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Interventional Procedures for Cancer
(Interventional Oncology)

Doctors treat most cancers with surgery, chemotherapy, radiation therapy, or some combination of these treatments, depending on the type and stage of a patient's cancer. Interventional radiologists, working together with NYU clinical oncologists, have developed procedures to treat many cancer patients and to improve quality of life. The following interventional procedures for cancer are available at NYU Medical Center:

Chemoembolization
Tumor Ablation
Relief of Obstructions
Tumor Biopsy

Chemoembolization

Chemoembolization is a method used to deliver chemotherapy medication directly to liver tumors -- either primary tumors that originated in the liver, or metastases that migrated to the liver from cancers at other sites. Even in cases where chemoembolization is not curative, this approach may relieve a patient's symptoms and extend survival.

Doctors begin the procedure by inserting a catheter into a blood vessel in the patient's groin and advancing it into the specific artery supplying the liver. The doctor then injects a dye and visualizes the tumor and blood vessels on an x-ray to determine the condition of the portal vein (a major blood vessel in the liver) and assess blood supply to the tumor.

The physician then injects an emulsion of anticancer drugs and radiopaque oil through a catheter selectively placed into the artery feeding the tumor. This mixture keeps a high concentration of medication in contact with the tumor for a period of time longer than that associated with traditional systemic chemotherapy. After the treatment is administered, the catheter is withdrawn, and the patient can usually return home after an overnight stay in the hospital.

Chemoembolization offers several advantages over traditional systemic chemotherapy: Prolonging the time the medication stays in contact with the tumor -- up to as much as a month -- increases the treatment's effectiveness. Moreover, because the medication is delivered only to the tumor -- rather than administered throughout the patient's bloodstream -- healthy tissues are spared from side effects, allowing doctors to administer dosages that are up to 200 times greater than those used in conventional chemotherapy. The substances that are part of the injected mixture not only hold the medication in place, but also block the blood supply to the tumor -- depriving it of oxygen and nutrients and thereby halting its growth.

Chemoembolization is not for every patient with liver tumors. Those who have blockages of the portal vein or of the bile ducts may not be eligible for this form of therapy.

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Tumor Ablation

Doctors are also using interventional radiology techniques to apply heating, freezing, or substances such as acetic acid or ethanol directly into tumors as a means of killing cancer cells. This type of treatment, called tumor ablation, is a relatively new technique that is showing promising results for treating cancer.

 
Kidney tumor (arrows).   A special probe called a radiofrequency electrode is inserted into the tumor using a CT scanner to position the probe in the center of the tumor. This probe destroys the tumor with heat.
 
The patient's kidney 3 months later, showing that the tumor has been destroyed while leaving the rest of the kidney intact.  

During the procedure, using a CT scanner or ultrasound machine, a small needle-like device is inserted into the tumor through a tiny nick in the skin.  The doctor wastches this probe as the images are projected with the CT scanner or ultrasound machine onto a viewing screen so that the probe can be precisely guided into the tumor.  The probe is then attached to an energy source that delivers heat (using radiofrequency, laser, or microwave energy) or freezing (a treatment called cryoablation), or a special needle (infusion needle) that allows the tumor to be  injected with a tumor-destroying substance.

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Relief of Obstructions

Some cancers can grow to the point where they obstruct the normal flow of urine or bile, causing these fluids to build up in the body. Without treatment, such obstructions can cause not only pain, but possibly infection or even liver or kidney failure. Doctors can insert an x-ray-guided catheter into the obstructed area to drain excess fluids. They may also choose to insert a stent -- a tiny wire mesh tube -- into the organ to bypass the obstruction and permit fluids to drain normally.

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Tumor Biopsy

Many cancers are now diagnosed by needle biopsy. During this procedure, a doctor uses imaging techniques (such as CT, x-ray, ultrasound, or MRI) to guide the insertion of a fine needle into a patient's tumor. A small amount of tissue is removed and then examined by a pathologist to determine if cancer cells are present. Needle biopsies are less painful, less disfiguring, and result in a shorter recovery time than conventional surgical biopsy procedures.

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Other NYU Resources

Interventional radiologists work closely with doctors of the Perlmutter Cancer Center to ensure that patients receive treatment that is as effective as possible while maintaining an optimal quality of life. For more information, visit:

The Perlmutter Cancer Center

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