October 20, 2021

Selective Internal Radiation Therapy: A first for Northern Health

One of the latest and highly specialised cancer treatment options available, known as SIRT (Selective Internal Radiation Therapy), was successfully performed at Northern Health on 13 October. Only a relatively small number of hospitals offer this treatment in Australia.

Says Dr Terry Kok, Interventional Radiologist, “Our patient was diagnosed with liver cancer that was not suitable for surgical treatment and we were asked to provide minimally invasive treatment for his tumour. SIRT, also known as Y90 radioembolisation, was chosen to provide the best chance of curative treatment.”

The complex procedure involved the combined Radiology and Nuclear Medicine teams including Nuclear Medicine Physician, Dr Anthony Hannah, supported by specialist nurses and technicians working closely together to plan and administer the treatment.

It also involved expert input from specialist colleagues in Hepatobiliary Surgery, Gastroenterology-Hepatology and Oncology through our cancer multidisciplinary team.

Dr Terry Kok and Dr Mark Goodwin implanting the SIR-Spheres.

“We were very grateful to have the support of two experts, Dr Mark Goodwin (Interventional Radiologist from Austin Health) and Dr Yung Kao (Nuclear Medicine Physician from Royal Melbourne Hospital) to guide us through the first SIRT procedure at Northern Health,” says Terry.

SIR-Spheres are tiny radioactive ‘beads’, one-third the width of a human hair. The microspheres are injected directly to the liver tumours using the tumour’s own blood supply. The microspheres, light enough to be carried by the blood flow, yet too large to pass through the small blood vessels, become permanently trapped in the small blood vessels that are in and around the tumours.

They then emit high doses of radiation to the tumour cells to destroy them. This targeted nature of the procedure, enables doctors to deliver up to 40 times more radiation to the liver tumours than would be possible using normal radiation therapy, while sparing the surrounding healthy liver tissue.

“The procedure went very smoothly due to the meticulous planning put in by the IR and Nuclear Medicine teams and our patient made an uneventful recovery after a short overnight stay in hospital. The treatment will take effect over the coming weeks and he will be followed-up by his surgical team under the care of Mr Russell Hodgson, HPB Surgeon,” says Terry.

A tender moment amidst the technology, as RN Maryann Chetcuti, checks in on the patient.

“The establishment of a SIRT treatment program at Northern Health has been the product of over two years of hard work as part of a greater aim to establish an Interventional Oncology centre of excellence for our patients. We offer a comprehensive and holistic service to patients with cancer, covering a wide range of procedures from biopsies and vascular access for chemotherapy, to minimally invasive treatments such as tumour ablation, chemoembolisation and most recently, SIRT radioembolisation,” he explains.

“Patients who would have previously had to be referred to other health services for some of these specialised treatments, are now able to benefit from comprehensive and ongoing care at Northern Health by their doctors, nurses and healthcare professionals who know them best.”

“Associate Professor Wanda Stelmach and Dr John Ferguson (current and former Chief Medical Officers) have provided invaluable support over the years in our endeavours and this achievement is something that Northern Health can be proud of,” he adds.

Chief Medical Officer, Wanda Stelmach, congratulated the team for their dedication and persistence to set up this service which supports the care of our community.

“I have heard from a number of sources how well the procedure went and the collegiate atmosphere that allowed everyone to contribute to the success of the procedure – truly a multidisciplinary effort! Well done to everyone! I look forward working with you to support your to aim to establish an Interventional Oncology Centre, ” she said.

Featured image shows Dr Terry Kok, Dr Mark Goodwin and Dr David Burrows, performing angiography before delivery of radioactive Y90 SIR-Spheres to the tumour. In the background is Maryann Chetcuti RN.