Interventional Oncology

What Is Interventional Oncology?

Interventional oncology is a subspecialty of interventional radiology used in the diagnosis and treatment of cancer. In this field, imaging methods such as angiography, computed tomography, ultrasonography and magnetic resonance imaging are used to obtain information on the location, size and spread of cancerous tissue, and minimally invasive treatments are planned accordingly.

Compared with surgical procedures, the most important advantages of interventional oncology are that it usually does not require general anesthesia, the hospital stay is very short, the treatment is minimally invasive and the recovery period is short.

The main methods used in interventional oncology include tumor ablation (radiofrequency ablation, microwave ablation, laser ablation, cryoablation and alcohol ablation), embolization (chemoembolization, radionuclide embolization, mass embolization) and catheter-directed chemotherapy.

The aim of interventional oncology is to effectively destroy cancerous tissue or keep tumor growth under control, reduce pain, prevent metastasis or make the tumor suitable for surgery. These methods make an important contribution to the multidisciplinary approach to cancer treatment and offer hope to many cancer patients.

How Is Interventional Oncology Performed?

Interventional oncology uses methods that require no surgery, incisions or stitches in order to speed up the diagnosis and treatment of cancer patients. Under the guidance of imaging methods, suitable technological devices such as biopsy needles, ablation electrodes, intravascular catheters and microspheres loaded with radiation or chemotherapy drugs are directed at the cancerous tissue.

Interventional oncology procedures are generally day procedures that do not require hospitalization. This allows patients to return home on the evening of the same day. By offering a minimally invasive approach to cancer treatment, these methods speed up recovery and carry a lower risk of complications than surgery.

Which Diseases Is Interventional Oncology Used to Treat?

Interventional oncology methods are used in the diagnosis and treatment of liver, kidney, bone, lung, breast, prostate and pancreatic cancers, as well as hematological cancers such as those of the blood and lymph nodes.

These treatment methods include:

• Biopsy: Biopsy, performed for tissue diagnosis in many types of cancer, is an important component of interventional oncology. Under imaging guidance, the cancerous tissue is reached, a sample is taken and examined for diagnosis.

• Ablation techniques: Ablation methods involve entering the tumor directly with special needles to burn or freeze it. Techniques such as radiofrequency (RF) ablation, microwave ablation and cryoablation are used to treat liver, kidney, lung and bone tumors.

• Chemoembolization: In liver tumors, the delivery of chemotherapy drugs directly through the artery that feeds the tumor is called chemoembolization. This method stops tumor growth or brings it under control.

• Radioembolization: Radioembolization methods deliver radioactive material directly into the tumor through the artery. In this method, radioactive substances are directed to the tumor to achieve a therapeutic effect.

• Cancer pain management: Interventional oncology also plays an important role in managing cancer pain. Procedures such as nerve blocks and nerve ablation aim to relieve or control pain.

These interventional oncology methods are used in the diagnosis and treatment of liver, kidney, bone, lung, breast, prostate and pancreatic cancers, as well as hematological cancers of the blood and lymph nodes. Suitable treatment methods are determined individually for each patient, and the treatment plan best suited to the patient's needs is created with a multidisciplinary approach.

Diagnostic Methods Used in Interventional Oncology

Biopsy

Biopsy is a diagnostic method used in interventional oncology. It allows a sample of cancer cells to be taken so that the cancerous tissue can be examined directly. This procedure is important for determining the type and characteristics of the cancer, creating the treatment plan and assessing the stage of the disease.

Biopsy is usually performed under imaging guidance. Imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI) or ultrasonography are first used to determine the location and size of the cancerous tissue. Then, guided by these imaging methods, a sample is taken from the cancerous tissue using a fine needle.

The biopsy sample is sent to the laboratory and examined by pathologists. The cells in the sample are evaluated under a microscope to determine the type, grade and other characteristics of the cancer. This information helps establish an accurate diagnosis and an appropriate treatment plan.

A biopsy is usually performed under local anesthesia and is generally a minimally invasive procedure. Biopsy is an important step that contributes to an accurate diagnosis of cancer and to personalized treatment.

Ablation

Tumor ablation is an alternative treatment method used when surgery, chemotherapy or radiotherapy is not effective. It is especially preferred for patients with lung, liver and kidney tumors who are no longer candidates for surgery.

Tumor ablation involves chemical or thermal applications focused on the tumor area in order to destroy the tumor completely or damage it to a certain degree. The main aim of these methods is to treat the tumor by killing tumor cells or controlling their growth.

