One of the most rapidly expanding areas of cancer treatment is interventional radiology, also known as interventional oncology. Interventional radiologists use imaging, such as fluoroscopy, ultrasound, and computed tomography (CT), to deliver cancer therapies directly to tumors, leaving surrounding healthy tissue untouched.
Most interventional radiology procedures can be done in an office setting and involve no anesthesia, minimal discomfort, and a fast recovery. These treatments are often used in conjunction with other cancer treatments such as chemotherapy or immunotherapy—especially when cancer has spread (metastasized) or when surgery isn't an option.
Interventional Radiology as Part of Your Treatment
Columbia's interventional radiologists work closely with your cancer care team to coordinate your care. These highly focused treatments can shrink or kill tumors, relieve pain, and often significantly extend life. Most important, our patients maintain their quality of life while undergoing treatment. Usually, patients go home on the day of their procedure and resume their activities within a couple of days.
Embolization is a minimally invasive technique used to block or stop flow in blood vessels. Embolization is especially useful in the treatment of tumors that rely on their blood supply to grow, as well as with tumors that are difficult or impossible to remove surgically.
Through a tiny nick in the skin, we insert a catheter into the artery and guide it to the desired location using real-time imaging. A contrast agent or dye is injected to highlight the vessels for targeting, and then tiny beads are deposited to block the vessel. This prevents oxygen and nutrients from reaching the tumors.
Sometimes we inject chemotherapy medications directly into the tumors or we may inject beads that release high doses of chemotherapy (chemoembolization) or radiation (radioembolization) to treat the tumor most effectively. We can also inject immunotherapy medications directly into the tumors to assist the body's own immune defenses to fight off the tumors. These treatments may also make surgical removal possible once the tumors have shrunk.
Embolization is performed while the patient is conscious but sedated and feeling no pain. It does not require general anesthesia and there is minimal recovery time.
Ablation is an image-guided, non-surgical treatment in which interventional radiologists shrink or destroy tumors with extreme heat or cold. Through a tiny nick in the skin, the interventional radiologist guides a needle-tipped catheter directly into the tumor. We use several different kinds of ablation to treat cancer:
- Thermal ablation: We transmit either argon or helium gas through a needle, lowering the temperature in the tumor to -40°C for several minutes to freeze the tumor (Cryoablation) or we transmit electromagnetic microwaves through the needle which agitate water molecules in the tumor cells and create enough heat to destroy the tumor (Microwave ablation).
- Chemical ablation: We inject chemicals or medications directly into the tumors to destroy the cancer cells
With all ablation techniques patients generally resume their daily activities within 24 to 48 hours. After tumor ablation, the dead tumor tissue shrinks and is replaced by scar tissue over time and may eventually disappear. Because ablation can shrink tumors, it may extend life, relieve pain, and in some cases can cure cancer.
Y90 is a relatively new and highly successful treatment for primary or secondary liver cancer. The treatment targets tumors with a high dose of radiation without affecting other, healthy parts of the body.
Y90 refers to the radioactive isotope yttrium90, which is inserted into tiny particles and used to deliver radiation directly to tumors. The treatment is not a cure for cancer in the liver, but it has been shown to prolong lives for months or years and to greatly improve the quality of life of cancer patients. Patients experience few, if any, side effects from Y90 treatment, which is performed in an outpatient setting. Patients generally resume normal activities within one or two weeks.
Y90 treatment can be used in combination with traditional treatments for cancer, including surgery, chemotherapy, and immunotherapy. Our interventional radiologists will work with your medical oncologist to determine the proper timing of a Y90 treatment as it relates to your other treatments.
People who receive regular treatments with intravenous medications or require blood transfusions may benefit from a central venous catheter. A central venous catheter is a tube that is inserted beneath the skin to allow for a simple, pain-free way for doctors or nurses to draw blood or give medications or nutrients. These catheters also spare patients the irritation and discomfort of repeated needle sticks.
There are several types of central venous catheters, including tunneled catheters (Hickman or Broviac), peripherally inserted central catheters (picc lines), and implantable ports. Implantable ports are used when patients are receiving extended chemotherapy treatments. The device consists of a catheter attached to a small reservoir, both of which are placed completely under the skin. Interventional radiologists implant the port under the skin on the chest and insert the catheter in a large central vein in the chest. It can be done with local anesthetic or a small amount of intravenous conscious sedation.
One common side effect of cancer or cancer treatments is the development of blood clots. Blood clots can be life-threatening if they travel to the brain, lungs, or heart. There are several minimally invasive interventional radiology procedures that can reduce the risks posed by blood clots.
- Thrombolysis: We administer clot-dissolving drugs directly into the clot to break it up.
- Thrombectomy: We use a catheter tipped with a tool that mechanically breaks up the clot.
- Inferior Vena Cava (IVC) filters: A tiny, umbrella-like device can be placed in a major vein called the inferior vena cava to catch blood clots, usually temporarily.
Treatment for blood clots is done with a local anesthetic or a small amount of intravenous conscious sedation and involves little or no recovery time.
Visit the Columbia Radiology website to learn more about interventional radiology procedures.
Interventional Radiology at Columbia Cancer
Interventional radiologists are an integral part of any comprehensive multidisciplinary cancer program. At Columbia Cancer, our interventional radiologists perform thousands of procedures each year to treat cancer and many other conditions. With two outpatient offices in midtown Manhattan and Westchester, we can provide state-of-the-art cancer treatment in a location that's convenient to you.
Our interventional radiologists provide in-person or video consultations for most procedures. If you think you are a candidate for an interventional radiology procedure and would like to schedule a consult, call 212-326-8874.
