Radiologists Provide Services throughout Cancer Care
Working closely with referring physicians, interventional radiologists with Virginia Interventional & Vascular Associates (VIVA) perform thermal ablation, chemoembolization, and other specialized procedures usually available only in major metropolitan areas. Interventional radiology treatments are enhancing and improving the care of patients with cancer.
VIVA is the interventional radiology and vascular surgery practice of Radiologic Associates of Fredericksburg (RAF). R. Donald Doherty, Jr., MD, board-certified interventional radiologist with VIVA, noted that the group’s diagnostic radiologists and interventional radiologists also provide 24/7 services throughout the continuum of cancer care. Their services cover:
Cancer Diagnosis – needle biopsy
Cancer Treatment – minimally invasive interventional therapies
Cancer Management – venous access, procedures to manage pain and complications
Needle Biopsy. Image-guided needle biopsy, performed by interventional radiologists, provides a minimally invasive option for many patients requiring cancer testing. Through a tiny incision in the skin, interventional radiologists guide a needle to the suspicious mass to obtain tissue samples, using ultrasound or CT images as an anatomical roadmap. Pathologists later examine the specimens to determine a diagnosis.
Needle biopsy is a same-day procedure for most patients and a time saver for medical and surgical oncologists. “It is so much easier for the surgeon to plan a procedure based on needle biopsy results than to perform an open biopsy, wait for the results, and then plan the procedure,” explained John D. Statler, MD, board-certified interventional radiologist with VIVA.
Interventional radiology cancer treatments are minimally invasive procedures performed through a tiny incision in the skin. Interventional radiologists use medical imaging technology to help them guide treatments directly to the tumor.
Thermal Ablation. In this procedure, which can benefit certain patients with bone, breast, kidney, liver, or lung cancer, interventional radiologists use either radiofrequency ablation (RFA) to destroy tumor cells with heat, or cryotherapy, also known as cryoablation, to freeze tumor cells, while sparing healthy tissue nearby. Depending upon the type of tumor, thermal ablation can reduce pain, improve quality of life, and provide treatment options for inoperable cancers.
“Thermal ablation allows us to directly target tumors, and it is tissue sparing,” Dr. Statler said. “Years ago a patient with kidney cancer, for example, would have to have their kidney removed. Today, we can often spare the kidney and, with very small tumors, cure the cancer.”
Chemoembolization. This interventional radiology cancer therapy is used primarily for certain liver tumors that are too large to treat or are in locations that cannot be treated with thermal ablation. Chemoembolization delivers a high concentration of chemotherapy drugs targeted directly to the tumor by using the patient’s arteries as a pathway to the tumor. Interventional radiologists then close the arteries feeding the tumor, allowing the chemotherapy drugs to work for a longer period of time. The procedure can be combined with other cancer treatments and, depending upon the type of cancer, can alleviate pain and improve quality of life.
“The goal of chemoembolization is to reduce the tumor and protect the liver as much as possible,” explained Dr. Doherty. “In some cases, the procedure also extends survival. We have been treating one patient, who had an estimated 18 months’ survival, for five years.”
A relatively recent advance in chemoembolization is the use of drug-eluting beads, which release chemotherapy agents over time for sustained treatment of tumors, Dr. Doherty noted.
Central Venous Access. By inserting tiny catheters beneath a cancer patient’s skin, interventional radiologists provide venous access for chemotherapy, giving oncologists a pathway for delivering medications without repeated needle sticks. Interventional radiologists maintain the catheters throughout the course of treatment, which can last months and even years, Dr. Statler said.
Managing Complications. Sometimes cancer patients experience biliary, kidney, or other drainage as a complication of their conditions. Interventional radiologists can relieve discomfort by implanting catheters to drain excess fluids, Dr. Doherty said.
Spinal fractures are another painful condition that can affect patients with bone cancer, particularly multiple myeloma. Interventional radiologists can inject bone- grade cement into the fractures to strengthen the spine and eliminate pain, a procedure known as vertebroplasty or kyphoplasty.
Interventional radiologists also assist cancer patients when needed by implanting intravenous catheter filters to reduce the risk of fatal blood clots, establishing feeding tubes for delivering nutrition, and providing other interventions.
“We see patients frequently throughout their cancer journey. Working closely with oncologists, surgical oncologists, and other members of the healthcare team, we strive to provide an optimized plan of care for every patient,” Dr. Doherty said.
For more information, contact R. Donald Doherty, Jr., MD, at doherty@vivassociates. com , and John D. Statler, MD, at statler@ vivassociates.com; call (540) 361-1000 and leave a message for the doctors; or visit www.vivassociates.com/Cancer.
Pictured above is John J. McLaughlin, MD, performs an interventional radiology procedure at VIVA with the assistance of Kim Calamos, RT. VIVA services include procedures for cancer diagnosis, treatment, and management.