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Interventional Therapy for Intraocular Melanoma
Even after treatment with radiation therapy or surgery, some intraocular tumors may metastasize, or spread. The liver is usually the first place they spread. Many of these secondary tumors can be treated with interventional therapies, or minimally invasive methods to shrink tumors.
These treatments are performed in the hospital using local anesthesia. Most people return home after an overnight stay in the hospital.
Our doctors use heat and other techniques to shrink or destroy liver tumors.
Thermal ablation involves the use of heat—generated from high-frequency radio waves, or microwaves—to shrink tumors. In this procedure, an interventional radiologist places a small, needle-shaped probe directly into the tumor to destroy cancer cells, while avoiding healthy tissue.
The doctor uses an imaging technique, such as ultrasound or MRI, to guide the probe through the skin and into the liver to reach the tumor.
Sometimes, thermal ablation is performed using a laparoscope—a thin, lighted tube with a tiny camera attached to it. This instrument gives doctors a better view of a tumor deep inside the liver or several tumors in the organ. In this approach, the doctor makes a few small incisions near the liver. He or she then inserts the thermal ablation probe through the laparoscope.
Ethanol ablation may be used to destroy or shrink very small liver tumors. In this procedure, the doctor uses a needle to inject ethanol, or grain alcohol, directly into a liver tumor. The alcohol causes cells to dehydrate, or lose fluid, and die. The procedure is performed using ultrasound guidance.
A doctor may use ethanol ablation for tumors that are smaller than those treated with thermal ablation.
In chemoembolization, doxorubicin—a chemotherapy or anticancer drug—is delivered directly to the liver to kill cancer cells. The drug is given in combination with small particles that help to block blood flow in vessels that feed a tumor.
This treatment is delivered via a catheter—a thin, hollow tube—that’s inserted into a blood vessel into the groin and advanced into the artery that leads to the liver. The catheter is also used to deliver a dye that enables the doctor to view the liver and surrounding blood vessels with imaging.
Chemoembolization offers several advantages over traditional systemic chemotherapy, which treats cancer throughout the entire body. It prolongs the time doxorubicin stays in contact with the tumor—as long as a month—increasing the drug’s effectiveness.
Delivering chemotherapy directly to the tumor spares healthy tissue, reducing the risk of side effects. As a result, the doctor may give higher-than-standard doses. In addition, blocking blood flow to the tumor helps to hold the chemotherapy in place while depriving the cancer of oxygen and nutrients, helping to slow its growth.
Surgical Options for Liver Metastases
For people with several large liver metastases that cannot be treated with interventional techniques or systemic therapies such as chemotherapy, surgery may be needed to remove one or more portions of the liver.
Our eye cancer experts can refer you to a surgical oncologist at NYU Langone who specializes in treating liver tumors.
For tumors located near the outer portion of the liver, surgeons are often able to remove the tumor along with a small portion of liver tissue. For larger tumors located in the liver, the surgeon may need to remove a larger portion, or lobe, of the liver. After surgery, the remaining healthy tissue regrows in as little as two to three weeks, restoring normal liver function.
Liver surgery can be complex because of the many important blood vessels that are found throughout the organ. NYU Langone surgeons are specially trained to remove the cancer while protecting important arteries and veins. Depending on the location of the tumor, liver surgery may be performed using open surgical or minimally invasive techniques, such as laparoscopy or robotic surgery, which require smaller incisions.
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