How to Cleanse Your Liver
Taking Treatment Directly to the Liver
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I am deciding between clinical trials and isolated liver perfusion for colorectal liver mets. The liver perfusion operation does not thrill me but the results do. Why don’t more people consider liver perfusion?
At times, patients with metastatic colorectal cancer have disease that only involves the liver, and, as such, local and regional treatment options such as surgical resection, radiofrequency ablation or hepatic artery infusion have been used for treatment. Hepatic artery infusion (HAI) is based on the concept that tumors in the liver derive their blood supply predominantly from the hepatic artery – the main blood vessel leading to the liver – whereas, normal liver tissue gets its blood supply from the portal vein. So by directly infusing chemotherapy in the hepatic artery, one could theoretically treat the tumors in the liver.
This technique has been used in the past four decades. It is invasive because it requires surgery to place an infusion pump in the hepatic artery – a procedure patients may not like or may not be a candidate for. Studies have demonstrated that this type of infusion shrinks liver tumors better than giving intravenous chemotherapy; however, the studies do not consistently show prolonged survival for patients. In other words, the liver tumors may shrink, but the patient doesn’t necessarily live longer. It is for this reason that hepatic artery infusion is not considered more often.
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