Can putting small beads into the body cure liver cancer? -- Yttrium 90 microspheres treatment

A major difficulty in fighting cancer is that cancer cells are hiding in our bodies. While killing them, our bodies, which are made up of normal cells, will often suffer some damage.

So there is a famous joke: when someone claims that something can kill cancer cells, don't get too excited, because a gun can also kill cancer cells (but do you dare to use it...). In short, the main difficulty lies in how to achieve "cancer is gone (small), but the person is still alive".

At present, various cancer treatment methods actually draw inspiration and nutrients from the continuous innovation of various related disciplines, and constantly try to make the effect better and the harm less, and finally they are widely used. Today, we will introduce such a therapy - Yttrium 90 microsphere therapy, which is mainly used in the field of liver tumors.

From pixabay.com

Let’s start with a real case that happened not long ago.

An old artist with advanced cancer

Mr. Zhou is a famous artist in my country. His large-scale works are all over the country, and many of his works have been given as state gifts to foreign friends. He once had a close brush with death due to cancer.

It was a Friday in early January 2022. Mr. Zhou suddenly felt a stomachache. At first, he didn't take it seriously because a similar situation had occurred a few months ago. He was prepared to take some medicine to get through it as usual. But this time, the pain came with a bad taste. He went to the emergency room twice in two days. After doing relevant examinations, the doctor looked at the film and told Mr. Zhou, "You have to have surgery immediately." Unfortunately, after removing the mass that was more than ten centimeters long and had already compressed the intestine overnight, the doctor found that the cancer cells had metastasized to the liver.

Mr. Zhou endured the side effects and took anti-cancer drugs, and the tumor growth was temporarily controlled. But how can he further control the disease and get better treatment results?

Mr. Zhou read the news online about a pilot surgery of Y-90 performed by Academician Dong Jiahong in Boao, Hainan. Academician Dong Jiahong happened to be the director of Tsinghua Chang Gung Memorial Hospital where he was currently receiving treatment. So Mr. Zhou asked if he was suitable for this treatment. After a series of screenings including technetium-99, the hospital determined that Mr. Zhou met the conditions for Y-90 microsphere treatment.

Therapeutic devices

On September 30, 2022, Mr. Zhou was pushed into the operating room. Chief Physician Zhang Lin performed the operation himself, and he was discharged from the hospital on October 1. A follow-up examination after discharge showed that the tumor had shrunk to 3.9 cm. Regular check-ups are required in the later stages to steadily control the progression of the tumor. After 10 months, this critically ill patient with advanced liver cancer finally saw hope for a healthy life again. Of course, this miracle was not entirely due to the drugs, but a good attitude also played an important role . After the diagnosis, Mr. Zhou, who was nearly 80 years old, wrote a will, put it behind him, and continued to paint.

What exactly is Yttrium 90 microsphere therapy?

The principle of this therapy is not mysterious at all, it relies on radioactive substances. Radioactive substances can kill cancer cells by emitting radiation, but in actual operation, if the radiation is too strong, it will harm the human body, and if it is too weak, the effect will be worrying.

Based on the principle that "the benefits outweigh the disadvantages", people have come up with many methods, one of which is very effective, which is to find a way to send less radioactive substances into the body and "pile" them next to cancer cells. In this way, cancer cells will be killed in large numbers, while the damage to surrounding healthy tissues becomes acceptable.

It's a bit like a big bomb can bring down a building on the spot, but it will also affect other surrounding buildings. A series of small bombs placed in a building can also bring down the building, but have little impact on the surrounding areas.

How is this achieved? It all starts with the blood supply to liver tumors.

It turns out that normal liver tissue and liver tumor tissue rely on different blood vessels for blood supply, and liver tumors are almost 100% supplied by the hepatic artery. In this way, we can deliver various anti-cancer "weapons" directly to the tumor cells by inserting the catheter directly into the blood vessels that supply blood to the tumor through interventional surgery with very small wounds.

Diagram of blood supply to the liver

But if radioactivity is used for treatment, the radioactive material must stay next to the tumor cells. If it just passes by, the effect will be very poor. Therefore, the researchers attached the radioactive material yttrium-90 to very small beads. The diameter of these beads is 20~60μm, which is about 1/2 to 1/3 of a hair. They travel unimpeded in the hepatic artery and larger blood vessels, but when they encounter the capillaries in the tumor with a diameter of less than 10μm, they will get stuck on the spot. In this way, the small beads with the radioactive material yttrium-90 can accumulate at the tumor, giving enough damage to the tumor cells.

So the question is, is it really okay to put radioactive materials and beads into the body?

