Interventional Oncology | Dallas Fort Worth Carrollton TX | Precision VIR

Interventional Oncology

Introduction

Precision Vascular & Interventional offers new and expanded opportunities to investigate cancer therapies that use imaging technology to diagnose and treat localized cancers in ways that are precisely targeted and minimally or non-invasive. By use of advanced imaging technologies located at the Clinical Center, including cutting-edge magnetic resonance imaging (MRI), positron emission tomography (PET), and computed tomography (CT) – combined with the capability to use all three technologies simultaneously to navigate a therapeutic device through the body, the new center’s goal is localized treatment and drug delivery.

Treatments

Interventional oncology, practiced by interventional radiologists, is one of four parts of a multidisciplinary team approach in the treatment of cancer and cancer-related disorders. The others include medical oncology, surgical oncology, and radiation oncology. Interventional oncology procedures provide minimally invasive, targeted treatment of cancer. Image guidance is used in combination with the most current innovations available to treat cancerous tumors while minimizing possible injury to other body organs. Most patients having these procedures are outpatients or require a one night stay in the hospital.

  • Some of these therapies are regional, as when treating cancers involving several areas of the liver with chemoembolization or radioembolization.
  • Others are better classified as local, as when treating focal lesions in the kidney, liver, lung and bone with cryoablation (freezing), or microwave or radiofrequency ablation (heating).

In general, these techniques are reserved for patients whose cancer cannot be surgically removed or effectively treated with systemic chemotherapy. These procedures are also frequently used in combination with other therapies provided by other members of the cancer team.

Epidemiology

The overall incidence of colorectal cancer is higher in men than in women. Incidence and death rates for colorectal cancer increase with age, with over 90% of new cases and deaths occur in individuals 50 and older. Colorectal cancer is mainly a disease of developed countries with a Western culture (Boyle 2000). However elsewhere the incidence is increasing rapidly, particularly in countries with a high-income economy that have recently made the transition from a relatively low-income economy, such as Japan, Singapore, and Eastern European countries (Haggar 2009).
Oncology - epidemiology
Oncology

Five-year survival rates for patients with colorectal cancer have improved in recent years. This fact may be due to wider surgical resections, modern anesthetic techniques, and improved supportive care. In addition, better preoperative staging and abdominal exploration reveal clinically occult disease and allow treatment to be delivered more accurately. Survival also has improved through the use of adjuvant chemotherapy for colon cancer and neoadjuvant chemoradiation therapy for rectal cancer. Nonetheless, 5-year survival rates for patients with distant metastases are only 10%.

Colorectal Cancer

Colorectal cancer, or colon cancer, occurs in the colon or rectum. As the graphic below shows, the colon is the large intestine or large bowel. The rectum is the passageway that connects the colon to the anus.Colon cancer, when discovered early, is highly treatable. Even if it spreads into nearby lymph nodes, surgical treatment followed by chemotherapy is highly successful. In the most difficult cases — when the cancer has metastasized to the liver, lungs or other sites — treatment can prolong and add to one’s quality of life.

Symptoms
Screening for colon cancer saves lives.

Liver (Hepatocellular) Cancer

Hepatocellular cancer (HCC) is the fourth most common cancer in the world.  Age-standardized incidence rates vary from 2.1 per 100,000 in North America to 80 per 100,000 in China.  In the United States, it is estimated that there will be 35,660 new cases diagnosed in 2015 and 24,550 deaths due to this disease.  There is a distinct male preponderance among all ethnic groups in the United States, although this trend is most marked among Chinese Americans, in whom the annualized rate of HCC among men is 21.6 per 100,000 and among women is 8.1 per 100,000 population

When the valves do not perform their function, blood can flow backwards or reflux. This reflux results in what is known as venous insufficiency, a very common condition that results in the pooling of blood in the veins

Risks
Likely Etiology of HCC

Percutaneous Minimally Invasive Biopsy

Percutaneous biopsy is minimally invasive, causes little pain and requires usually a tiny incision. Most percutaneous needle biopsy procedures are performed with image guidance, with x-rays, ultrasound or CT.  Patients undergo percutaneous biopsy procedures while awake or with moderate sedation. Many patients resume their normal lifestyle and routine the same day of the procedure.

Services
What to expect

Mediports

Interventional Oncology - MediportsA mediport is a small medical device implanted beneath the skin, to give chemotherapy, to receive blood transfusions or draw blood, and to receive IV fluids or IV medications. The port consists of a reservoir which attaches to a catheter, a thin, soft plastic tube. The catheter connects the port through a vein in the neck. It is inserted in the upper chest and appears as a bump on the skin.

The mediport requires no special maintenance on your part and is completely internal, so swimming and bathing are not a problem.

Secondary Hepatic Malignancies

Many recent advances in medicine and surgery have made it possible to successfully treat, and sometimes cure, cancers that were previously considered incurable. At Precision Vascular & Interventional, these advances have been incorporated into a multidisciplinary approach that can offer treatment for most patients who have developed metastatic liver lesions from malignant tumors such as colon cancer or breast cancer. Our team of specialists will work with you to provide a comprehensive treatment plan that includes the latest technology in diagnosis and treatment.

What Are Metastatic Liver Lesions
Detecting and Staging Metastases

Treatment Options for Metastatic Liver Lesions

Once a metastatic liver lesion is detected, patients should undergo a rapid medical, oncologic and surgical evaluation to determine the most appropriate treatment. The treatment may vary between patients, and will be tailored to best fit each individual’s specific needs. Frequently, combinations of treatments, rather than a single type of treatment will be required, and you will meet with a team of specialists to discuss these different options during your evaluation.

Systemic Chemotherapy
Transarterial Chemoembolization (TACE)
Radiofrequency Ablation

Urologic Interventions

The kidneys produce urine, which is drained through the ureters into the bladder, before passing through the urethra and leaving the body. Sometimes cancer in the lower abdomen can block one or both of the ureters. When this happens, urine can’t leave the kidney, causing damage.

A nephrostomy allows urine to be drained through a tube inserted through the skin on your back and into the kidney. Using an X-ray or ultrasound, your doctor will find the best place within the kidney to place the tube. The doctor numbs your back with a local anaesthetic and inserts a fine guidewire into the kidney. The guidewire helps the doctor place the nephrostomy tube correctly. Stitches hold the tube securely in place, and it’s connected to a urine collection bag which can be worn under your clothing. Your nurses will give you advice and support on looking after your nephrostomy outside of hospital.

Some people will need the nephrostomy for only a short time, while others may need to keep it permanently. Schedule your free consultation with us today to receive more information.

Symptoms
Treatments