Surgery vs. SIRT

As I initiated the question if dad was a suitable candidate for surgery due to dad's heart-attack history and portal vein thrombosis, Dr C was somehow impatient with us and probably felt my challenge. He threw dad's scan report across the desk and asked, "Which line of the report said so?"

I pointed at no. 2 under the venous phase of the examination - 

Dad's CT report- Point no. 2 under venous phase examination - Tumorial Thrombus of right portal vein

Dr C eventually explained to us that the portal vein will be cut off and he was not fond of radiation embolisation, i.e. SIRT due to its risk of shunting. Based on my understanding, shunting means leaking of radiation and if too much has gone to other organs, it could be very damaging and even fatal.

FYI, SIRT using Yttrium-90 has become relatively safer because the doctor will do a test run for patient to access the shunting as well as the calculation of dosage.  Nowadays the doctors who are specialised in SIRT are rather precise of its dosage calculation.

At the end, we left Dr C's clinic in puzzles at the back of our heads with his comments playing repeatedly, 

"Surgery is the only cure for your father!"

"In fact, you should pray for a surgery!"