Liver Cancer & Interventional Radiology
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 Sarasota Interventional Radiology |
| Interventional Radiologist Dr. Gerald Grubbs |
| Liver Cancer: An Overview |
| Symptoms of Liver Cancer |
| Diagnosing Liver Cancer |
| » Needle Biopsy |
| » Needle Aspiration Biopsy |
| What to Expect During Treatment |
| Minimally Invasive Liver Cancer Treatments |
| » Embolization/Radioembolization /Chemoembolization |
| » Radiofrequency Ablation (RFA) |
| » Cryoablation |
| New Treatments On the Horizon |
| » Magnetic Chemotherapy |
| » Gene Therapy |
| » Developing Treatments |
| Contact Us |
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Interventional Radiologists Offer New Hope
The rapidly growing
specialty of Interventional Radiology
offers those with liver cancer new minimally invasive approaches for diagnosis and treatment that hold the promise of less pain, quicker recoveries and a better quality of life. |
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Sarasota Interventional Radiology
Interventional radiology is the surgery of the 21st century and it is revolutionizing modern health care by changing the way we treat a host of conditions.
Cancer is just one example.
Interventional radiology treats
it as a chronic condition; something you live with, not something you die from. So our goal at Sarasota Interventional Radiology is to get your cancer under control and put it in remission. If your tumors start to grow again, we can often perform additional procedures to eradicate them and reset your clock – your tumors – to zero. And in the process restore your quality of life.
Our
liver cancer diagnosis
and treatment program is generally less costly and time-consuming than traditional surgical treatments. And happily, most patients usually experience less pain and shorter recovery periods. And the technology we have at the office allows us to provide you with immediate answers to your critical questions.
We believe in treating the whole person at Sarasota Interventional Radiology. We understand how difficult battling this disease can be. So you and your family can count on our support through every step of the process, from providing critical information to making sure you’re comfortable when you receive treatment.
Our office will be happy to try to accommodate any special needs you may have and will inform you of any special preparations you need to make before your appointment. |
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Interventional Radiologist Dr. Gerald Grubbs
A native of Tennessee, Dr. Gerald Grubbs attended college and medical school there before going on to complete his residency at the University of Tennessee in Diagnostic Radiology.
Excited at how the new field of interventional radiology was revolutionizing minimally invasive surgery – and by the benefits it held for patients – the doctor took a Fellowship in Cardiovascular and Interventional Radiology at the Miami Cardiac and Vascular Institute at the Baptist Hospital of Miami. It was there he learned the basics of many of the procedures he’s now performing. In 1993, after completing his Fellowship, Dr. Grubbs received his Board Certification in Interventional Radiology from the American Board of Radiology.
The following year, Dr, Grubbs moved to the Suncoast and joined Naples Radiologists, P.A. doing Diagnostic as well as Vascular and Interventional Radiology. In 2006 he opened his own practice, Sarasota Interventional Radiology. Here he brings his skills in imaging, his procedural expertise, his experience in research and his clinical practice to offer minimally invasive diagnostics and treatments for patients whose conditions would have once required open surgery.
The author of numerous articles and a noted lecturer, Dr. Grubbs lives with his wife and two children in Osprey.
Learn more about Dr. Grubbs background and experience |
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Liver Cancer: An Overview
FYI: Some facts about liver cancer:
- Every year, approximately 18,500 cases of
primary cancer are diagnosed
. The most common type of liver cancer, hepatocelluar carcinoma, called HCC, occurs twice as often in men as in women.
- HCC is most frequently found in those with cirrhosis, a disease where the liver is diseased and develops scarring. As the liver tries to repair itself, it forms tumors. Alcohol abuse or hepatitis B or C are generally the causes of cirrhosis.
- Because of the worldwide increase in hepatitis C, the incidence of HCC is on the rise.
- Because cancer cells circulating through the bloodstream all pass through the liver, patients with other types of cancer are at a much greater risk for liver cancer. Nearly half of the 140,000 Americans diagnosed with colon cancer this year will develop liver cancer.
- Chemotherapy has been ineffective at curing liver cancer.
For more than two-thirds of those with primary cancer and 90% of those with
types of liver cancer
that have metastasized into other organs,
liver cancer surgery
simply isn’t possible. Sometimes it’s because tumors are either too big or have grown into other organs. Sometimes, surgery for liver cancer is too risky because too many small tumors are spread throughout the liver.
