The development of new and more effective cancer treatments is breaking previous limitations and providing clinicians with new and more capable tools to fight the disease. The traditional pillars of cancer treatment have been surgery, radiotherapy, and chemotherapy. Now cancer patients have the benefit of a fourth pillar, interventional oncology (IO), to diversify and personalize their treatment options.
As the fastest growing specialty in oncology care, IO is drastically improving the lives of cancer patients across the globe by providing minimally invasive advances in the diagnosis, treatment, and management of cancer.
What is interventional oncology?
According to the Society of Interventional Oncology, IO provides image-guided, minimally invasive procedures, to diagnose and treat cancer. IO also plays a crucial role in pain palliation and treating other cancer-related health issues. They can be performed in place of or in combination with open surgical procedures, radiation, and/or chemotherapy to provide truly comprehensive and less invasive treatment options.
With a combination of skill sets in the fields of radiology and minimally invasive techniques, interventional radiologists provide IO treatments to cancer patients under image guidance, like Computed Tomography (CT) or ultrasound, through small incisions in the skin, reducing time, pain, and risk. IO procedures also have the added benefit of being able to treat difficult to reach organs and tissue not easily accessed by surgery.
What are examples of interventional oncology procedures?
Today, the IO specialty is a rapidly growing field in cancer diagnosis, cancer therapy, and symptom palliation.
Cancer diagnosis
Biopsy: During a biopsy procedure, cells or tissues are extracted for examination in the pathology lab in order to determine whether the tissue is cancerous. If cancer is present, the biopsy can identify where in the body the cancer originated from and what grade of cancer it is.
Cancer therapies
Ablation: Ablation procedures physically destroy the cancerous tumors without surgical excision. Radiofrequency ablation (RFA) and microwave ablation (MWA) use intense heat to destroy tissue, while cryoablation uses extreme cold to destroy tissue. Cryoablation has the additional benefits of being well visualized under image-guidance to ensure adequate margins of tissue are treated and is considered as almost painless procedure because the ice ball that grows has a numbing effect.
Example of the ProSense Liquid Nitrogen system freezing a tumor
To read more on cryoablation visit our blog on How Does Cryoablation Work to Destroy Tumors by Freezing Them
Drug delivery: Interventional oncologists can deliver therapeutic agents (such as chemotherapeutic drugs and radiation) directly into the tumor or through the use of intravascular catheters.
Pain Palliation
IO plays a crucial role in providing palliative care to cancer patients, including pain relief, mitigation of cancer-related symptoms, and end-of-life care. Pain as a result of metastasized cancer (that has spread to other parts of the body) affects 60%-90% of patients with advanced cancer. As opioids are often insufficient due to their high side effect profile, it can be a major challenge to treat. This is especially true for metastatic bone tumors.
Recent studies have shown that cryoablation can provide rapid and durable pain palliation especially for metastatic soft tissue and bone tumors, improving quality of life, and offering an alternative to opioids for pain control. to treat painful bone metastases using the ProSense liquid nitrogen cryoablation system. Watch this video of a procedure to treat painful bone metastases using the ProSense™ Liquid Nitrogen cryoablation system.
When is interventional oncology considered?
As an emerging subspecialty of interventional radiology, IO plays an increasing role in cancer treatment guidelines and on multidisciplinary tumor boards that determine the best treatment options for patients.
According to the International Accreditation System for Interventional Oncology Services, the surgical removal of cancerous tumors is still generally accepted to provide the best long-term solution for cancer treatment. However, for smaller tumors or for tumors that cannot be treated surgically due to the size, number, location of the tumor, and/or the patient not being a candidate for surgery. IO offers an alternative treatment approach. IO also offers an approach to provide precision cancer therapy for multiple organ systems.
What are the benefits of interventional oncology?
The minimally invasive nature of IO procedures means they cause less pain, requiring only local anesthesia or mild sedation, and have improved cosmetic outcomes. They are also associated with fewer side effects and shorter recovery times, with patients discharged the same or the next day. Furthermore, they can be performed on an outpatient basis, reducing hospital stays and costs.
IO therapies can also be used to shrink tumors (tumor debulking), enabling future surgical or interventional treatments. In complex cases where patients are too weak or have other comorbidities to undergo surgery, IO treatments can be applied to provide effective and milder forms of treatment. Oncological techniques can also be used in combination with other treatments to help increase their efficacy.
The evolution of IO in the 21st century
Over the last decade, image-guided oncology interventions have helped clinicians treat cancer more effectively. In interventional oncology, any malignancy that can be reached by needle or catheter is treated using image-guided approaches.
With high-quality medical imaging, targeted treatment can be delivered more effectively and with less invasive procedures. Due to the risks of infection and damage to surrounding healthy tissues, needle biopsies and other types of interventional treatments are generally preferred to more invasive treatments.
An article from the British Journal of Radiology further highlights the progress of IO in the 21st century. In addition to surgery, chemotherapy, and radiotherapy, IO has proven highly effective in the local treatment of numerous malignant tumors. As interventional oncology’s targeted treatments become standard of care worldwide, this can have a real impact on the overall patient experience including improved results and prolonged survival.
With the advent of immune-oncology and its ability to control tumors at the molecular and cellular levels, a system change is currently taking place – IO is shaping the future of oncology!
Interested in learning more about cryoablation?
Meet us at the 2023 SIO Annual Scientific Meeting,
January 19-23 at booth #27!
