Imagine an exquisitely precise cancer therapy procedure done through a small opening in the body that can:
- Kill tumor cells, shrink tumors, or regrow the healthy part of a cancerous organ.
- Deliver chemotherapy or radiation directly to the cancer site.
- Usually be done as an outpatient procedure with fewer side effects than conventional treatments like chemotherapy.
- Potentially treat many types of cancer, either alone or combined with other therapies.
Sounds too good to be true, right? Not necessarily, since this type of therapy, called interventional oncology, is now being performed hundreds of times every day by specialists in a medical field that is unfamiliar to many cancer patients. Many predict this fast-growing specialty will soon join medical, surgical and radiation oncology as the fourth pillar of cancer care.
Pioneers in Precision Medicine
Interventional oncology is an image-guided, minimally invasive surgery done by radiologists that uses imaging scans as maps to identify the location of tumors and blood vessels as pathways to kill tumors or shrink and prepare them for removal. Most procedures are either outpatient or require a brief overnight stay in the hospital. Recovery time is minimal; some patients are active as early as the next day. Plus, there are rarely the physical complications associated with surgery nor the side effects with chemotherapy or external radiation, like hair loss.
Interventional oncology is a subset of the field of interventional radiology and will be the hottest topic at the Society of Interventional Radiology annual meeting in Vancouver next week. It's also part of a broader healthcare trend called Interventional Medicine, which pinpoints problems inside the body and delivers treatments exactly where they're needed most with minimal impact on the patient and their quality of life.
More Options for Older and Sicker Patients
Because of advances in medicine and post-operative care, many cancer patients today are older, sicker and have had more chemotherapy and surgeries than ever before. Interventional oncology offers some ingenious therapies for these and other patients with difficult-to-treat cancers. For example:
- Tiny beads -- some the width of a human hair or smaller -- can be injected directly into blood vessels that feed a cancerous tumor to cut off its blood supply and starve the tumor.
- In another procedure, microscopic beads deliver precise doses of radiation directly to the tumor in higher amounts than could ever be imagined with traditional external beam radiation in a single session. My company, BTG, a leader in interventional medicine, will soon launch new treatment planning software that even allows physicians to send out molecular "scout doses" to anticipate how much radiation will go to the tumor allowing them to personalize the dosage.
- Interventional radiologists have developed a technique that induces regrowth on the healthy side of patients' livers prior to surgery on the cancerous side, which makes surgery a viable option for patients with liver cancer.
- Instead of using blood vessels as the route to the tumor, interventional radiologists can also use image guided procedures combined with high tech needles to destroy tumors with heat (radiofrequency or microwave ablation) or freeze tumors to death (cryoablation).
Ready for a Bigger Role in Cancer Care
If you were designing an ideal cancer therapy from scratch, it would probably look a lot like interventional oncology. It's precise, personalized and patient-friendly. It's potent, flexible and offers a range of new weapons to attack tumors. Its effects are local, not systemic. Many of the techniques in interventional oncology also "play well with others" and potentially can be combined with other therapies, including the newest class of drugs called immunotherapies.
New developments in imaging technology will continue to make interventional oncology even more precise. BTG recently collaborated with Phillips, a leader in medical imaging, to treat cancer patients with LC Bead LUMI™, the first commercially available bead in the U.S. that can be seen on an X-ray or CAT scan by the interventional radiologist. This product allows doctors using advanced imaging techniques to see the exact location of the beads during the procedure and make real time adjustments to block or reduce blood supply to the tumor.
Even with all the advances being made in medicine and technology, much more needs to happen before interventional oncology reaches its full potential. First, this image-based specialty needs to continue building its own image campaign to raise its profile among medical and surgical oncologists, insurance companies, patient advocacy groups and the general public. Greater education and awareness would increase the likelihood that these innovative techniques are considered as a potential therapeutic option whenever appropriate.
Second, the medical device industry -- including us at BTG -- and government agencies must support new research that would generate the data and evidence to support broader adoption of these new approaches. Perhaps interventional oncology should get a share of the $1 billion allocated by the U.S. government for its new cancer "Moonshot" initiative, which supports precision medicine.
It's time to give interventional oncologists the attention and recognition they deserve for improving the lives of cancer patients. These pioneering healthcare professionals are using tools and techniques that would have seemed like science fiction only a generation ago in the fight against one of humanity's worst enemies. Although it's still in its infancy, there's no doubt interventional oncology will continue to play an increasingly prominent role in cancer care.