Interventional oncology (IO) is a subspecialty of interventional radiology (IR) that uses image guidance to perform minimally invasive procedures or interventions in an effort to diagnose, treat and cure patients with a variety of cancers. IO is the fastest growing area in IR and has been recognized as another pillar of oncologic care, together with radiation oncology, medical oncology and surgery oncology.
Interventional treatments are highly focused, direct and targeted, which results in greater potency of doses to the tumor with improved sparing of normal, noncancerous tissue.
The procedures are minimally invasive with no surgical incisions, faster recovery times, less morbidity and shorter to no hospital stays.
IO therapies fall into two main categories:
Arterial-based treatments block blood vessels leading to tumors using tiny beads soaked in chemotherapy drugs or loaded with radiation. These procedures starve the tumor of blood while poisoning it directly without causing side effects to the rest of the body. The two main treatments are called transarterial chemoembolization (TACE) or transarterial radioembolization (TARE). Radioembolization is also known as selective internal radiation therapy (SIRT) or Y90 treatment. These therapies are primarily used to treat primary liver cancer or metastatic disease to the liver from cancers such as colon, breast, lung, pancreas and neuroendocrine.
Ablative therapies use needles, called probes, that can get hot or cold in a very controlled manner to treat tumors through a small puncture in the skin. These technologies more or less are either cooking or freezing the tumor. The tumor subsequently dies and then gets reabsorbed by the body. The two main treatments are called microwave ablation and cryoablation. These therapies can be used to treat a variety of primary tumors including liver, lung, kidney and almost any metastatic process that affects these organs.
Interventional oncology procedures
In addition to cancer treatment, IO is vital in cancer diagnosis, management of cancer complications, management of complications of cancer treatment and palliative care. The following procedures are routinely performed by the interventional oncology service:
- Image guided biopsy using CT, US and fluoroscopy
- Long term IV access including port and PICC insertion
- Drainage procedures (tunneled peritoneal and pleural catheter, abscess drains, thoracentesis/paracentesis)
- Enteral access including primary G and GJ tubes
- Genitourinary access including suprapubic, nephrostomy and nephroureterostomy catheter
- GI procedures including percutaneous biliary drainage and portal vein embolization
- Palliation including cryoablation for soft tissue and osseous metastasis, kyphoplasty/vertebroplasty, back pain injections (epidural and facets), celiac plexus blocks
- Vascular recanalization for tumor compression or obstruction
- Bland embolization of bleeding tumors
- IVC filter insertion and removal
- Thoracic duct embolization
Interventional Oncology will be a critical component of the multidisciplinary cancer team at the White Plains Hospital Center for Cancer Care—recognized throughout the region as a destination for top quality and lifesaving cancer care.