Selective Internal Radiation Therapy - FAQs

What are SIR-Spheres®?
SIR-Spheres® are microscopic polymer beads that have radioactive material inside them. The microscopic beads are delivered to the tumor through a catheter placed into the artery that supplies blood to the liver. By using these radioactive microspheres, treatment can be sent directly to the tumor without affecting the entire body. Usually, there will be two infusions -- one each to the right and left lobes of the liver. There is a minimum four-week interval between infusions.

What happens to SIR-Spheres® once they are inside the liver?
SIR-Spheres® continuously deliver radiation to the tumors over a period of approximately two weeks. (The half-life for Y-90 microspheres is 64 hours). The microspheres remain trapped in the liver, however they are extremely small and are biocompatible so there is no danger in them remaining there.

Will patients have to stay at the hospital overnight?
Patients can usually expect to go home within 24 hours after the treatment. Since sedation is given for the angiogram and SIR-Spheres® infusion, patients cannot be released from the hospital unless there is someone to take them home. If the patient does not have someone to take him/her home, arrangements will be made to stay at the hospital overnight.

How long does this procedure take?
The procedure usually takes less than an hour, but recovery can take from two to six hours.

If the patient lives outside of the Baltimore metropolitan area, how many trips will the patient have to make to Baltimore?
Patients can expect to visit Baltimore between three and four times.

Does the size and amount of tumors make a difference?
No. A benefit of the SIR-Spheres® treatment is that unlike most of the other liver-directed therapies, it can treat multiple tumors of different sizes.

Does insurance pay for this?
Medicare covers 80 percent of the cost of the treatment. Insurance companies in the State of Maryland are required to cover all treatment costs. Other companies may not cover SIR-Spheres® treatment. We encourage patients to contact their insurance companies directly for more information.

The University of Maryland has an insurance authorization team. If you would like to talk to them about insurance coverage, please contact Ms. Rosemary Wilson at 410-328-7904.

Are there side effects of this treatment and how long do they last?
The most common side effects are fatigue, low-grade fevers, vomiting, nausea and abdominal pain. Usually, side effects subside or disappear in 3-5 days and are generally self-limiting. The fatigue typically lasts longer and patients should expect 2-3 weeks of reduced energy.

Patients will be given emergency contact numbers for physicians at the University of Maryland in case they experience any side effects.

What kind of cancers can SIR-Spheres® treat?
SIR-Spheres® are FDA approved for colorectal metastases in the liver.

Who is a candidate for this treatment?
Each candidate is evaluated by the SIR-Spheres® team. In order to be considered for the treatment, patients will need to fax their medical records and contact information to Ms. Rosemary Wilson at 410-328-3018 (please see Records Required for Evaluation letter). After the team reviews the records the patient is contacted. This process takes a few days.