Specialties

  • Interventional Oncology

  • Interventional oncology focuses on the diagnosis and treatment of cancer using image-guided technology, such as CT scans, MRIs, X-rays, and ultrasound, to detect and target cancer and solid tumors. Doctors who practice interventional oncology are called interventional radiologists or interventional oncologists. Compared to more invasive open surgery, interventional oncology procedures offer the potential for less pain, less bleeding, faster recoveries, shorter hospital stays and fewer complications.

    Diagnosis

    To diagnose cancer, interventional radiologists often use imaging techniques to guide the insertion of a fine needle into a patient's tumor to conduct a biopsy. A biopsy is a procedure to remove a small amount of tissue for examination under a microscope to determine if cancer cells are present. Needle biopsies offer the potential for less scarring, less pain, and shorter recovery times compared to traditional surgical biopsies.

    Treatment

    Guided by imaging technology, interventional radiologists insert thin tubes (catheters, endoscopes, and other small specialty tools) into your body to view the surgical area and deliver targeted treatments that destroy cancer cells and abnormal growths. Interventional oncology treatment techniques include freezing tumors, exposing them to radiation, blocking blood supply to the tumor, delivering chemotherapy, and more. Many types of endoscopic surgical tools have been developed to enable the interventional oncologist to perform minimally invasive surgery. While the specifics of these procedures vary widely, the image-guided system provides a view of the surgical site through a tiny camera so your doctor can target the treatment and limit damage to nearby healthy tissue.

    More recently, researchers have developed methods to look inside your body without using tubes. For example, tiny endoscopes shaped like capsules can be swallowed to transmit images of your gastrointestinal tract wirelessly. Or interventional radiologists can use a special CT scan to look inside the organs in a procedure called a virtual endoscopy. Examples of virtual endoscopies include a virtual bronchoscopy to look inside the lungs and a virtual colonoscopy or virtual colonography to look inside the colon.

    Palliative Care

    Endoscopic surgery can be used to control symptoms in patients with inoperable cancer. For example, interventional radiologists can thread tiny instruments through an endoscope to remove blockages in a patient’s lungs. Or the surgeon can use endoscopic tools to open a narrowed airway by placing a stent (a small rigid tube) into the airway.

    Examples of interventional radiology procedures used to treat cancer include:

    • Radiofrequency ablation (RFA) is a localized cancer treatment that uses high-energy radio waves to heat and destroy cancerous cells. During RFA, a thin, needle-like probe is temporarily inserted into a tumor through a tiny incision in the skin using CT scan or ultrasound guidance. The probe releases electrodes that heat and destroy cancer cells. RFA may be used to treat tumors when surgery is not an option or to relieve other symptoms related to cancer treatment.

    • Cryosurgery (or Cryoblation) is a localized technique that uses a cold probe to freeze a tumor or cancerous tissue. It may be used on the skin or inside the body on a tumor. In the case of internal tumors, liquid nitrogen or argon gas is circulated through a hollow tube called a cryoprobe to target the tumor. The interventional radiologist uses ultrasound or MRI to guide the cryoprobe. Imaging technology allows your doctor to carefully monitor the freezing of the cells to limit damage to healthy tissue. Cryotherapy is less invasive than traditional surgery, involving only a small incision to insert the cryoprobe through the skin. Because additional studies are needed to confirm the effectiveness of cryosurgery in controlling cancer and in improving survival, some insurance may not cover this technique.

    • Chemo-Embolization is a localized procedure to treat tumors of the liver that either originated in the liver or spread (metastasized) to the liver from other organs. The procedure relies on image guidance to deliver targeted chemotherapy directly to the site through its blood supply. It is performed by placing a small hollow tube (catheter) from the blood vessel in your groin into the artery that supplies blood to the liver. This delivery method better targets the cancer cells and allows the medication to stay in contact with the tumor for up to a month. It also reduces levels of chemicals randomly circulating throughout the patient’s system.

    • Selective Internal Radiation Therapy (SIRT) uses image guidance to target and treat malignant tumors in the liver directly via its blood supply using radiation-coated particles. Because it’s so targeted, this method allows very high doses of radiation to be delivered to the tumor, while protecting the organs around the tumor from radiation damage.

    Research and Certifications

    Interventional oncology/radiology is considered the fourth arm of cancer therapies alongside medical, surgical and radiation therapies. It may be used alone or in combination with these and other cancer therapies. The National Institutes of Health (NIH) is currently conducting research to expand the use of interventional radiology in the treatment of cancer. These studies include developing imaging methods for targeted drug delivery systems to cancer cells, developing “Smart” biopsy using electromagnetic navigation, combining anti-cancer treatments with radiofrequency ablation (RFA) of solid tumors, and combining ablative techniques, such as RFA, with immunotherapy of solid tumors.

    In 2012, the American Board of Medical Specialties (ABMS) approved interventional radiology as a primary specialty in medicine. In 2013, the American Board of Radiology (ABR) announced that it would certify interventional radiology doctors in interventional radiology and diagnostic radiology. The field of interventional radiology continues to make significant contributions to cancer diagnosis and treatment, offering patients less invasive options and highly targeted therapies.

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