The optimal way to treat colorectal cancer that has spread to the liver is by administering chemotherapy directly into the liver. This method allows a much higher concentration of the chemotherapy on the tumor itself while helping reduce the systemic side effects of the chemotherapy. Particularly for colon cancer metastases to the liver, there appears to be a higher response rate among patients treated with the chemotherapy drug FUDR (fluorouracil deoxyribose) delivered by an implanted hepatic artery pump.

The procedure
The surgeon makes an abdominal incision under the right ribs and places a small metal pump (about 3 inches in size) in a pocket under the skin. The pump has thin tubing that goes into a side branch of the hepatic (liver) artery and delivers chemotherapy (or saline) directly into the liver. At the time of surgery, the pump is filled with heparinized saline to prevent the tubing from clotting off. The operation lasts about 2 hours and typically requires a hospital stay of 3-4 days.

Two weeks after the surgery, the pump is refilled in the medical oncologist’s office and chemotherapy begins. The pump holds two weeks’ worth of chemotherapy and delivers 1 ml per day slowly into the liver. Every two weeks, the pump needs a refill, a usually painless process that takes only about 10 minutes. Generally speaking, there’s an alternating schedule of chemotherapy for two weeks, followed by two weeks of rest with heparinized saline. Your team of Liver Tumor Program doctors at the Kimmel Cancer Center at Jefferson will determine the length of time required chemotherapy.

Candidates for intrahepatic pump therapy for metastatic colon/rectal cancer
There are two primary indications for this type of treatment. It is best suited to:

• Patients who have unresectable metastatic colon cancer to the liver who have failed standard chemotherapy
• Patients who have had cancer resected or removed from the liver, but who are at high risk for developing further cancers in the liver because of the likelihood of remaining microscopic cancer cells within the liver. (Recent publications suggest that patients with this form of adjuvant chemotherapy after surgical resection of tumor metastases from the liver are much less likely to experience a recurrence of the liver metastases than patients who are not treated this way.)

Your team of Liver Tumor Program doctors at the Kimmel Cancer Center at Jefferson will help determine if intrahepatic pump therapy is a viable treatment option for your metastatic colorectal cancer.

Contact us
To schedule an appointment with a Jefferson physician call 1-800-JEFF-NOW or click here.

To contact the Liver Tumor Program team at the Kimmel Cancer Center at Jefferson, please call 215-503-8752 and/or fax your records to 215-503-8755. We aim to schedule your first clinic visit within two weeks of your diagnosis being made and records being received.