TREATMENTS FOR HEMANGIOENDOTHELIOMA

Many cases of hemangioendothelioma are asymptomatic and are treated with a ‘wait and see’ approach. It is sometimes considered prudent to wait until the hemangioendothelioma declares it’s intentions, before starting to fight back. If hemangioendothelioma is active and causing problems, treatment options have to be considered.

 Treatment depends on a number of factors such as the location of the tumor, the speed at which the tumor is growing and its appearance under a microscope (grade) and whether it has spread to other parts of the body (stage). A person’s general health and symptoms are also taken into account.

Upon diagnosis, your specialist may tell you one of two things:

Treatment is not required, but the tumors will be monitored and checked again in six months time.

Hearing either of these options can be very scary for newly diagnosed patients, for different reasons.

First

a change in lifestyle might be required for some people who are over-stressed, inactive, and don’t eat a sensible diet. These changes, as well as a healthy dose of optimism are all a step in the right direction towards beating, or coping with this cancer.

What works for one patient, does not necessarily work for the next.

It must be noted that there is no standard treatment for hemangioendothelioma, and almost ALL treatments are relatively unproven and somewhat experimental. Because of the rarity of the disease, the usual manner in which therapies are tested is just not possible. None of these treatments have been tried on a large number of patients, as the numbers are just not there. There has been a degree of success with some treatments, but the success is inconsistent – what works for one patient, does not necessarily work for the next.

The degree of success

may be caused by the variability of the growth of the tumor. The confusion about the pattern of growth, the “best time to treat” and the low number of patients to study makes it difficult to recommend a single therapeutic modality. Thus, because of the rarity of the disease, many centres use therapies that are “generally” applicable to other soft tissue tumors, and with which the oncologists are more familiar. This may not be the best therapies for this type of tumor.

• Conventional (or Western medicine) treatments

• Surgery Where possible

  • For a single tumor, resection with wide margins may be suitable.

• medications

Newer approaches

There are also several newer approaches, which are being used to treat HE including anti-angiogenic drugs ch restrict the growth of the tumor by restricting its blood supply. Examples of these are Thalidomide (or the newer Revilimid), Celebrex, Interferon and Avastin.

More conventional approaches

• Radiation treatment (Radiotherapy).

  • Radiotherapy may be prescribed for some cases to try to shrink the tumor and/or as a form of pain relief for the patient. However, there have not been many cases indicating efficacy of radiotherapy for EHE.

• Transplant surgery

  • might be provided for those with hepatic hemangioendothelioma, Interestingly, it is often still a possibility when the patient has additional tumors outside the liver. This is one of the few diseases where evidence of MULTI-ORGAN involvement does not preclude transplant.

• Radio-frequency treatment

• Electroporation

• Vascular embolization

• Fractionated stereotactic radio-surgery

A reminder - This is not a medical document – please discuss treatment options with your own medical team.