Y-90 SIR-SPHERES THERAPY

INFORMATION FOR NURSING STAFF

B Dr McHarg (Northside Nuclear Medicine) and Dr Eisen Liang (SAN Interventional Radiology)

Use:
Y-90 Sir-Spheres are tiny micro spheres which contain the radioactive element Yttrium-90.
These are injected into the liver in the Radiology Department, via catheterisation of the hepatic artery.  This method is used to treat patients with liver metastases from bowel cancer, or primary liver cancer.

Isolation:
The patient is admitted to a single room (the lead lined room if available, but this is not essential).  The patient will generally be discharged the following day.

Visiting:
Restricted visitors and radiation signs should be displayed.
No children under the age of 10 years or pregnant visitors.
Visits should be restricted to 20 minutes per person per day and the visitor should sit at least three metres away from the patient.
Close contact is allowed for short periods e.g. nursing care.

Nursing considerations:
Pregnant nurses should not attend this patient.
Prolonged attendance should be on the left side of patient if possible.
Handle all urine with gloves and avoid spillages.
Report any spillages and emergencies to Nuclear Medicine (Dr McHarg or Dr Burke, available after hours through Sydney Adventist Hospital Switch).
Common side effects are:

1. Abdominal pain.  May occur at the time of injection and can be severe, perhaps requiring pain killing injections.  This usually subsides over an hour or so but some pain relief may be needed for several days.
2. Nausea. Common, sometimes severe, and may require medication.  May last several weeks.
3. Fever.  Very common and can last for a week.
4. Tiredness/Fatigue and loss of appetite for 4-6 weeks are common (about one third of patients).
5. Damage to other tissues.  This will usually become apparent following discharge.  For example pancreatitis, gastritis, enteritis, hepatitis, or pneumonitis.
   

If any dressing over the groin wound needs attendance then gloves should be worn as a matter of routine.  Any dressings removed should be placed into the infection control bin for assessment by Nuclear Medicine and storage if required.