Download Welcome Packet SIRT - Metro - Advanced Radiology Services

Thank you for trusting us with your care.
What is an interventional oncologist? An interventional oncologist is a board certified physician, trained in a subspecialty of interventional radiology to use live imaging (X-ray, CT, MRI, Ultrasound, etc.) to perform minimally invasive
procedures which diagnose and treat cancer.
You probably already have an oncologist (cancer doctor). This doctor manages the plan for treating your cancer and will
ask for support from other doctors at times, including an interventional oncologist. In many cases, interventional
oncology offers hope to patients who have been told traditional surgery is not an option.
Navigating life as a cancer patient is overwhelming, time-consuming, confusing, scary, and exhausting. You and your
family and friends are not only tasked with the emotional strain brought on by your diagnosis, but also the logistical
demands of a multi-physician treatment plan. At Advanced Radiology Services, we aim to help by delivering high quality
care and offering hands-on support. In being a part of your cancer treatment, we promise you the following:
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Personalized care, specific to your needs and disease progression
Assistance navigating insurance authorization and payment for services
Available staff to address questions and concerns as they arise
Open communication about your treatment plan
Your team here at Advanced Radiology Services appreciates the opportunity to be a part of your care.
Dr. Todd Durham, MD
Dr. Manish Varma, MD
Interventional Radiologist
Interventional Oncology, Liver Therapy
Interventional Radiologist
Interventional Oncology, Liver Therapy
Nursing Team
Mary Dirkse, RN
Cindy Shepard, RN
Brenda McNeil, RN
Becky Schuitema, RN
Ryan Jacques, MPH
Interventional Oncology Coordinator
If at any point in your treatment you need to contact your treatment team (nurses and doctors), please use the following
information to do so:
Advanced Radiology Services, PC
3264 N Evergreen Dr. NE
Grand Rapids, MI 49525
To reach Ryan, the Interventional Oncology Coordinator, call (616)498-0619
To reach the nursing staff, call (616)459-7225*
* Option #2 will connect you with a nurse. This line is staffed from 8 AM- 5 PM (M-F). Urgent calls made on
weeknights and weekends will be transferred to on-call medical staff.
Step 1
Office Consult
(Day 0)
Step 2
Mapping
Angiogram
Procedure
(Day +7-14)
THIS STEP MAY BE
REPEATED
Often times, both
sides (lobes) of the
liver must be
treated. This will be
done one side at a
time, in two
treatments spaced
approximately 4
weeks apart.
Step 3
Treatment
Procedure
(Day +14-28)
Step 4
•Goals
•To meet our team and cover your medical history
•To discuss treatment options and get a better
understanding of interventional radiology
•To develop a plan moving forward
•Goal
•To determine whether or not the patient is a candidate for Y-90
radioembolization therapy. This will depend on the patient's vascular
anatomy and the ability to contain flow of the microbeads to primary
tumor site (without damaging other neighboring organs)
•This is an outpatient procedure.
•The procedure itself takes about 2-3 hours, but the patient should
expect an 8-12 hour day at the hospital from arrival to discharge
•Goal
•To deliver microbeads treated with radioactive Y-90
directly to the liver tumor site with use of a
catheter, guided from an entry site in the patient's
groin
•This is an outpatient procedure.
•The procedure itself takes 2-3 hours, but the patient
should expect an 8-12 hour day at the hospital from
arrival to discharge
•Goal
•To obtain additional information that will support
the evaluation of the success of treatment
Follow-Up Labs •Follow-up plans are very specific to the patient and
and Imaging
can include labs as early as two weeks postprocedure or as late as 4 months.
(Month +1-3)
NOTE: All timeframes
provided are estimates.
The timeline will depend
upon insurance approval,
how well you respond to
treatment, and availability
of both you and the
physician.
Step 5:
Follow-Up
Office Visit
(Month +3-4)
•Goal
•To discuss treatment outcomes and to create a plan
moving forward
Recovering from Y90 Radioembolization
Immediately after procedure
-
You will be taken to a recovery room and asked to lie in a flat position for several hours. This must be done to
properly heal the entry point in your groin and to ensure you will not bleed after discharge.
This is an outpatient procedure. Without complication, you should expect to be sent home.
For the next 24-72 hours, you can expect to feel some of the following post-procedure side effects:
o Nausea and/or vomiting
o Fever
o Fatigue
o Abdominal/stomach pain
You will be given specific discharge instructions by your nurse. Follow those closely and call if you have any questions.
They will be similar to what is detailed below.
Activity
- Do not smoke or use tobacco
- For the first 24 hours post-procedure
o Do not drive
o Do not use heavy machinery
o Do not make important decisions
o Do not drink alcohol
o Do not go back to work
o Do not take medicine that makes you sleepy
o Do not smoke or use tobacco
- For the first 48 hours post-procedure
o Avoid strenuous activity and lifting anything weighing more than 10 lbs.
- Should you feel ready, you may return to work 3 days after procedure
Bandages/Wound Care
- Bandages may be removed the day after your procedure. You may have a small bruise or a tiny bump. This may
take 2 weeks to go away.
Call the Advanced Radiology Services Doctor at 616.459.7225 if:
- Your side effects are not manageable with the medications provided at discharge
- You have very bad pain at or around the puncture site
- Your affected arm or leg gets cold or there is a change in color of skin
- You feel dizzy, light-headed, or faint
- You are bleeding or there is a bump that is getting bigger and bigger at the puncture site
o If this occurs, press on the site for at least 15 minutes and go to the emergency department.
Returning to Work/Normal Activities
- Following your mapping procedure, we recommend you plan for at least two at home recovery days. Returning
to work on Day 3 may be possible, but should depend on how you are feeling.
- Following your treatment procedure, recovery may be a bit longer. In addition, radiation safety guidelines must
be followed when returning to high traffic or public places.
Radiation Safety
RADIATION SAFETY INSTRUCTIONS MUST BE FOLLOWED AFTER YOUR Y90 TREATMENT PROCEDURE.
THESE GUIDELINES DO NOT APPLY TO YOUR PLANNING/MAPPING PROCEDURE.
Although the microspheres should not pose a risk to others, we value the safety of those around you and ask that you
are aware of the following radiation guidelines to be used for 7 DAYS post-procedure.
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DO NOT use public transport, including air travel, for time period lasting more than 2 hours
AVOID crowded public places
DO NOT share a bed. Please sleep alone.
DO NOT have prolonged direct contact with children, pets, or pregnant women
DO NOT be in close proximity (within 6 feet) to another adult for a period lasting 1 hour or more