Written by Dedes Ioannis MD, PhD, Interventional Radiologist - Interventional Oncologist, Interventional Radiology Department, European Interbalkan Medical Center, Athens Medical Group
Why is interventional oncology the rapidly evolving specialization in cancer treatment? The results of 15 years of experience in the management of cases at the Department of Digital Angiography of the Interbalkan Medical Center of Thessaloniki, are presented by its head Dr. John Dedes, member of the Cardiovascular and Interventional Radiology Society of Europe (CIRSE) specialized in Interventional Radiology-Interventional Oncology (Frankfurt University Clinic) and a post-graduate (Germany, Great Britain, USA). His article:
“Interventional Oncology (IO) provides via minimally invasive methods targeted therapy of a cancer tumor, with the assistance of guided imagery and innovative techniques, thus minimizing the possibility of injury to healthy organs. Generally, it offers assistance to patients who can not have surgery either because of their compromised clinical condition, or because the size, location or tumor number (tumor foci) does not allow it. Also it gives prospect in patients where standard chemotherapy doe not have the desired effect.
Treatments are performed in two ways:
A) Intra-Arterial: By use of a microcatheter on the digital angiogram, chemotherapeutic drugs are effused directly into the tumor in high concentrations and embolism (obstruction with microspheres) of the arteries that supply blood to the tumor is performed, leading gradually to the shrinkage and necrosis of the tumor. It is usually regional (eg. intra-arterial chemoembolization of the liver).
B) Transdermal: With the patient on the CT, a thin needle electrode is positioned in the tumor. This caused overheating (burning 60-100 C) of the tumor within a few minutes (e.g. cauterization with radio frequency (RF) or microwaves (MW) of foci in the liver, lungs, kidneys).
Thus IO treatments are applied in the treatment of unresectable primary tumors of the liver (hepatocellular cancer, cholangiocarcinoma), lung (non small cell) or secondary tumors (liver and lung metastases) from other primary cancers such as colon, stomach, lung, kidney, ovarian, melanoma, sarcoma, neuroendocrine tumors, breast and others, where conventional treatments do not have the desired response. They are always done with the consent of the treating oncologist.
Also drainage and angioplasty of cholangioma offer significant aid in patients with obstructive jaundice. IO advantages include a good quality of life offered to patients with minimal intervention, less pain, fewer side effects and quick recovery. It contributes to increased life expectancy, while most treatments require one day of hospitalization
In several patients combination therapies are applied with chemoembolization and cauterization having spectacular results, as I announced in my speech at the world congress of (IO) in New York in May (WCIO 2015). Some patients with non-invasive hepatocellular carcinoma and a life expectancy of a few months, today surpass a survival of 10 years with a good quality of life.