Why is interventional oncology the fastest evolving specialty in cancer treatment? Dr. Ioannis Dedes, a member of Cardiovascular and Interventional Radiological Society of Europe (CIRSE) specialized in Interventional Radiology – Interventional Oncology (Frankfurt University Clinic) and Continuing Education (Germany, USA) presents the results of his 15 years of experience in managing the cases of the Department of Digital Angiography of the Inter-Balkan Medical Center at Thessaloniki, of which he is the head.
"Interventional Oncology provides targeted cancer treatment with minimally invasive methods, with the help of visual guidance and innovative techniques, thereby minimizing the chance of injury to healthy organs. In general, it provides assistance to patients who cannot be operated on, either because of an aggravated clinical situation or because the size, the location or the number of the tumors (cancer cells) does not allow it. It also gives prospects to patients where classic chemotherapy does not have the desired effect.
The treatments are performed in two ways:
A) Cardiovascular: With the use of microcatheters in the digital angiographer, chemotherapeutic drugs are injected directly into the tumor at high concentrations and embolization (occlusion with microspheres) of the arteries that supply the tumor with blood, leading to gradual shrinkage. They are usually regional (e.g. intra-arterial liver embolism).
B) Percutaneous: With the patient on the CT scan, a thin needle-electrode is inserted into the tumor. It then causes overheating (burning 60-100 C) of the tumor within minutes (e.g. thermal cautery with radiofrequency (RF) or microwaves (MW) of foci in the liver, lungs, and kidneys).
Thus Interventional Oncology treatments are applied to the treatment of uninjured primary liver tumors (hepatocellular carcinoma, cholangiocarcinoma), lung (non-small cell carcinoma) or even secondary tumors (liver and lung metastases) from other primary cancers, such as renal and ovarian cancer, melanoma, sarcoma, neuroendocrine tumors, breast cancer etc. where conventional therapies do not have the desired response. They are always performed with the agreement of the oncologist.
Drainage and angioplasty of the bile duct also provide significant assistance to patients with obstructive jaundice. The advantages of Interventional Oncology are the good quality of life it offers to patients with minimal invasiveness, less pain and side effects and quick recovery. It helps prolong life expectancy, while most treatments require a day of hospitalization.
Many patients are receiving combination treatments of chemo embolism and thermal cautery with spectacular results, as I announced in my speech at the World Conference on Interventional Oncology in New York in May (WCIO 2015). Some patients with undiagnosed hepatocellular cancer and life expectancy of few months today exceed 10 years of survival with a good quality of life.”