Frequently asked questions

Chemosaturation therapy (also known as percutaneous hepatic perfusion or PHP) is a technique which has been specially developed to treat liver metastases, cancer which has spread to the liver from another tissue or organ within the body.

The technique has proven particularly effective in patients who have developed liver metastases from ocular melanoma (eye cancer). It has also been used to treat cancer that starts in the liver, known as primary liver cancer. 

In order to determine if chemosaturation therapy is the right treatment for you, you will need to have a number of tests such as a blood test and a scan of your liver. You doctor will also consider:

• The stage and grade of your cancer
• Your overall health
• Your age
• If the cancer is primarily in the liver, or if it has spread elsewhere
• The part of your liver that has been invaded by the cancer cells
• If vital vein and arteries are located near your tumour
• The type of treatment you have had in the past

Chemosaturation therapy is carried out under general anaesthetic, so you will be asleep during the procedure. It is rare for any post-operative pain and simple medication such as paracetamol is often all that is required. If you do feel any further discomfort after the procedure, inform the nursing or medical team; in many cases this can be alleviated using slightly stronger medication.

The treatment takes around 4-5 hours, this being dependent on a number of factors that you should discuss with your doctor. You will need to stay in hospital for up to 2 further days. Again, the admission and discharge dates can depend on many factors such as distances you are travelling, level of medical support back home and any complications that might arise.

As is with other types of chemotherapy, there are some side effects associated with chemosaturation therapy. The most common ones include:

• Nausea and vomitting
• Anaemia (a decrease in the total amount of red blood cells or haemoglobin the blood).
• Neutropenia (low levels of Neutrophils, a type of white blood cell that help the body fight off infection).
• General tiredness

However, since this procedure aims to minimise any systemic chemotherapy (by filtering the blood as it leaves your liver), the side-effects are usually very limited.

Side effects of the general anaesthetic may be drowsiness, nausea and a sore throat, although these usually pass fairly quickly.

As a specialist procedure, chemosaturation therapy involves a highly skilled team including a Consultant Interventional Radiologist, Consultant Anaesthesiologist & Intensivist and Perfusionist, together with the dedicated staff of the Angio suite, Critical Care and Spire ward staff.

Your care will be jointly managed with your Oncologist, both for pre-workup and post-procedure follow up.

Chemosaturation therapy has been shown to help slow or reverse the growth of tumours from certain cancers in the liver. It is not a cure, but a way to manage certain liver cancers.

There are several important differences between chemosaturation therapy and other liver cancer treatments:

• Because a higher dose of chemotherapy is used in a more targeted way, there is greater chance that otherwise ‘chemo-resistant’ tumours will be destroyed.
• By delivering the anti-cancer drug to potentially the entire liver, tumours unseen by your doctor are more likely to be treated.
• Because most of the anti-cancer drug is kept from spreading to the rest of your body, you should not have as many side effects as you would with other liver cancer treatments.
• Because chemosaturation therapy does not involve major surgery, you should recover faster.

Chemosaturation therapy has been shown to be particularly effective in patients with Ocular Melanoma Liver Metastases.  However, there is no standard of care for Ocular Melanoma Liver Metastases, and management of it is taken on a case by case basis. You should therefore discuss your eligibility with your doctor/surgeon.

You can also contact our team at Spire who would be happy to arrange a consultation for you.