Treating Liver Cancers with Selective Internal Radiation Therapy

Selective Internal Radiation Therapy pic
Selective Internal Radiation Therapy
Image: sirtex.com

Honored by numerous publications for her work, Dr. Laurie Cuttino serves as an associate professor at Virginia Commonwealth University (VCU) in Richmond, Virginia. She is also affiliated with VCU Massey Cancer Center and Henrico Doctors’ Hospital. Among the methods Dr. Laurie Cuttino employs to treat liver cancers is using selective internal radiation therapy (SIRT) with SIR-Spheres®.

SIRT is a form of internal radiotherapy used to treat liver cancers when surgical removal of the cancer (or tumor) is not an option. With the use of a catheter, millions of microspheres, each smaller than the width of a hair, are delivered to the hepatic artery, the main blood vessel providing blood to the liver.

The radioactive microspheres , known as SIR-Spheres®, become lodged in the small blood vessels surrounding the tumor, reducing the blood supply and preventing the tumor from receiving the nutrients that enables it to grow. The radiation from the microspheres destroys the vessels and the tumor. As the radiation travels only a short distance, there is minimal damage to nearby tissue. Also known as radioembolization, it is not a permanent cure for the majority of patients, but can lengthen the period of survival.

An Overview of Selective Internal Radiation Therapy

Selective Internal Radiation Therapy pic
Selective Internal Radiation Therapy
Image: cirse.org

For over 15 years, Dr. Laurie Cuttino has served as a radiation oncologist with the Virginia Commonwealth University Health System in Richmond, Virginia. A nationally recognized expert in accelerated partial breast irradiation, Dr. Laurie Cuttino also has experience with a range of other treatment modalities, including selective internal radiation therapy (SIRT).

Used to control liver cancers in patients who cannot be treated surgically, SIRT is a form of radiotherapy that uses a microcatheter to deliver radiation directly into the hepatic artery, which provides 20 percent of the liver’s blood supply. Although it only delivers one-fifth of all the blood the liver needs, the hepatic artery provides 80 percent of the blood that cancer involving the liver uses to survive and grow. By taking advantage of this difference in blood supplies, SIRT delivers millions of radioactive microspheres into the tumor while limiting the harmful effects of the radiation on healthy liver cells.

Typically, SIRT is provided in an outpatient setting, and the treatment may take place in one or two sessions depending on the individual patient’s needs. If a patient does require two sessions, the treatments will usually be performed 30 days apart. In some cases, SIRT is combined with chemotherapy, but it is often reserved for patients who have had minimal success with chemo or have had difficulty tolerating the treatment.

Common side effects of SIRT include flu-like systems such as fever, nausea, and fatigue that may last anywhere from a few days up to a week after treatment. Most patients are able to return to their normal activities within one to three days. Although SIRT research and clinical trials are still ongoing, the treatment has been shown to reduce tumor size and tumor activity in a large percentage of patients.

ASTRO to Hold 58th Annual Meeting in Boston

American Society for Radiation Oncology  pic
American Society for Radiation Oncology
Image: astro.org

Since 2001, Dr. Laurie Cuttino has practiced as a radiation oncologist in the Virginia Commonwealth University Health System. An involved professional, Dr. Laurie Cuttino has served as a principal investigator in a number of national clinical trials and maintains memberships in several professional organizations, including the Alliance for Clinical Trials in Oncology and the American Society for Radiation Oncology (ASTRO).

Registration is open for ASTRO’s 58th Annual Meeting, which will be held September 25-28, 2016, at the Boston Convention Center in Boston. Over the course of the four-day event, attendees will have the opportunity to take part in a scientific program replete with poster presentations, clinical trials sessions, workshops, panel discussions, and other educational activities.

The meeting will also feature a number of networking events and an exhibit hall where over 200 organizations will be showcasing the latest products, services, and technologies available in the radiation oncology field. Additional details on ASTRO’s 58th Annual Meeting can be found at www.astro.org.

SIRT – Localized Internal Radiation Approach to Treating Liver Cancer

Selective Internal Radiation Therapy pic
Selective Internal Radiation Therapy
Image: cirse.org

Dr. Laurie Cuttino earned her MD at Virginia Commonwealth University (VCU). For the past 15 years, Dr. Laurie Cuttino has served as associate professor of radiation oncology at her alma mater. She also works with Henrico Doctors’ Hospital, which offers leading-edge treatments such as selective internal radiation therapy (SIRT).