The beta rays produced by the injection of yttrium 90 into the human body have very low penetrating power, with an average tissue penetration distance of only 2.5mm. It can kill cancer cells very accurately and cause little damage to surrounding tissues. Moreover, the half-life of yttrium 90 is only about 2.7 days, and it is basically consumed in about 2 weeks. As for the beads, they remain in the blood vessels of the tumor (the material of the beads itself is non-toxic and harmless), and are finally taken out when the tumor is removed surgically. During interventional treatment, doctors will also temporarily block some surrounding blood vessels according to the situation to prevent the beads from leaking to other parts of the body and causing unnecessary damage.

So overall, compared with the serious consequences caused by liver tumors, the slight risks brought by yttrium 90 are completely acceptable.

Some friends may still be confused. They have never heard of Yttrium 90 microsphere therapy before. Is it a scam?

It is great that you asked this question. There are indeed many so-called anti-cancer therapies on the Internet that are making money and harming people. You must be careful. Today, I will take the opportunity to introduce this kind of therapy and briefly talk to you about how to distinguish them.

Scammers are "all-powerful" , medicine doesn't brag

In order to attract patients' attention, scammers often exaggerate the efficacy of a certain drug or treatment, claiming that it can cure any cancer, any person, and has no side effects, fearing that you will not use it. However, truly reliable treatments will rigorously list various applicable conditions, contraindications, side effects, etc., fearing that you will abuse them.

For example, Y-90 microspheres are clearly indicated for the treatment of liver tumors. A series of contraindications are also listed, including poor liver and kidney function, large tumors, etc. The side effects are also clearly stated, such as low fever, nausea, fatigue, etc. There are also a large number of supporting evaluations to adjust the treatment plan according to the different conditions of the patients. As for the efficacy, it will not be exaggerated, but it can prolong the survival rate of some liver cancer patients, control the development of tumors or even reduce the stage, and lay a good foundation for surgical resection or liver transplantation, etc. It will never boast that it can cure liver tumors.

Swindlers emerge from nowhere , and medicine has traces to follow

Many people are a little hesitant about Y-90 microsphere treatment, thinking that this treatment has only appeared in the past one or two years and seems a bit hyped. In fact, it is normal to have such doubts, and it can even be said to be very good - indeed, many scams are exposed and hyped in a short period of time to make themselves look high-end, and it is not easy to be fooled if you are more vigilant. It is not difficult to identify such hyped things, because fabricated things will be exposed once they are checked, and in medicine, the development of a treatment must have traces to follow.

Take yttrium-90 microsphere therapy as an example. The reason why we feel it is a bit new is that it was approved in China not long ago. The first yttrium-90 microsphere therapy in China was led by the team of Academician Dong Jiahong on September 28, 2021, and it has only been two years.

However, the history of the development of this therapy can be traced back to the 1980s , and it was approved by US regulators in 2002. Moreover, with a little research, we can find that this therapy can only be developed naturally if the supporting oncology, materials science, radiology, medical imaging, interventional medicine, etc. have sufficient accumulation. In actual treatment, it is also necessary for nuclear medicine, interventional therapy, tumor surgery, oncology, radiotherapy, laboratory and other departments to be seamlessly connected in order to successfully complete the treatment.

Because of this, any hospital that wants to introduce this therapy must apply for relevant qualifications, which requires a lot of work such as multi-party consultation, communication and demonstration, space coordination and structural transformation, human resource training and qualification assessment, protection facility material configuration, expert demonstration and qualification acceptance, etc., which can take up to a year. And this is definitely not something that can be done by a "master" just by inspiration.

Treatment site

The liar said it without hesitation , and there is medical evidence to prove it.

In medicine, even a promising therapy with a solid theory will be subject to strict scrutiny and testing. It will take several years or even more than ten years to pass the test and be widely used. For example, since the birth of Yttrium 90 microsphere therapy, more than 150,000 doses have been used in more than 1,000 medical institutions in more than 50 countries. In this process, a large amount of statistical data and research work will be generated. Therefore, if we open any academic search engine (pay attention to choosing the appropriate academic search engine), we can easily find a large number of research papers and see relevant data.

Taking Yttrium 90 microsphere therapy as an example, we can try to search by keywords and easily find various information.

But those scammers often only dare to use examples like "I cured XX's great uncle's second uncle's cancer". If you search for papers, there is often no relevant research at all or only a few papers.

To sum up, this therapy has strict conditions for use, but for most suitable liver tumor patients, its efficacy is worth looking forward to. It can prolong the patient's life and lay the foundation for further treatment.

Hopefully, you’ll never need this treatment, but it does offer a glimmer of hope.

Planning and production

Author: Ding Zong

Editor: Ding Zong