When a diagnosis of cancer or a tumor is made, it is difficult to fathom that it happened to you or someone you love. The good news is there may be multiple options for treatment.
Newer approaches developed in the last 10 years help to preserve as much of the affected organ(s) as possible. While cancer is not the most common cause of death (cardiovascular disease is), a number of subtypes of cancer are still quite harmful, so it is good to know some newer treatment options.
Interventional radiology uses image-guided techniques to perform minimally invasive procedures. Catheter and needle-based approaches provide lower-risk alternatives to many traditional medical and surgical therapies for patients with cancer. The ability to precisely administer therapy and chemotherapeutic agents directly to tumor cells helps to decrease the impact to non-cancerous cells.
Renal tumors
For certain cancers, interventional radiology treatments may even be curative.
For example, an option is now available for tumors involving portions of the kidney (also known as Renal Cell Carcinoma) to be treated using cryoablation (freezing the cancerous cells). A hollow needle is introduced into the cancerous mass under CT guidance. A cryogen (frequently liquid nitrogen) will flow through a wand to freeze the fluid in adjacent cells. The time the cryogen is allowed to flow through the specifically sized wand will determine the radius of the cells that are impacted. Longer flow time will result in a greater radius of frozen cells. Results will vary depending upon the size and location of the tumor.
The interventional radiologist will want to minimize inclusion of normal renal tissue in the "freeze zone." CT or MRI imaging is generally used in the subsequent months to monitor the process by which the body clears these tumor cells and ensure that new lesions do not occur.
Liver tumors
For liver tumors, a catheter-based approach now exists for those isolated to segments of the liver.
While many different tumors can spread (metastasize) to the liver, treatments have had traditionally involved IV infusion of chemotherapy regardless of the number of locations of these lesions. By allowing the chemotherapy to travel throughout the body, these drugs induce many side effects on their way to the liver. By using a catheter to inject the chemotherapeutic agents directly into the portion of the liver that is involved, interventional radiologists can infuse the agent at a higher dose directly at the site of the tumor.
The ability to increase the dose that is delivered through the catheter helps to eradicate the tumor cells at a much higher rate. This approach also decreases the drug's side effects, minimizing harm to normal cells throughout the body. As with treatments for renal tumors, the liver lesions are monitored with CT or MRI imaging every three months to ensure the effect of the treatment is sustained.
Unfortunately, such liver therapies are less likely to be curative, as multiple lesions usually exist by the time this technique is utilized. Early diagnosis of cancer generally increases the chances for successful treatment. Everyone's situation is unique. The Interventional Radiologist will discuss with the patient the likely benefit of the treatment.
Screening for early detection
Many cancers, including the most lethal one -- lung cancer -- have screening tests. For those who do not have cancer, but may be at risk, a screening test is recommended.
One example of a screening test many people are familiar with is a mammogram, which has been shown to save lives by finding breast cancer as early as possible.
Another example is a low-dose CT lung cancer screening. According to the American Lung Association, more than 90 percent of eligible patients do not get screened. If you or a loved one has ever smoked, you can find out if you are eligible for a lung cancer screening by going to savedbythescan.org. In the event that a screening test finds a concerning area, an Interventional Radiologist can obtain a sample of the tissue, when necessary, without needing general anesthesia.
Do yourself a favor and talk to your primary care provider about the benefits of screening tests.
Veeral Bhoot, D.O., M.A, specializes in Interventional Radiology at SSM Health St. Mary's Hospital. He completed an Interventional Radiology fellowship at the Hospital of University of Pennsylvania, Philadelphia. Dr. Bhoot completed his Diagnostic Radiology residency at Mercy Catholic Medical Center, Darby, Pennsylvania. He received his Doctor of Osteopathic Medicine degree at the University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine. In addition, Dr. Bhoot received a Master of Arts in Biotechnology at Boston University. To speak with the Interventional Radiology Nurse Navigator at SSM Health St. Mary's Hospital, please call 573-681-3164 or email [email protected].