Hepatic Arterial Infusion (HAI) Program
The Hepatic Arterial Infusion (HAI) Program at Smilow Cancer Hospital consists of a multidisciplinary team of nationally recognized physicians who are experts in diagnosing, treating, and providing care for patients with colorectal cancer, cholangiocarcinoma (bile duct cancer), and liver cancer.
HAI is a specialized and targeted approach to deliver chemotherapy directly to the liver, primarily used in the treatment of advanced liver metastases from colorectal cancer, in addition to intrahepatic cholangiocarcinoma. Traditional systemic chemotherapy and immunotherapy may not provide enough concentration of the drug within the liver while minimizing exposure to the rest of the body.
Our Approach
The procedure involves implanting an HAI pump (the size of a hockey puck) under the skin between the patient’s ribs and pelvis. The pump contains a catheter connected to the hepatic artery, the main blood vessel that supplies the liver with blood. This catheter allows for the direct infusion of chemotherapy drugs into the arterial blood supply of the liver. By administering chemotherapy directly to the affected organ, HAI will maximize the concentration of the drugs in the tumor tissue while minimizing their dilution and distribution throughout the rest of the body.
The procedure typically lasts about three hours, and the pump will remain in the patient for several years. Patients will need to visit their doctor every two weeks to have the pump filled with chemotherapy, which takes approximately 10 minutes. Generally, patients will not notice the presence of the HAI pump, but should avoid rigorous physical activity, contact sports, or exposure to extreme heat, which could allow too much chemotherapy to enter the liver.
The benefits of HAI include:
- Fewer side effects: The HAI pump allows for chemotherapy to be released directly into the liver, which is significantly more effective than traditional chemotherapy treatment. This chemotherapy remains in the liver and does not circulate throughout the patient’s body, thus limiting the side effects of treatment.
- Better outcomes: Chemotherapy is released into the liver continuously and is highly effective in reducing the recurrence of, controlling, or shrinking cancerous tumors in the liver.
While uncommon, the HAI procedure does present a risk of complications, including infection, bleeding around the pump, or damage to the hepatic artery. Patients can be assured that our clinicians have extensive processes and procedures in place to ensure that risks are reduced before, during, and after surgery.
Despite its benefits, HAI is not suitable for all patients. It is typically considered when the cancer is confined to the liver and systemic disease is limited. Patient selection is crucial, and our multidisciplinary team of medical oncologists, surgical oncologists, and interventional radiologists collaborate to determine the most appropriate candidates for this treatment.