.

What is the longest someone has survived liver cancer? ›

The longest patient survived 43 years and 2 months. Five young patients got married after resection and have had babies. One patient with a tumor measuring 17 x 13 x 9 cm (the largest tumor) survived for 37 years after resection, still alive, free of disease.

Can you be around people after Y90 treatment? ›

After treatment with Y-90 radioactive material, you will emit a small amount of radiation. These levels are quite low. After treatment, you have no special precautions to follow to limit exposing other people to radiation. It is safe for people to be around you.

Is Y-90 better than chemoembolization? ›

Radioembolization (Y-90) is very similar to chemoembolization but uses radioactive microspheres which are tiny beads instead of chemotherapy drugs as the payload to kill cancer cells.

Can Y-90 be curative? ›

The treatment is not a cure for cancer in the liver, but it has been shown to prolong lives for months or years and to greatly improve the quality of life of cancer patients. Patients experience few, if any, side effects from Y90 treatment, which is performed in an outpatient setting.

What to expect after Y-90 treatment? ›

What can I expect after the procedure?
  1. Fatigue that lasts for several weeks after treatment.
  2. A low fever (less than 100.4°F or 38.0°C) for a week after treatment.
  3. Nausea, vomiting, and loss of appetite.
  4. Pain from the blood supply being cut off to the area.
Jul 3, 2023

How long does Y90 fatigue last? ›

Overall the treatment is very well tolerated with minimal side effects. The most common side effect is fatigue, which can last two to four weeks.

Is Y90 painful? ›

Radioembolization is generally painless; however, some patients may experience brief pain when the microspheres are injected.

What precautions should be taken during Y90 radioembolization? ›

Patient precautions and side-effects
  • Contact with others is limited over the week as the radiation diminishes.
  • Patients shouldn't sleep in the same bed as a partner over that week.
  • Patients should avoid public transport that requires them to sit next to another person for more than two hours.
Oct 31, 2019

How long is life expectancy with Y90 treatment? ›

While the patients treated with Y-90 radioembolization with chemotherapy, ranged from 43%-74% (about 29 months survival expectancy); in comparison to patients having received a traditional form of treatment.

How do I know if my Y90 is working? ›

Once the catheter reaches your liver, Dr. Christenson will take pictures with x-ray to see how the blood flows to your liver. Based on how the blood flows, Dr. Christenson will be able to tell if Y-90 Radiotherapy will work for you or not.

How long does Y90 mapping take? ›

Each procedure (mapping angiogram and Y90 treatment) can take 2–5 hours. It depends on how many tumors are being treated and where they are.

How long can an elderly person live with liver cancer? ›

Around 35 out of 100 people (around 35%) with stage 2 liver cancer will survive their cancer for 4 years or more after they're diagnosed. More than 10 out of 100 people (more than 10%) with stage 3 liver cancer will survive their cancer for 4 years or more after they're diagnosed.

Can a person survive with 90 percent liver damage? ›

If you have end-stage liver disease, your lifespan will be about 2 years, unless you get a liver transplant. Once your liver starts to shut down (liver failure), you can only live for a day or two.

What is the survival benefit of Y90? ›

Patients with CP class A (85%) had a median progression-free survival (PFS) of 3 months (95% CI: 2.99–5.55) and median OS of 17 months (95% CI: 9.59–23.10) from date of Y90 treatment compared to a median PFS of 4 months (95% CI: 2.07–8.28) and OS of 8 months (95% CI: 4.60–15.64) for patients with CP class B.

What is life expectancy when cancer spreads to liver? ›

Overall, the 5-year survival rate for liver cancer is about 17%. For people whose cancer is found before it's spread outside the liver, the 5-year survival rate is about 31%. The 5-year survival rate for liver cancer that has reached nearby organs or lymph nodes is about 11%.

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