Big relief with new liver cancer technique

Professor Pua shows how the new technique to treat liver cancer works in a mock procedure. A catheter is inserted through the radial artery in the wrist instead of the femoral artery in the groin.
Professor Pua shows how the new technique to treat liver cancer works in a mock procedure. A catheter is inserted through the radial artery in the wrist instead of the femoral artery in the groin.ST PHOTO: SEAH KWANG PENG

Faster procedure and more patient comfort possible from simple change in treatment

Liver specialists at Tan Tock Seng Hospital (TTSH) have borrowed a technique from their colleagues in the heart department and started using it to treat liver cancer.

For patients, this means a faster, more fuss-free procedure which can be completed in under an hour.

Adjunct assistant professor Pua Uei, who is a senior consultant in TTSH's diagnostic radiology department, explained that typically, chemotherapy and other drugs are delivered directly to the liver via the femoral artery in the groin.

The new technique, however, involves inserting the catheter through the radial artery in the wrist instead.

While this change seems simple, the impact on patient comfort is big.

Those who undergo the old technique have to rest in bed for six hours and often require another catheter to be inserted to collect urine during that time.

MINIMAL DISCOMFORT

The real benefit (from the new technique) is patient comfort... If my mother had to do this, I would choose the radial (technique) any day.

ADJUNCT ASSISTANT PROFESSOR PUA UEI, a senior consultant in TTSH's diagnostic radiology department

In addition, they risk internal bleeding, which may not be detected immediately as the femoral artery sits several centimetres within the thigh.

As the radial artery in the wrist is just millimetres under the skin, undetected bleeding is not a problem.

"The patient also only needs to rest for an hour and he or she can use the toilet straight away," he said.

Liver cancer is among the top five most common cancers in men here, and is also among the top five most common cancer deaths in both men and women.

In Singapore, one of the main causes is infection by the hepatitis B virus.

One man who underwent the new technique in November last year is taxi driver Mr Seah, who declined to give his full name.

"When it was done, I could walk about," said the 61-year-old. "I had the operation in the afternoon and was discharged the same day."

Prof Pua said that most patients can undergo the new technique unless their radial artery is not suitable. This includes those who are having or will soon have dialysis.

"The old technique is still very important - we've been doing it for 15 to 20 years," Prof Pua noted. "The real benefit (from the new technique) is patient comfort.

But he added: "If my mother had to do this, I would choose the radial (technique) any day."

A version of this article appeared in the print edition of The Straits Times on January 28, 2016, with the headline 'Big relief with new liver cancer technique'. Print Edition | Subscribe