While there is no liver cancer cure, minimally invasive interventional radiological treatments such as those performed by Dr. Grubbs can help those with inoperable liver cancer extend and improve the quality of their lifes. |
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Symptoms of Liver Cancer
Unfortunately, the
symptoms of liver cancer
often do not appear until the disease has reached an advanced stage. They may include:
- A loss of appetite
- Unexplained weight loss
- Feeling full after a small meal
- Pain or swelling in the right abdomen
- A jaundiced tint to the skin
- Low blood sugar
- An enlarged liver
- Worsening of chronic hepatitis or cirrhosis
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Diagnosing Liver Cancer
Blood tests, X-rays, CT scans, ultrasound, and a liver MIR can all be used in the diagnosis of this cancer. Ultimately however, only a biopsy can provide a definitive diagnosis of cancer of the liver. By examining a sample of tissue, a Pathologist can determine whether cancer is present and how fast it’s growing, crucial information to determining the best course of treatment. The doctor will of course discuss your liver biopsy results with you
Using minimally invasive interventional radiology techniques, Dr. Grubbs is able to perform both Needle and Large Core Needle biopsies in his office. |
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Needle Biopsy
A liver biopsy procedure is performed with the aid of computer-generated images that provide Dr. Grubbs with a look at the area to be biopsied from a variety of angles. This “stereotactic” equipment provides pictures of unprecedented clarity, enabling the doctor to pinpoint with unerring accuracy the exact location of any abnormal tissue.
Usually an outpatient procedure, a liver biopsy offers a number of benefits:
- None of the pain, scarring or complications associated with invasive surgery.
- A quicker recovery for a quicker return to normal activities.
- Complications are infrequent; less than 1% of patients develop bleeding or infection.
- For most patients, a needle biopsy provides enough tissue for diagnosis.
- With advanced image guidance, a biopsy can be performed without threat to surrounding organs and blood vessels.
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Needle Aspiration Biopsy
Also used to biopsy a suspected cancer, this technique also helps in the diagnosis of fluids that may have collected in the body. |
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What to Expect During Treatment
Your comfort is of primary concern to all of us at Sarasota Interventional Radiology. We understand that this can be a difficult time and treatment – even non-invasive treatment – can be stressful. That’s why we want you to know what you can expect during your visits with us. The better informed you are, the more comfortable you’ll be. Of course, if you have any questions at all, don’t hesitate to contact us. We’ll be happy to address any concerns you have. |
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Your 1st Appointment
Located in a serene setting on Cattleman near University just east of US 75, Sarasota Interventional Radiology is located on the first floor of the new Axcess Center.
We suggest arriving about 15 minutes before your appointment. You’ll be greeted by one of our two patient advocates. Highly trained and compassionate, these advocates will collect all your pertinent information and work with your insurance company.
You’ll then have a consultation with Dr. Grubbs, where he will review your medical history and discuss your planned course of treatment, taking you through the process step by step so you are informed and aware.
Before leaving the office, you’ll receive written instructions on how to prepare for your treatment. |
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The Night Before Your Procedure
Here’s what you need to do the night before to prepare for your procedure. It’s important you follow these instructions carefully, or it will be necessary to cancel your treatment that day. More importantly, failure to follow these instructions could be dangerous.
- Have nothing to eat or drink for at least 6 hours prior to your procedure.
- Take all of your normal medications before 8am with only one ounce of water. Do not take anything else or we will have to cancel your treatment that day.
- Bring a list of all your current medications and the doses you are taking.
- If you have an inhaler at home, you must bring it with you when you come in for your procedure.
- If you are a diabetic, start your medication once you resume your diet.
- If you are a diabetic taking insulin, wait until you have eaten to use your insulin.
- You cannot drive after your procedure for the remainder of the day. You must make arrangements to have someone drive you home.
- Please leave all your valuables at home. You won’t need them.
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The Day of Treatment
A nurse and board-certified anesthesiologist will prep you for your treatment. You’ll be administered what is called “conscious sedation”, which will allow you to wake up right away after your procedure – another of the benefits of minimally invasive treatment. Of course, in the extremely rare circumstance of complications occurring, Dr. Grubbs is always available. |
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After Treatment
Discharge instructions will vary, depending on the procedure you had. It is essential you follow these instructions carefully.
