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 to evaluate the current state of disease and develop the best treatment protocols to maximize positive outcomes. This multidisciplinary approach evaluates 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 directly communicate 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, the patient’s functional status, and liver arterial anatomy.
Chemoembolization
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.
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.
Bland Embolization
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 the 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, eliminate the tumor, leading to a 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 procedures in most cases.
Microwave Ablation
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 tumors.
Cryoablation
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 that decreases the temperature of the treatment area and destroys the abnormal cells.
Ancillary Procedures
Central Venous Catheters
A central venous catheter is a long, thin, flexible tube inserted into a large vein, typically in the neck, chest, or groin, through the skin into a large vein. These catheters give medicines, fluids, nutrients, or blood products that need to be given long-term.
PICC Catheters
PICC stands for ‘peripherally inserted central catheter,’ often called a PICC line, and is a catheter inserted into a vein in the arm. These catheters give long-term chemotherapy regimens, antibiotics, or nutrients.
Port Catheters
A Port catheter, or Portacath, is an implanted device that gives access to veins for a patient who needs regular long-term antibiotics or chemotherapy drugs. Ports can also be used to withdraw blood for blood tests.