Interventional Oncology

Interventional oncology is the treatment of cancer patients with minimally invasive techniques. Most commonly patients with primary liver cancer (hepatocellular carcinoma) or secondary liver cancer (metastatic spread from colon cancer, neuroendocrine tumor, and others) are treated with these techniques.

What types of cancers can be treated?
Primary liver cancer (hepatocellular carcinoma)

Metastatic cancers with spread to liver including:

• Colon cancer
• Neuroendocrine tumor
• Cholangiocarcinoma
• Breast cancer
• Pancreatic cancer

What types of treatments are available?
Interventional oncology treatments include:

• Ablation
• Chemoembolization
• Radioembolization

How long are the procedures?
The length of the procedure varies on procedure type and patient anatomy.

How long is the hospital stay?
For most procedures, patients are discharged home the same day or the following morning.

Are the treatments compatible with chemotherapy?
In most cases, concurrent treatment with chemotherapy is recommended.

Chemoembolization

Chemoembolization is a procedure designed to treat cancers in the liver.

During the procedure, a catheter will be placed in a vessel in the upper thigh and advanced into the blood vessels of the liver under X-ray guidance.  Once the catheter is placed, small particles are injected to kill tumor cells.

Chemoembolization treats tumor by two different mechanisms.  One is by shutting down the dominant blood supply to the tumor, the tumor is deprived of oxygen and nutrients required to survive and grow.  Secondly, chemotherapeutic agents are infused directly into the tumor leading to a higher concentration of chemotherapy around the tumor and less chemotherapy elsewhere in the body.

The aim of the procedure is to increase the patient’s life expectancy and improve cancer-related symptoms. It treats primary liver cancer (Hepatocellular carcinoma) and metastatic liver disease from several organs.

Each procedure lasts for two hours or less.  More than one treatment may be necessary depending on the tumor volume.

Most patients are discharged home the morning following the procedure.  Some patients may be discharged the day of the procedure depending on their symptoms following the procedure.

Radioembolization

Radioembolization (Yttrium-90 Treatment) is a procedure designed to treat cancers in the liver.  During the procedure, a catheter will be placed in a vessel in the upper thigh.  Using X-ray, the catheter is advanced into the blood vessel in the liver.  Once the catheter is placed, small particles are injected to treat the tumor.  Attached to the particles are Yttrium-90 radiation particles.

The radiation delivered to the liver is thought to selectively target the tumoral tissue rather than normal liver.  This is based on the normal blood flow of the liver and tumor itself.

The procedure is done at two stages. The first stage is to block the arteries supplying the stomach and intestine and to determine the dose of radiation that should be given. Two weeks later the patient will come for the treatment with radiomebolization.

Similar to chemotherapy, radioembolizationis designed to increase the patient’s life expectancy and improve cancer-related symptoms.

Radioembolization treats cancers in the liver, including Primary liver cancer (Hepatocellular carcinoma) and metastatic liver cancer.

Ablative Therapies

These methods involve placing a needle into the tumor and delivering heat or cold to destroy the cancer cells. It requires no incisions and is effective for some patients who are not candidates for surgery and who have isolated tumors less than 3 cm. Ablation is also used in bones either to relieve pain or sometimes to keep metastases under control after resistance to targeted therapies.

What types of tumors are treated?

• Primary liver cancer
• Metastatic cancer to liver
• Lung cancer
• Kidney cancer

How is the procedure performed?

The procedure is performed with the patient under general anesthesia or conscious sedation.  A needle is placed through the skin and into the tumor under visualization using CT or ultrasound.  Energy is then transmitted through the needle, killing tumor tissue.

How long is the procedure?

Depending on the amount of tumor to be treated, the procedure lasts between 1-4 hours.

How long is the hospitalization?

Patients are usually discharged home the same day or next day after the procedure.

How long is the recovery?

Patients usually return to their baseline status days after the procedure.

How much pain is there after the procedure?

Most patients have very mild pain after the procedure.  Many patients do not require pain medication afterwards.