Ablation can be performed using various techniques:

• Radiofrequency Ablation (RFA): Heat is generated by sending a high-frequency electric current to the tumor area. This heat causes the tumor cells to die.

• Microwave Ablation: Heat is applied to the tumor area using microwave energy. Microwave energy heats the tumor cells and causes them to die.

• Cryoablation (Freezing): A gas or liquid at a very low temperature is delivered to the tumor area, causing the tumor cells to freeze. This freezing helps kill the tumor cells and shrink the tumor.

• Alcohol ablation: In this technique, which has been used safely for many years, pure alcohol is injected into benign or malignant tumors, disrupting the proteins of the tumor cells and rendering them non-functional. In alcohol ablation, a fine needle is inserted into the tumor under local anesthesia with ultrasound or CT guidance, and pure alcohol is injected.

Ablation techniques are minimally invasive procedures usually performed under local anesthesia. Patients can often be discharged on the same day without needing to stay in hospital. Recovery after treatment is usually quick and improves patients' quality of life.

Tumor ablation is an effective treatment method used as an alternative to surgery in cancer treatment. However, the right treatment option for each patient and tumor is evaluated and determined by doctors according to the patient's condition and the characteristics of the tumor.

Other Cancers Treated with Ablation

Ablation treatments can be an effective option when cancers such as neuroendocrine tumors, breast cancer and ovarian cancer have spread to the liver and surgery is not possible. Ablation techniques are also used as an important treatment method for tumors in organs other than the liver, such as lung and kidney cancers and bone metastases.

In lung cancer in particular, when surgery is not suitable, ablation techniques may be preferred in order to preserve lung reserve. By targeting the areas where the cancer has spread in lung tissue, these methods can neutralize tumors and contribute to longer survival.

In the case of painful bone metastases, ablation treatments can also be used as a treatment alternative to relieve pain. Ablation applied to areas with bone metastases helps neutralize the tumor tissue and can reduce pain.

Ablation treatments can be performed in a minimally invasive way and are usually carried out under local anesthesia. They can be done as day procedures without hospitalization, and recovery is quick. These treatments help control symptoms by improving patients' quality of life.

However, the right treatment option for each patient and tumor must be carefully evaluated and determined by doctors. Treatment options should be planned individually according to factors such as the patient's general health, the characteristics of the tumor and the extent of its spread.

Chemoembolization

Chemoembolization is an interventional oncology method used in cancer treatment. Its aim is to deliver chemotherapy drugs directly to the tumor area and to block the tumor's blood supply in order to stop the growth of cancer cells or shrink the tumor.

Chemoembolization is performed through endovascular procedures, which are a type of angiography. During the procedure, a catheter (a thin tube) is usually used to reach the arteries close to the tumor's blood supply. Chemotherapy drugs that are effective against cancer cells are delivered through the tip of the catheter.

Because the chemotherapy drugs are given directly to the tumor area, less of the drug spreads throughout the body. This allows a higher concentration of the drug to reach the cancer cells. At the same time, small particles or gel-like substances called embolic agents may be used during chemoembolization to block the tumor's blood supply. These embolic agents block the tumor's blood vessels, preventing it from being nourished and accelerating the death of cancer cells.

Chemoembolization is widely used, especially for primary and metastatic liver tumors. In some cases, it may also be preferred for treating tumors in the lungs, kidneys and other organs. The procedure is usually performed under local anesthesia, and patients may need to stay in hospital for one night.

Chemoembolization can be an effective option for patients who are not suitable for surgery or who need treatment after surgery. However, treatment options should be evaluated according to the patient's condition and the characteristics of the tumor, and determined by the doctor.

Radioembolization

Radioembolization is an interventional oncology method used in cancer treatment. Its aim is to deliver radioactive material directly to the tumor area in order to control the growth of cancer cells or shrink the tumor.

Radioembolization is performed through endovascular procedures, which are a type of angiography. During the procedure, a catheter (a thin tube) is usually used to reach the arteries close to the tumor area. Microspheres containing radioactive material are delivered through the tip of the catheter.

Microspheres are tiny particles, usually coated with radioactive substances such as iodine-131 or yttrium-90. These microspheres reach the tumor area through the arteries and direct radiation straight at the tumor cells. The radiation emitted by the radioactive substances affects the tumor cells, controlling their growth or destroying them.

Radioembolization is generally used to treat liver tumors and is particularly effective for primary liver cancer (hepatocellular carcinoma) or metastatic liver tumors. In some cases, it may also be preferred for treating tumors in the lungs, kidneys and other organs.

