about the treatment

For some patients whose colon cancercancerAbnormally growing cells that can invade local tissue, often metastasizing (spreading) to distant areas of the... has spread to the liver, Hepatic Arterial Infusion (HAI) Therapy is a treatment where the chemotherapy medication is delivered directly to the tumor site via an implanted infusion system.

HAI therapy requires a surgical procedure to install the pump and to surgically remove the liver tumor. HAI using the pump allows for site specific or regional delivery of the chemotherapy directly to the liver. HAI is appropriate for the treatment of tumors within the liver either after surgical resectionresectionThe surgical removal of part of a structure, such as bone. to control recurrent disease or in situations where the size, location or number of tumors cannot be surgically removed HAI pumps and RFA (Radiofrequency Ablation) have also been used in combination with success.

Traditional systemicsystemicSynovial fluid. chemotherapy delivers the cancer fighting medication using an intravenous line. Systemic chemotherapy is administered by introduction of a needle into the forearm and use of an external infusion pump. Some patients are offered a permanent IV or what is known as a vascular access port. This device is surgically implanted in the chest wall and a tube is inserted into the venous system for repeated infusion of drug. Alternatively, some chemotherapy agents are administered by mouth. The type of traditional chemotherapy is up to the physician.

New research studies suggest that the use of HAI therapy in combination with traditional systemic chemotherapy after liver resection may extend life expectancy and reduce the recurrence of more tumors in the liver. HAI Therapy has been shown to improve quality of life since the implanted pump continuously administers therapy as the patient participates in activities of daily living. (1,2,3) Refilling the pump is a simple outpatient procedure that is usually performed every two weeks. Patients also experience fewer side effects than with traditional chemotherapy.

HAI therapy requires the use of an implanted drug delivery system to deliver the chemotherapy directly to the liver through the hepatic arteryarteryA thick-walled blood vessel carrying blood flow from the heart to any organ of the body, including the brain.. The hepatic artery is one of the two main arteries in the liver. Liver tumors larger than 3 cm receive 80 % of their blood supply from the hepatic artery. The surgeon will insert the pump cathetercatheterA small tube used to inject a dye to see the blood vessels, similar to that used for looking at vessels in the... (tube) that will deliver the chemotherapy directly to the liver. Care will be taken during the surgerysurgeryThe branch of medicine concerned with the treatment of disease, injury, and deformity by operation or manipula... to be sure that the pump cathetercatheterA hollow flexible tube for insertion into a body cavity, duct, or vessel to allow the passage of fluids or dis... is inserted in the right position to only administer regional or site specific delivery of the drug to the liver. Regional delivery of the chemotherapy agent exposes the tumor to high concentrations of the drug while sparing the normal liver cells. The liver will metabolize 94-99% of the drug and only a small amount will go to the systemic circulation (other parts of the body).

It is common to experience some soreness at the incisionincisionA cut or surgical wound. sites for the first few days after surgery. After the incisions heal, no special care of the sites will be required and patients will be able to shower and bath as usual.

Prior to discharge, the doctor or health care team member will provide patients with important information regarding the new CODMAN 3000 Pump and instructions for the care the incisions. Patients will also receive a Codman Patient Medical Alert Card for identification. They should carry this card with them at all times.

Depending upon the flow rate of the individual pump, the doctor or nurse will refill the pump every four to eight weeks.

Oncologists will determine which patients are the best candidates for Hepatic Arterial Infusion Therapy after evaluation of the following:

• Evidence of tumor any place outside the liver
• Tolerance and response to chemotherapy
• The presence of active infection
• The occurrence of new tumors or recurrent tumors in the colon
• Whether the patient’s arterial anatomy is appropriate for the HAI therapy
• If the patient’s body size or weight is large enough to accommodate the pump
• The percentage of the liver that is free of tumors
• The patient’s history of emotional or neurologic disturbances
• The patient’s ability and willingness to return for pump refills