Interventional Oncology as cancer treatments
Interventional radiology is the newest pillar of cancer treatme. In the past, there were three main avenues to treat cancer: surgery, chemotherapy or radiation. In the past 20 years, the minimally invasive treatments offered by interventional radiologists have become a fourth option to manage cancer. This is a specialized area of interventional radiology called interventional oncology.
Percutaneous tumor ablation
For cancers of certain sizes within solid organs, such as the kidney, liver and lung, image-guided ablation is a minimally invasive alternative to surgical removal. In this procedure, CT or ultrasound is used to guide a small needle or probe into the tumor. A power source will transmit either hot or cold thermal energy to the tip of these needles to either burn or freeze tumors. This is done through a tiny incision that doesn’t require a stitch.
Percutaneous ablations are often done on an outpatient basis, or with an overnight hospital stay. The most common types of ablations are microwave ablation, cryoablation and radiofrequency ablation.
Spine ablation with vertebral augmentation
The bones of the spine are common sites for the spread of cancer. In some cancers, such as breast and prostate cancer, 75% of patients may develop spread of cancer to the spine. These areas of tumor spread are typically very painful, many times requiring narcotic medication. They are classically diagnosed by patients complaining of severe back pain waking them up at night.
Over the years, cancer treatment has evolved from surgical resection to external radiation therapy. However, there are some tumors that are resistant to radiation, such as kidney, liver and colon tumors, which require a much higher dose of radiation. These patients are at risk for a post-radiation fracture occurring up to one-third of the time.
The pain can also make it difficult for patients to endure the radiation treatment. For these and some other reasons, percutaneous ablation of the spine with cement stabilization is an excellent option. This is an outpatient procedure providing pain relief faster than radiation or surgery, in a single session.
Liver directed therapy as a cancer treatment option
The liver is a common site of cancer. Primary malignant liver tumors arise from the liver or bile duct cells. Patients with these types of cancer often have a risk factor, such as HCV or cirrhosis. Because of the liver’s function and location, tumors often spread, or metastasize, to the liver. The most common culprit is cancer arising from the colon.
In either case, liver directed therapy is often an excellent an option to treat this disease. This refers to injection of particles (also known as embolization) in bland form, mixed with chemotherapy, or attached to a radioactive substance customized to treat cancer. These treatments are referred to as bland embolization, chemoembolization, or radioembolization, respectively. Most of the time, these options can be done as an outpatient, with short recovery and minimal side effects.
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