Radioembolization has the advantage of delivering a high dose of radiation to cancer cells. This makes it possible to neutralize or shrink tumors. The procedure is usually performed under local anesthesia, and patients may need to stay in hospital for one night.

Radioembolization can be an effective option for patients who are not suitable for surgery or who need treatment after surgery. However, treatment options should be evaluated according to the patient's condition and the characteristics of the tumor, and determined by the doctor.

Other Supportive Interventional Methods in Oncology

Drainage Treatment for Bile Duct and Urinary Tract Obstructions

Drainage of bile duct and urinary tract obstructions is a treatment method frequently used in interventional oncology. These obstructions are usually caused by cancer or other diseases.

Bile duct obstructions: The bile ducts are channels that carry bile from the liver to the intestines. Blockages can form in the bile ducts due to causes such as cancer or gallstones. In this case, interventional oncologists perform a drainage procedure to clear the blockage. Using methods such as percutaneous transhepatic cholangiography (PTC), the blocked area is reached and a stent is placed to restore the flow of bile.

Urinary tract obstructions: The urinary tract consists of the channels that carry urine from the kidneys to the bladder. Blockages can form in the urinary tract due to prostate cancer, urinary tract tumors or other causes. In this case, interventional oncologists or radiologists perform a drainage procedure to clear the blockage. During this procedure, a thin catheter or stent is used to restore urine flow and preserve normal kidney function.

Drainage of bile duct and urinary tract obstructions relieves patients' symptoms, reduces the risk of infection and helps organs continue to function properly. These procedures can be performed with minimally invasive techniques and usually allow the patient to be discharged on the same day without hospitalization.

Treatment of Bowel and Esophageal Obstructions

Bowel and esophageal obstructions are common conditions in interventional oncology. These obstructions may be caused by cancer or other diseases. Interventional oncologists use various treatment methods to relieve these obstructions and ease patients' symptoms.

Bowel obstructions: Bowel obstructions occur when the lumen of the intestine is partially or completely blocked. They can be caused by colon cancer, intestinal tumors or intestinal adhesions. In this case, interventional oncologists offer various treatment options to relieve the obstruction. Using methods such as percutaneous gastrostomy (PEG) and percutaneous enterostomy, the obstruction is relieved and bowel function is restored.

Esophageal obstructions: Esophageal obstructions may be caused by cancer of the esophagus or pharynx, swallowing difficulties or other causes. In this case, interventional oncologists use fluoroscopic methods to clear the obstruction. Techniques such as balloon dilation or stent placement relieve swallowing difficulties and improve patients' nutrition and swallowing function.

Relieving bowel and esophageal obstructions eases patients' symptoms, resolves nutritional problems and improves quality of life. These procedures are usually performed with minimally invasive techniques and allow the patient to be discharged on the same day without hospitalization. The appropriate treatment option is determined according to the patient's condition and the location and severity of the obstruction.

What Are the Benefits of Interventional Oncology for Patients?

Interventional oncology can offer cancer patients many important benefits. Here are some of the advantages it provides:

• Minimally invasive treatment: Interventional oncology methods offer minimally invasive procedures for cancer treatment without the need for surgery. This means less pain, a lower risk of complications and a shorter recovery time for patients.

• Targeted treatment: Interventional oncology provides direct access to cancerous tissue, offering targeted treatment options. Procedures such as biopsy, ablation and embolization focus on cancer cells, increasing the effectiveness of treatment.

• Faster treatment process: Interventional oncology methods can speed up diagnosis and treatment. Biopsy methods are used for fast and accurate diagnosis, while treatments such as ablation or embolization speed up patients' recovery.

• Fewer side effects: Interventional oncology can reduce the side effects of chemotherapy or radiotherapy. For example, with methods such as radioembolization or chemoembolization, drugs or radioactive substances are delivered directly to the cancerous tissue, reducing damage to healthy tissue.

• Better quality of life: Interventional oncology methods help control cancer symptoms and improve patients' quality of life. Procedures such as pain control, bleeding control and clearing obstructions also bring patients relief.

• Easier recovery: Interventional oncology includes day procedures performed without hospitalization. As a result, patients can be discharged quickly after the procedure and continue their treatment at home.

Interventional oncology is becoming increasingly important in cancer treatment thanks to technological advances. These methods offer patients a more effective, less invasive and faster treatment process while also improving their quality of life.

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