WVU Medicine interventional radiologists provide minimally-invasive kidney, liver, and lung cancer treatments that target the cancer in ways chemotherapy or conventional surgery can’t. Although these treatments may not cure cancer, they can make a patient more comfortable, possibly extend life, or improve their quality of life. These procedures attack cancer while sparing the healthy tissue in the surrounding area. There are also several techniques used to treat cancer complications, including:

  • Pain
  • Bleeding
  • Obstruction of vital organs
  • Blood clots
  • Infection

There are two main methods by which interventional radiologist can treat cancer. First, they use the vascular system to deliver chemotherapy medicine directly to the cancer’s vascular supply. This limits damage and toxicity to the rest of the body while delivering the highest dose of the chemotherapy to the cancer. Second, they cook or freeze the cancer by inserting a small, energy-delivering needle directly into the cancer. This heats or freezes the cancer without significant damage to the nearby normal tissue. Since these methods focus on the cancer, it results in fewer overall side effects, making this especially useful for patients with other significant medical problems.

Cancer Treatments include:

Chemoembolization is a minimally-invasive procedure used to primarily treat inoperable liver cancer in patients whose tumor(s) began or spread to the liver.

This treatment is not a cure, and results last approximately ten to fourteen months. The procedure benefits include:

  • Decreases tumor size
  • Improves patients quality of life
  • Causes minimal side-effects
  • Faster recovery
  • The procedure can be repeated

There are two blood supplies that feed the liver; the portal vein and hepatic artery. The liver receives most of its blood through the portal vein and a small portion via the hepatic artery. When the tumor develops in the liver, the blood and nutrients supply supporting the growth come from the hepatic artery.

Interventional radiologists use embolic agent to block the blood flow that feeds the growth and deliver a targeted dose of chemotherapy to the tumor. By feeding chemotherapy drugs through the hepatic artery, the tumor is directly targeted and healthy tissue in the liver is preserved. Another advantage is that the cancer drugs do not affect the rest of the body.

Depending on the type of cancer and number of tumors, other treatment options may be paired with chemoembolization including:

  • Surgery
  • Radiation therapy
  • Radiofrequency ablation

The Procedure

Not everyone with inoperable liver cancer is a candidate for this procedure. Prior to the procedure, testing will be done to determine your rate of kidney function and to verify that your blood clots normally.

Be sure to tell your doctor if you:

  • Are diabetic
  • Have kidney disease
  • Have a coagulation disorder
  • Are taking medications
  • Are taking herbal supplements
  • Are allergic to
    • local anesthetics like Lidocaine, Procaine, and Benzocaine
    • general anesthesia
    • iodine
  • Are pregnant

Before the procedure, patients are sedated. Then, using a fluoroscope is a guide, the radiologist makes an incision and insert a catheter through the groin area and guides the catheter to the hepatic artery.

Once in place, the chemotherapy and embolic agents are introduced into the bloodstream. The embolic agents block the food supply that feeds a tumor and cause it to wither, while the good tissue in the liver remains healthy because it receives blood from portal vein. Over the next month, the liver will process and eliminate chemotherapy drug.

The procedure is usually complete in about one and a half hours, followed by a stay at the hospital for one or more days.

Recovery

Most patients are able to resume normal activities within a week.

In the month following the procedure, be prepared for follow-up testing to determine the success of the treatment.

 

Selective Internal Radiation Therapy (SIRT)

Radioembolization is a minimally-invasive procedure used to treat inoperable liver cancer. This treatment is not a cure, but can give a patient a better quality of life. The procedure benefits include:

  • Decreases tumor size
  • Causes minimally minimal side-effects
  • Fast recovery
  • The radiation use does not affect the rest of the body

Depending on the type of cancer, SIRT may also be used prior to, in conjunction with, between, or following chemotherapy

The Procedure

Not everyone with inoperable liver cancer is a candidate for this procedure. Prior to the procedure, testing will be done to determine if you are eligible.

Be sure to tell your doctor if you:

  • Have a coagulation disorder
  • Are taking medications
  • Are taking herbal supplements
  • Are allergic to
    • local anesthetics like Lidocaine, Procaine, and Benzocaine
    • general anesthesia
    • iodine
  • Are pregnant

This procedure is usually performed on an outpatient basis and takes approximately 30 to 90 minutes to complete followed by two to six hours in recovery

There are two blood supplies that feed the liver; the portal vein and the hepatic artery. The liver receives most of its blood through the portal vein and a small portion via the hepatic artery. When a tumor develops in the liver, the blood and nutrients supply supporting growth come from the hepatic artery.

Before the procedure, patients are giving medication that helps with relaxation and blocks pain. Then, using a fluoroscope as a guide, the radiologist makes an incision and inserts catheter through the groin area and guides it into the hepatic artery. Once in place, microscopic beads are introduced into the blood system. The microspheres act as an embolic agent and contain Yttrium 90 isotopes, meaning they block the food supply and deliver a dose of radiation to the tumor. By inserting the radiation via the hepatic artery, the tumor is targeted and healthy tissue in the liver is preserved.

Recovery

Most patients are able to resume normal activities within a day or two. During recovery, many patients experience the following:

  • Fatigue that can last up to four weeks
  • Nausea
  • Vomiting
  • A low-grade fever
  • Loss of appetite
  • Abdominal pain

Most of these symptoms resolve themselves within three to five days. For safety reasons, the first week after treatment avoid extended or close contact with people, particularly pregnant women and children.

Patients can expect to be monitored in the following month with CT, MRI, or PET scans.

 

Radiofrequency ablation (RFA) is a minimally invasive procedure that uses an electrical current to treat tumors that cannot be surgically removed in the liver, kidney, lung, and bone. The procedure is very specific. It is used to treat tumors:

  • Less than two inches in diameter
  • Less than four in quantity
  • Located in specific areas of the body

The procedure can also be used to treat tumors: before a surgery, that recur after a surgery, if the chemotherapy didn’t succeed, or to control cancer before an organ transplant.

RFA targets the treatment area and limits destruction of healthy tissue. It has few side effects, most patients recover quickly, and the procedure can be repeated if necessary. For people with inoperable cancer, radiofrequency ablation is not a cure, but can improve their quality life and eliminate tumors.

In order to determine if you are qualified for radiofrequency ablation, you will need to undergo additional tests. Be sure to tell your doctor if you:

  • Are taking blood thinners or supplements that thin blood
  • Have clotting or a coagulation disorder
  • Are allergic to iodine
  • Are pregnant or nursing

Treatment

Patients are often sedated and given local anesthetic. Grounding pads are placed on your abdomen or legs. Next the doctor uses ultrasound or a CT scanner to locate the tumor.

During the radiofrequency ablation procedure, a probe is inserted into the tumor. When the probe is inserted within the tumor, electrodes are extended from the tip of the probe, and it forms an umbrella shape around the tumor. Next, a radio frequency wave runs through the probe and heats the tumor destroying the diseased tissue. Simultaneously, the blood vessels supporting the tumor are cauterized, minimizing blood loss. The tumor shrinks and the body replaces the dead cells with scar tissue

The entire procedure takes between one to three hours, depending on the quantity of tumors and their dimensions.

Recovery

Patients spend time in recovery and an overnight stay in the hospital. Most patients can return to their regular routine the day after treatment.

Follow-up CT may be ordered to verify that the treatment was successful.