Interventional oncology: an indispensable part of modern cancer care (#107)
Interventional Oncology offers both palliative and curative procedures. It is based on technology but is not defined by it. It is an alternative to surgery in appropriate patients and is complementary to chemotherapy and radiotherapy.
Interventional radiologists have used palliative procedures in cancer patients for decades. However, in recent years, potentially curative techniques that have been developed, including tumour ablation, embolization with radioactive beads, and chemoembolization. The potential that these techniques have for curing cancer makes it necessary to consider new patient pathways and makes it possible for interventional oncologists to receive direct referrals.
Interventional Oncology is developing fast. There are rapid advances in interventional equipment and in imaging guidance. The results of combining interventional treatment with radiotherapy and chemotherapy are being actively investigated. Relatively new methods of treatment, such as irreversible electroporation and microwave therapy are dealing with some of the obstacles previously encountered in tumour ablation.
Imaging guidance is at least as important as interventional radiological equipment when it comes to ablation. Instant 3D CT and computerized methods of planning are already beginning to make a contribution and will revolutionise treatment in the future.
Novel therapies are also being introduced. Innovation sometimes involves new methods of applying established concepts, such as chemosaturation, which was previously possible only with surgery, and which was therefore very difficult to use repeatedly. Interventional techniques have enhanced the potential of this treatment. Nanoparticles can be used to deliver drugs or radiation to a tumour using a variety of approaches. Oncolytic viral therapy is also being explored.
The combination of percutaneous tumour ablation techniques with chemotherapy or radiotherapy is producing very promising results.