SIRT is a method of employing radiotherapy on cancers of the liver that are not removable through traditional surgery. This form of internal radiotherapy involves the insertion of a catheter, or tiny tube, within the hepatic artery, which is the main supplier of blood to the liver. The catheter distributes microspheres (also known as SIR-spheres), which are minute beads smaller in diameter than a human hair.

The radioactive substance yttrium 90 contained within the microspheres delivers precisely calibrated radiation to the tumor. This impacts the blood supply that the tumors require to survive and results in radioembolization. In addition, the tumor DNA is damaged while leaving the healthy tissue virtually intact. This is because the microbeads emit radiation only a few millimeters from their contained location within the tumor area.

World Pediatric Ponseti Method Program in Belize

Ponseti Method pic
Ponseti Method
Image: worldpediatricproject.org

Dr. Laurie Cuttino is a radiation oncologist based in Richmond, Virginia. Additionally, Dr. Laurie Cuttino is active in World Pediatric Project, a nonprofit organization that helps children in countries outside the United States who have treatable birth defects and illnesses. World Pediatric Project is made possible by the efforts of medical professionals who volunteer their skills and services.

Working in parts of Central America and the Caribbean, where access to health care is often limited, World Pediatric Project runs a number of special programs, including an initiative in Belize to eliminate the birth defect commonly known as clubfoot.

People born with clubfoot have feet that are twisted out of shape or not in the correct position. Traditionally, people with clubfoot underwent painful surgeries or had to walk on their ankles or the sides of their feet. However, the Ponseti Method, a non-invasive treatment that uses plaster casts and specific positioning of the foot, has been recognized in recent years as being a more effective way of correcting clubfoot.

World Pediatric Project saw the need for this treatment in Belize and worked with organizations in the country to a get a Ponseti Method program established. As a result, there has been a significant reduction of clubfoot in the country.

How to Choose a Radiation Oncologist

How to Choose a Radiation Oncologist pic
How to Choose a Radiation Oncologist
Image: hopkinsmedicine.org

Dr. Laurie Cuttino has conducted research and served as an associate professor at Virginia Commonwealth University (VCU) for nearly 10 years. In addition, Dr. Laurie Cuttino focuses on treating patients who have been diagnosed with a wide range of malignant tumors in her role as a radiation oncologist.

When searching for a radiation oncologist, it is important to evaluate several factors to make the important decision of who you will see for treatment.

Credentials
In general, oncological physicians possess a degree as either an osteopathic or medical doctor, which signifies that they have completed four years of medical school and the required postgraduate training. To become a subspecialist in radiation oncology, a physician must undergo 5 additional years of specific residency training in the field. In addition to assessing a doctor’s training, you can check to see whether your prospective radiation oncologist is board certified in the specialty.

Personal Repertoire
While knowing that a radiation oncologist holds the proper credentials, you also should determine whether or not you will be comfortable working with the practitioner. Some patients prefer a stoic, professional physician while others seek care from someone who also can tend to their emotional needs. If you require long-term care, you may wish to find a radiation oncologist with whom you can form an amiable relationship. No matter your requirements, you should choose the physician who will be the best fit for you throughout your treatment.

An Introduction to Accelerated Partial-Breast Irradiation

A board-certified radiation oncologist and researcher in the field of breast cancer treatment, Dr. Laurie Cuttino of Virginia Commonwealth University has developed a reputation as a national expert in the use of accelerated partial-breast irradiation. Dr. Laurie Cuttino has authored a number of peer-reviewed articles and book chapters on the technique.

Accelerated partial-breast irradiation, or APBI, exists primarily as a component of breast-conserving therapy. This treatment methodology typically begins with a segmental mastectomy, in which the surgeon removes the cancerous tissue. The patient then receives targeted radiation to the area around the surgical site, as this region typically carries the greatest risk of cancer recurrence. Treatment delivery occurs over the course of 5 days and focuses on a 1- to 2-cm area of tissue.

APBI may use a variety of radiation delivery techniques. The methodology with the most supporting data is multicatheter interstitial brachytherapy, which delivers radioactive sources through 10 to 20 catheters placed in the breast tissue. Radioactive sources in this methodology are in the body only temporarily and offer the benefit of transmitting very little radiation to nearby tissues. Practitioners may also choose to use alternative delivery system, including single-dose intraoperative treatment or external beam radiation. In general, APBI therapy has demonstrated recurrence rates comparable to whole-breast irradiation.