Cancer Procedures

Prior to a chemoembolization, CT scans, MRIs, and blood tests (used to assess kidney function and clotting), will likely be performed. Additionally, patients may be prescribed antibiotics to decrease the possibility of infection, reduce nausea, and protect kidneys from harmful substances released from dying tumor cells.

During chemoembolization, an interventional radiologist will insert a catheter into the artery, guide it to the blood vessels that supply the cancerous tumor, and inject contrast dye for real time visualization purposes. From there, a mix of chemotherapy drugs that attack the cancer cells directly, and an embolic agent that blocks blood flow and prevents further growth, is injected.

This procedure requires only local anesthesia and IV sedation and lasts one to two hours – not including preparation and recovery time. Patients may be required to spend the night at the hospital for observation and pain medications or may be released the same day.

Chemoembolization is often used as palliative procedure to improve quality of life and reduce symptoms for patients with advanced liver cancer who are not candidates for surgery or a liver transplant. In some cases, it may also be used as a bridge to surgery or transplantation to shrink the tumor prior to a curative procedure.

The location and size of the tumor, as well as a patient's overall health, are also important factors in determining whether chemoembolization is the right course of procedure. Certain health conditions, such as blood clotting disorders or kidney disease, may prohibit your ability to undergo chemoembolization.

Chemoembolization stops cancerous tumor growth in approximately 70 percent of patients. It preserves liver function, involves a shorter recovery time than traditional cancer procedure options, and can significantly improve survival rates.

For some, chemoembolization is the only procedure necessary. For others, it may be used in conjunction with surgery, systemic chemotherapy, ablation, or radiation therapy.

Common side effects of chemoembolization include soreness at the catheter insertion site, fever, pain, nausea and vomiting, fatigue, and loss of appetite. More serious complications include infection or damage to blood vessels and nearby organs (like the liver or kidneys). In some cases, it may be necessary to repeat chemoembolization to ensure desired effect.

The tunneled PleurX catheter works by providing an exit pathway for fluid buildup in the lungs or abdomen. During this outpatient procedure, patients receive local anesthesia, and an interventional radiologist inserts the PleurX catheter through a small incision in the skin.

Using real time imaging technology, the PleurX is guided into the lung's pleural space or abdomen's peritoneal cavity. Once in place, the catheter is secured to the skin with a suture or adhesive dressing. The other end of the tube has a one-way valve and connector that allows for the attachment of a drainage system that consists of a vacuum or manual pump to draw fluid out, and a bottle or bag to collect it.

This procedure makes it possible to drain excess fluid at home. Following instructions (regarding frequency and duration) and training given by the overseeing healthcare provider, the patient or caregiver can connect the drainage system to the catheter and open the one-way valve to drain excess fluid out of the body and into the collection bag or bottle.

The PleurX system can help alleviate uncomfortable or painful symptoms and improve the quality of life for patients with recurrent pleural effusions or malignant ascites. As an added benefit, the end of the PleurX system catheter is covered by a thin dressing and can be discreetly hidden beneath your clothing.

If you have reoccurring, symptomatic fluid accumulation in your lungs or abdomen and other interventions have been unsuccessful, you may be a candidate for PleurX, an indwelling catheter. Talk to your healthcare provider to determine if PleurX is the right option for you.

PleurX is a safe, proven option that has provided relief to over 500,000 patients suffering from fluid buildup since 1997.

PleurX is generally well tolerated with a low incidence of adverse effects. With any medical procedure, however, there is a possibility of risk. Serious complications in the lungs include pneumothorax, expansion pulmonary edema, hypotension, circulatory collapse, and infection. Risks associated with the abdomen include hypotension, circulatory collapse, electrolyte imbalance, protein depletion, ascites leakage, peritonitis, wound infection, and division within the peritoneal space.

Approximately half an inch thick and the diameter of quarter, the tiny port is hugely beneficial. This small metal or plastic device allows easy access to a vein for repeated access, sparing patients repeated and often painful needle sticks.

A port implantation is an outpatient procedure performed by an interventional radiologist while the patient is under light anesthesia. A small incision is made in the neck to access the vein using imaging as guidance. Another small incision is made in the chest, arm, or abdomen for port placement. After connecting the two via catheter, a pouch is created beneath the skin and the port is implanted.

An X-Ray is performed to ensure the port is in the correct location and the incisions are closed with dissolvable stitches or surgical adhesive. Recovery time for this procedure is relatively short and a slight bulge in the skin where the port was placed may be visible.

Going forward, needles can be inserted into the port's silicone top or septum. This is followed by another needle that flushes the device to prevent blockages or blood clots. The site is then covered with a clear bandage to ensure symptoms of infection (like red streaks) are visible.

