For patients

Chemoembolization (also called transarterial chemoembolization or TACE)  is a minimally invasive treatment for liver cancer. Using real-time imaging an IR first places a small catheter in the femoral or radial artery. They will then direct and move the catheter towards the liver arteries supplying the tumor. When the IR finds the precise artery, they will deliver a chemotherapy agent to the tumor which then stops the blood supply to the tumor causing the tumor cells to die. 

Radioembolization, or selective internal radiation therapy (SIRT) or transarterial radioembolization (TARE), is a treatment used to destroy tumors. The doctor makes a tiny cut in the skin and inserts a catheter (a thin, flexible tube) into the femoral or radial artery (the large artery of the leg or wrist). The catheter is then maneuvered into place, guided by live X-rays.

Once at the tumor site, the doctor injects the radioactive beads into the blood vessels that supply the tumor. The beads give off radiation over a very short distance, which concentrates the radiation inside the tumor, helping to reduce radiation exposure to the rest of the body. This treatment may also be referred to as Y-90 because it commonly uses a radioactive isotope called yttrium-90.

Bland embolization deploys the same techniques as above, but without radiation or chemotherapy drugs included in the embolization medium. This approach is frequently used to treat neuroendocrine tumors, which can affect the gastrointestinal system, the kidneys, the pancreas or the lungs, among other organs.

Cryoablation destroys cancer cells by emitting extremely cold temperatures at the location of the tumor.

Irreversible electroporation is the newest form of ablation technique that uses electromagnetic waves to destroy cancer cells.

Microwave ablation uses electromagnetic waves to destroy a tumor. The tumor is localized via image guidance and then a thin microwave antenna is placed directly into the tumor. A microwave generator emits an electromagnetic wave through the antenna and these waves agitate water molecules in the surrounding tissue. The friction and heat generated by this action cases cell death helping to destroy the tumor.

Radiofrequency ablation (RFA) uses radio waves to create heat and damage tissue. RFA is used to decrease pain by damaging pain-sensing nerves or to treat cancer by damaging tumor cells. A probe is placed into the target tissue where they emit an electrical current to transmit radio waves to the surrounding tissue, which heats up causing cells to die.

MRI-guided transurethral ultrasound ablation (TULSA) is a minimally invasive procedure for prostate cancer. In this treatment, an IR inserts a small catheter-like device through the urethra into the prostate. Once there, MRI is used to guide precise positioning of 10 therapeutic ultrasound elements into the prostate. MR thermometry is used to monitor the tissue while heating to more than 55 degrees within the prostate and limiting heat to the sensitive nerves surrounding the prostate as the device rotates around the entire gland. The procedure can be performed in an outpatient or in-patient facility under general or spinal anesthesia in 2–3 hours. This image-guided therapy maximizes our ability to kill cancer cells while minimizing collateral damage to the prostate to achieve the ultimate trifecta in prostate cancer treatment: full local cancer control while maintaining urinary continence and potency. The latter are the complications of most prostate cancer therapies that patients hate and often result from a lack of precision in treatment monitoring.

Control of pain is one of the most important aspects of cancer care. Pain not only affects patients’ quality of life and ability to function, but it may also lower their tolerance for needed cancer treatments.

In many cancer patients, pain results from the spread of the tumor into surrounding nerves and other tissues. To treat the pain, interventional radiologists insert catheters or needles into the affected area and apply techniques to destroy the nerves causing the pain.

A particularly painful complication of cancer is when the disease spreads (metastasizes) to bones. In patients with cancer that has spread to their bones and is causing constant pain that has not improved with medication, different interventions can be used to improve symptoms.

Inserting a needle into the soft tissue around the spinal cord or spinal nerves and injecting medications to relieve pain.

Placing a catheter into the spinal fluid and connecting it to a medication pump that delivers pain medication directly to the pain receptors through the spinal fluid; the medication has a far lower dose and is much more effective than oral medication in decreasing pain.

Inserting needles into a fracture and injecting cement directly into the bone to stabilize the fracture and allow it to heal.

Using image guidance, an IR applies chemicals or physical agents to disrupt the pain signals damaged nerves send in order to relieve pain. This procedure can be used for nerves that are superficial or deep within the body.

Inserting a needle into the tumor located within the bone and delivering energy (heat, cold, or electromagnetic) to both kill tumor cells and reduce inflammation at the root cause of the pain.

These treatments are well tolerated, and most patients can resume their normal routine the next day, though some may feel tired for a few days to a week after a procedure. Pain for most procedures occurs for the first three days but can last up to a week. Some procedures have minimal or no recovery time such as routine, low risk biopsies. Symptoms and recovery depend heavily on how much tumor is treated at a time and the type of therapy used. Fatigue, nausea, or pain can be expected in varying degrees depending on the patient, therapy, and cancer treated. Speak to your doctor about the risks unique to you.

After treatment, you will follow up routinely with your oncologist and interventional radiologist. These follow-up appointments may include blood tests and scans to see if there are leftover or new tumor cells and to assess your overall health. Imaging in the form of CT or MRI will be performed at regular intervals based on what type of treatment you received to see how the cancer has responded to therapy. IR oncology treatments can be repeated if necessary and combined with other treatments to improve results.