Most cancer patients are treated with surgery, chemotherapy and/or radiation therapy, often in combination. Your doctor may also suggest one or more interventional radiology procedures, which can be used for diagnosis and staging of your cancer, insertion of medical devices (such as drains or PICC lines for chemotherapy) and to perform procedures that will keep you more comfortable.
Image-guided procedures are minimally invasive. This means they offer many advantages over traditional open surgery, including less risk, less pain and a faster recovery time. At Torrance Memorial we offer the following interventional radiology procedures for the treatment of cancer:
A needle biopsy is less painful, disfiguring and invasive than conventional surgical biopsy. Using imaging for guidance, a fine needle is sent into the tumor. Once there the needle is used to extract a small amount of tissue to be examined by a pathologist for diagnosis and staging of cancer.
This image-guided procedure delivers highly concentrated chemotherapy medication via catheter directly to a liver tumor. This has many advantages, including the ability to keep a steady stream of medication in contact with the tumor for long periods of time (up to a month). Chemoembolization also minimizes damage to nearby tissue and serves to block the blood supply to the tumor, also beneficial to patients.
Interventional radiologists can treat certain types of tumors by using extreme heat or cold to kill cancer cells. Using imaging technology for guidance, an interventional radiologist threads a needle (or probe) through a small incision in the skin and passes it through the bloodstream and into the tumor. Once there, the instrument is used to apply heat (using radiofrequency, laser or microwave energy) or cold (a treatment called cryoablation) with the goal of eradicating all cancer cells.
Relief of Obstructions
A tumor may grow to the point where it obstructs the flow or urine or bile, causing a buildup of fluids that is not only painful but dangerous. An interventional radiologist can insert an x-ray guided catheter to drain the fluid, sometimes also installing a stent (permanent or temporary) that will keep fluids draining normally.
Treating Complications of Cancer
Working in conjunction with oncologists, interventional radiologists are able to perform procedures that can be helpful in treating many complications of cancer, improving patient comfort and quality of life and sometimes even helping people to live longer.
Controlling pain is an important aspect of cancer treatment. Pain is often caused by a tumor's growth into surrounding tissue and nerves or when it spreads (metastasizes) to the bones. Pain is not just unpleasant and uncomfortable but can also affect a patient's quality of life and ability to function. Sometimes pain interferes with a patient's ability to tolerate helpful cancer treatments.
Two types of interventional radiology procedures can help.
If pain is the result of a tumor pressing on a nerve, a catheter may be inserted to deliver a destructive agent to eliminate the nerve. Catheters may be used to drain fluids, sometimes involving insertion of a stent to bypass an obstruction.
This procedure can be helpful in reducing pain as well as in controlling bleeding, which is another complication of cancer. Transcatheter embolization involves the injection of tiny particles (the size of a grain of sand) through a catheter and into an artery that supplies blood to the tumor. The procedure causes blood to clot, minimizing blood flow and shrinking the tumor.
Treating Blood Clots
Some cancer treatments cause blood to clot excessively. These clots (emboli) can be life-threatening if they travel to the brain, lungs or heart. Two interventional radiology procedures that prevent this from happening are:
Clot-busting drugs are delivered through a catheter to the site of a blood clot.
Caval Filter Placement
Typically used when a blood clot is found in the leg (deep vein thrombosis), this procedure involves inserting a small filter into the vena cava, the blood vessel that carries blood from the lower body to the heart. The filter remains in place to catch and trap clots so they won't reach the heart.
Delivering Drugs or Nutrition
People with cancer may need to have tubes placed in their body for the delivery of medications or nutrition. An interventional radiologist can perform this procedure non-surgically, which is far more comfortable and less invasive to patients.