In the days following your procedure, you may feel a degree of tenderness at the site where the catheter entered. This is perfectly normal. Generally there is little or no bleeding around the site and the tenderness will pass. If there the tenderness continues, if there is bleeding or excessive oozing from the site, call us, or your referring physician, immediately. |
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Minimally Invasive Liver Cancer Treatment
While the best chance of a cure is the surgical removal of tumors, Interventional radiology offers those patients that may not tolerate surgery because of other medical conditions a minimally invasive alternative. Indeed, the National Cancer Institute says, “targeted cancer therapies give doctors a better way to tailor cancer treatment.”
Interventional radiology’s breakthrough techniques make it possible to attack tumors from inside the body using a catheter to deliver targeted treatments with the precision of a smart bomb, leaving healthy tissue unaffected.
As an interventional radiologist, Dr. Grubbs is uniquely skilled at using a catheter to deliver treatments to specially targeted areas of the body. Called Thermal Ablation, these treatments use heat or cold to attack the cancer. Among the procedures used by Dr. Grubbs are: |
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Embolization/Radioembolization /Chemoembolization
To feed and grow, tumors need a blood supply. Interventional radiologists can use minimally invasive procedures to cut off the tumor’s blood supply (embolization) and deliver either radiation (radioembolization), or, combining the technique with chemo, deliver high doses of cancer drugs right to the site of the tumor (chemoembolization). Chemoembolization usually involves a hospital stay of between two and four days and most patients do experience a short period of fatigue.
While these procedures are not cures for liver cancer, they have been shown to be extremely effective in treating primary liver cancers, especially when combined with other therapies. |
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Radiofrequency Ablation (RFA)
By using advanced imaging technology to guide a small needle through the skin and into the tumor, Dr. Grubbs is able to transmit radiofrequency energy into the target. There it produces heat that kills the tumor, while sparing the surrounding healthy tissue.
For someone living with inoperable liver cancer, RFA can extend and provide a better quality of life. By decreasing the size of a large tumor, it offers relief from pain and many of the tumor’s other debilitating side effects. However, while easier on a patient than systemic therapy, it is palliative not curative.
Like most radiological treatments, RFA can be performed in Dr. Grubbs’ office on an outpatient basis. Among its many other benefits:
- It can be used to treat primary liver cancer as well as tumors that have metastasized to other parts of the body, though it is most effective when all the cancer is localized in the liver.
- Depending on your comfort level, it can be done under conscious sedation or a general anesthesia.
- Most patients can resume normal activity the next day and may only feel a bit tired for a few days.
- If needed, RFA treatments can be repeated.
- RFA can be effectively combined with other treatment options.
- Relieves pain and the suffering that accompanies it.
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Cryoablation
Similar in delivery technique to RFA, Cryoablation uses an extremely cold gas to freeze and destroy the tumor. While surgeons have used this procedure in the operating room for years, needles are now small enough to be used through a nick in the skin, without surgery. An “ice ball” is created around the needle that freezes and destroys the tumor. |
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New Treatments Hold Promise As Cures for Liver Cancer
Interventional Radiologists like Dr. Gerald Grubbs are playing a critical role in developing minimally invasive surgical techniques for treating cancer that are not only extending life, they are providing a better quality of life |
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Magnetic Chemotherapy
Using magnets to pull chemotherapy drugs directly into tumors to bolster their effect is a treatment currently being investigated by researchers. Early research is promising and the hope is that the treatment will intensify the effects of chemotherapy, while avoiding some of the more difficult side effects such as nausea and hair loss that accompany it. |
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Gene Therapy
As researchers’ work with and gain a greater understanding of genes and the role they play in disease, the greater promise gene- based drug therapies hold as a treatment option in the not too distant future.
Though still in the experimental stage, doctors hope the therapy will be used in the future to:
- Alter the cells of the immune system with cancer fighting genes.
- Take cancer cells from the body, alter them genetically and letting the patient’s immune system battle the cancer.
- Replace a “bad” cancer gene with a “good” gene.
- Make tumors more susceptible to chemotherapy by injecting them with genes.
- Make bone marrow and other organs resistant to chemotherapy, so that the drugs will destroy tumors without damaging the healthy tissue that surrounds them.
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Developing Treatments
Other cutting edge developments for cancer treatment include:
- Epidermal Growth Factor Inhibitors designed to slow the growth of the Epidermal growth factor receptor that XXXXX.
- New anti-angiogenesis treatments use drug therapies to reduce blood vessel growth for cancer.
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