As Interventional Oncologists, we cure cancer and help patients with cancer live longer while enabling a high quality of life. We work directly with Oncologists, Surgical Oncologists, and Pathologists in order to evaluate the current state of disease and come up with the best treatment protocols to maximize positive outcomes. This multidisciplinary approach involves evaluating past/current treatments, disease pathology, and imaging during meetings such as Tumor Boards. We customize treatment protocols for each case and have established systems to streamline formal consultations, imaging protocols, and post-procedure follow up including overnight observation admissions (if needed) and follow up clinic visits. We take ownership of our patients and are in direct communication with the referring physician before and after the procedure.
LIVER-DIRECTED CANCER TREATMENT
Cancer that has metastasized to the liver or primary liver cancer can be effectively treated with intra-arterial liver-directed treatments. Cancers in the liver that have shown a good response to intra-arterial therapies include cancers that originate in the liver such as hepatocellular carcinoma, cholangiocarcinoma, or metastatic disease to the liver from colon cancer, breast cancer, neuroendocrine cancer, lung cancer, and melanoma.
There are three primary modes of intra-arterial treatment which include Radioembolization, Chemoembolization, and Bland Embolization. The treatment that the patient receives depends on a multitude of factors including cancer type, liver function, the volume of disease in the liver, patient’s functional status and liver arterial anatomy.
RADIOEMBOLIZATION (Y-90 Sirspheres)
Radioembolization is used to treat primary liver cancer and other cancers that have metastasized to the liver. Radioembolization is used to deliver targeted internal radiation therapy directly to the tumor.
Chemoembolization therapy is used to treat liver tumors or for postsurgical adjunctive treatment. Chemotherapy medicines are injected into the liver through blood vessels, delivering a high local dose of cancer-killing medicine directly to the tumor or tumor area.
Bland embolization therapy is used to treat liver tumors or for postsurgical adjunctive treatment. An embolic agent is also put into the liver arteries which cuts off the blood supply and essentially starves the tumor of the blood they need to survive and grow.
PERCUTANEOUS ABLATION OF CANCER
Percutaneous ablation is an outpatient procedure. It involves treatment of tumors by placing one or multiple probes through the skin into the tumor and then using heat (radiofrequency or microwave), cryotherapy or chemicals such as alcohol to kill the tumor cells. A small amount of healthy tissue around the tumor is also ablated to achieve clear margins similar to surgery. There are other percutaneous ablative therapies including high intensity focused ultrasound and electroporation that have limited use at this time.
These outpatient procedures, if performed appropriately, completely eliminate the tumor leading to cure without the need for large incisions or lengthy, often painful, recovery times. They are the perfect alternative to surgery and have minimal to no side effects.
We use two of the following percutaneous ablation procedure in most cases.
Microwave ablation is a treatment that uses electromagnetic waves to create heat and directs the heat through a needle probe which is inserted into a collection of abnormal cells or tumor.
Cryoablation is a treatment that freezes abnormal or tumor cells. A needle probe is inserted into the tumor using CT or Ultrasound guidance and releases a gas which decreases the temperature of the treatment area and destroys the abnormal cells.