CHEMOEMBOLISATION AND ABLATION OF TUMORS

“Cancer” the dreaded disease has been increasing in its prevalence over the past few decades. The ever increasing exposure to more smoking, chemicals, radiation in our daily lives added to changes in diet patterns and lifestyles have made this disease a pandemic. Genetics and environment both have their effects on an individuals chance of getting cancer.

Medical science has also been making quantum leaps to overcome this disease. Today many of these cancers can be cured n early stages or forced into remission by modern day medicinal therapeutics in terms of chemotherapy and immunotherapy or aggressive surgeries.

Interventional radiology has contributed immensely to this field with many centers in the world referring to this stream of interventional radiology treating tumors as interventional oncology.

In addition to the diagnosis of these cancers by performing image guided biopsies from deep seated tumors in the chest and abdomen or placing chemotherapy PICC lines and ports, now the interventional radiologists play a vital part even in the treatment of these tumors.

The Interventional Radiologists can ablate(burn) these tumors in organs like the liver, lung, kidney or bone without open surgery or incision by using their imaging precision and targeting the tumor with a needle by imaging guidance using ultrasound or CT. The needle is guided to the tumor location and the tumor burnt in its place, This saves the patient from an open surgery and its risks and usually involves only a day’s stay at the hospital. This is routinely performed when tumors are small in size in a wide variety of tumors like hepatocellular carcinoma, lung cancer, metastases, osteoid osteoma, etc to name a few. The technologies to ablate can vary from Radiofrequency ablation to microwave ablation to newer ones like cryo ablation and IRE.

Interventional Radiologists routinely help the surgeon to de-vacularise tumors before surgery by embolization which involves mapping out the blood supply to the tumor by angiograms and then reaching the arteries supplying the tumor by small tubes called catheters and closing these arteries by embolic material.

The same concept is extended to deliver chemotherapeutic drugs to the target tumor, there by increasing the local concentration of the drug in the tumor and to reduce systemic side-effects. This is known as chemoembolization. Radiation can also be delivered to advanced tumors by drug beads coated with radiation delivery isotopes (like y90 in HCC) known as TARE or transarterial radioembolization.

In cases of severe jaundice, IR doctors perform biliary drainage procedures, or diversion procedures for urinary decompression by nephrostomies all by minimally invasive pricks.  Palliative procedures like pleurex drainage procedures and pleurodesis etc are also performed.

The interventional radiologist is an important part of the cancer treatment team and patients can always talk to them and discuss if such advanced treatment options can help them.

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