A port may be the right option for patients who:

• Are receiving ongoing chemotherapy.
• Are undergoing long-term intravenous therapy.
• Have poor vein access.
• Receive frequent blood transfusions.
• Require regular blood sampling.

The decision to place a medical port is between you and your provider. There are a variety of other factors that must be considered, including your specific medical condition, overall health, and procedure needs.

Ports provide a reliable and easily accessible site for medical treatments, eliminating the need for multiple needle sticks. They are more comfortable than external catheters and present a lower risk of complications than other methods of vascular access. Additionally, ports are designed for long term use and can stay in place for years, if necessary.

Like with any medical procedure or device, there are risks associated with the implantation of medical ports, including infection, thrombosis (blood clots), catheter malfunction or dislodgement, mechanical complications, bleeding or hematoma, and allergic reactions.

Tumor ablation works by using various methods to shrink or destroy tumor cells within the body. Specific techniques used depend on the type, size, and location of the tumor. The three main types of tumor ablation treatments are:

• Radiofrequency Ablation: During this procedure, a needle-like electrode is inserted into the tumor under imaging guidance. Once properly positioned, high frequency electrical currents are passed through it, generating heat. The heat creates friction within the tumor, which leads to the death of the tumor cells.
• Microwave Ablation: This procedure also uses a needle-like probe that is guided into the tumor using imaging guidance. Instead of electrical currents, microwave energy is delivered through the probe. This generates heat and effectively kills the tumor cells.
• Cryoablation: During this procedure, tumor tissue is destroyed through a freezing process. Cryoprobes are thin, hollow, and needle-like probes, through which extremely cold gases or liquids can flow. This process cools the surrounding tissue and ice crystals form within the freezing cells. Direct freezing occurs and the blood supply to the tumor is cut, which leads to cell death of abnormal or diseased tissue.

Tumor ablation is minimally invasive, requiring only a small incision or needle puncture. This means a reduction in potential complications. A targeted approach to tumors means less damage to surrounding tissue and a shorter, less painful recovery than compared with traditional surgical options.

There are various factors that must be weighed when determining if a patient is a candidate for tumor ablation. The type, size, location, and characteristics of the tumor, as well as the overall health of the patient must be considered. Ideally, tumor ablation should be performed on small tumors (approximately three to five centimeters in diameter) that are difficult to reach, non-metastatic, and localized.

Talk to your healthcare provider today to determine if tumor ablation is the right option for you.

Tumor ablation is a valuable means of treating tumors with a high success rate. Assuming tumors fall within the necessary criteria, this procedure can be effective at shrinking and destroying tumors, as well as preventing their reoccurrence.

Often used in conjunction with other procedure methods, like chemotherapy or surgery, tumor ablation can significantly improve overall patient outcomes.

Specific risks vary depending on the type of ablation used to treat tumors, but primary complications include bleeding, pain and discomfort, damage to surrounding structures (a risk minimized when using imaging technology for guidance), nerve injuries, skin burns and rarely blood clots and allergic reactions.

Patients undergoing a Y90 procedure will receive a hepatic angiogram (imaging test) prior to surgery. This involves inserting a catheter through a blood vessel in the groin and guiding it to the blood vessels that supply the liver. Contrast dye is injected to visualize the blood vessels and identify the tumor feeding vessels.

Once the blood vessels feeding the tumor are identified, the Inerventional Radiologist will map out the procedure plan to determine appropriate dosage and activity level of the Y90 microspheres, small radioactive particles, to be administered.

During the procedure, the Y90 microspheres are injected through a catheter into the target blood vessels, lodging themselves into the tumor, and releasing a high dose of radiation to kill cancer cells.

After their injection, the catheter is removed, and pressure is applied to the insertion site to minimize bleeding. Following a few hours of observation, the patient is discharged.

Y90 can be an effective mode of procedure for patients with primary liver cancer (hepatocellular carcinoma) or metastatic liver cancer (cancer that has spread to the liver from another site). Those who undergo Y90 should have some preserved liver function to tolerate the radiation and tumors that are confined to the liver or with limited spread.

The decision to undergo Y90 procedure will be made in conjunction with a healthcare provider that can evaluate your individual needs. Talk to your doctor today to find out if Y90 is right for you.

Y90 has proven to be an effective therapy for the procedure of certain types of liver cancer. From controlling or shrinking tumor size to improved survival rates, Y90 is unrivaled. When used in conjunction with other therapies, like surgery or chemotherapy, Y90 can help eradicate residual disease and improve the quality of life for those suffering from liver cancer.

Like any medical intervention, Y90 poses potential risks. Following the procedure, patients are monitored closely to assess procedure response and manage potential side effects. Complications include radiation induced liver disease, non-target embolization, infection, pain and discomfort, nausea and vomiting, and fatigue.