OIA interventional radiologists, working together with area oncologists, have developed non-invasive procedures to treat a variety of cancers—giving patients an improved quality of life.

The following interventional procedures for cancer treatment are available through Overlake Imaging Associates:

• Tumor Ablation
• Chemoembolization of Liver Tumors
• Relief of Obstructions
• Tumor Biopsy (Needle Biopsy)

The most common cancers treated by OIA interventional radiologist using these methods are liver cancer, lung cancer and renal cancer. Other cancers may also be treated provided they are accessible and of appropriate size.

Fluoroscopy is normally used to guide the placement of the needle or probes in these procedures. In some instances, the procedures may be done in conjunction with another imaging modality such as MRI or CT to provide collaborating information.

Tumor Ablation

Tumor ablation is a minimally invasive method used to treat solid cancers. An interventional radiologist uses special probes to “burn” or “freeze” cancers without physically cutting the tumor out.

Fluoroscopy, multi-detector computed tomography (MDCT) or magnetic resonance imaging (MRI) is used to guide and position the needle probe into the tumor. This normally requires only a tiny 3mm hole via which the probe is inserted. When the imaging modality shows that the probe is located within the tumor, it is attached to a generator which “burns” or “freezes” the cancer, depending on the type of procedure being done.

The effectiveness of tumor ablation in treating cancer is dependent on the size of the tumor and its accessibility to the ablation probe. Typically, malignant tumors that are easily accessible percutaneously (through the skin) and have a diameter of 3 cm or less are targeted for eradication with this procedure. Early detection and treatment is crucial, because the larger the tumor size, the more difficult it is to completely kill the cancer.

Tumor Ablation Guidelines

When Your Procedure Is Scheduled

• Our scheduler will give you a date and time for your procedure at Overlake Hospital Medical Center. You will need to arrive at the hospital two hours before the procedure to allow the admitting and nursing staffs to get you ready.
• Please let the scheduler know if you take Coumadin, Plavix, Insulin or Metformin. You will need to receive specialized instructions.
• Patients over the age of 65 or with a history of heart disease will be required to have an electrocardiogram (EKG), which measures heart activity. If these tests are not done prior to your appointment, your procedure will be delayed or canceled.
• Please notify us if you’ve had a previous reaction to contrast dye.
• The admitting department will attempt to call you the night before your procedure to confirm your arrival time.
• Please plan to leave any jewelry or valuables at home.
• Make sure to arrange for someone to drive you home after the procedure.
• If you have any questions regarding your procedure, please call us at 425-688-5005 anytime Monday thru Friday from 8AM to 4PM.

Preparation

• Do not eat or drink for 4 hours before your exam
• Please take your normal heart and blood pressure medications with a sip of water.
• You will need to be at the hospital’s admitting area two hours before you procedure’s scheduled start time. This is located at the large desk at the hospital’s main entrance (across from Stanza’s Café).
• You will be taken down to your room where you will meet your nurse and be asked to change into a patient gown. An IV will be started and blood drawn for lab tests.
• The nurse will ask you for your medical history. If possible, bring a list of all the medications you take and when you take them.
• The nurse will also ask you about allergies. If you are allergic to radiology/contrast dye please let them know.
• If there is a possibility that you’re pregnant, please let the nurse know. You will be asked to sign a form if you are a female of childbearing age (12-57).
• Before the procedure, the interventional nurse will meet with you and your family to review the procedure and answer any questions you might have.
• The nurse or tech will clean and shave, as necessary, an area around the catheter’s point of entry. You will be covered with sterile drapes from your shoulders to your feet.

What to Expect During the Procedure

• The procedure takes from 1-3 hours. You will meet the interventional radiologist who will go over the consent form and answer any questions you might still have.
  
• During the procedure the nurse will be monitoring your heart, blood pressure and the oxygen level in your blood.
  
• You will receive sedation and a local anesthetic during the procedure, but pain is always a possibility. If you experience any pain during the procedure, DO NOT keep it to yourself! Tell the doctor or nurse, and they will take appropriate measures.
  
• The OIA interventional radiologist will numb the insertion site and using fluoroscopy, MDCT or ultrasound for guidance, will insert a small needle-like device into the tumor through a tiny nick in the skin.
  
• The doctor will then utilize the selected imaging modality to guide the probe to a precise position in 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.
  
• Once the procedure is over you will be transferred back to your room.

What to Expect After the Procedure

• If you feel fine after one hour, you will be released.
• You must have someone present to drive you home.
• You will be given written instructions and a phone number to call if you have any questions or concerns.
• One of the interventional nurses will do a follow-up call the next week-day after your discharge. Write down any questions you might have for them.
• To speak to an interventional nurse, please call 425-688-5005. It is best to call between 8AM and 4PM Monday thru Friday. You can leave a message on the voicemail, and a nurse will return your call as soon as possible.
• If you are on Coumadin and have been told not to take it before your procedure, you need to check with your physician, and/or the Anti-Coagulation Clinic for instructions.
• You may resume taking all of your normal medications once you are home.

Chemoembolization of Liver Tumors

Chemoembolization is another interventional radiology procedure for treating cancer without surgery. It used to deliver chemotherapy medication directly to liver tumors—either primary tumors that originated in the liver, or metastatic disease that migrated to the liver from cancers at other sites. An added benefit of chemoembolization is that often, even if the procedure does not kill the cancerous tumor, it may relieve the patient’s symptoms and extend his or her life.

If you are a candidate for chemoembolization, your referring physician may order several tests prior to the procedure. These include a liver function blood test, an MDCT (CAT) scan or an MRI of your liver. The results are used make sure that you do not have any blockage of the portal vein, cirrhosis of the liver or a blockage of the bile ducts. If you have any of these complications, your clinician may not allow you to have the chemoembolization procedure.

It is important to remember that chemoembolization currently only treats tumors in the liver and will have no effect on cancer elsewhere in the body.

Chemoembolization of Liver Tumors Guidelines

When Your Procedure Is Scheduled

• Our scheduler will give you a date and time for your procedure at Overlake Hospital Medical Center. You will need to arrive at the hospital two hours before the procedure to allow the admitting and nursing staffs to get you ready.
• Please let the scheduler know if you take Coumadin, Plavix, Insulin or Metformin. You will need to receive specialized instructions.
  
• Patients over the age of 65 or with a history of heart disease will be required to have an electrocardiogram (EKG), which measures heart activity. If these tests are not done prior to your appointment, your procedure will be delayed or canceled.
  
• Please notify us if you’ve had a previous reaction to contrast dye.
  
• The admitting department will attempt to call you the night before your procedure to confirm your arrival time.
  
• Please plan to leave any jewelry or valuables at home.
  
• Make sure to arrange for someone to drive you home after the procedure.
  
• If you have any questions regarding your procedure, please call us at 425-688-5005 anytime Monday thru Friday from 8AM to 4PM.

Preparation

• Do not eat or drink for 4 hours before your exam
  
• Please take your normal heart and blood pressure medications with a sip of water.
  
• You will need to be at the hospital’s admitting area two hours before you procedure’s scheduled start time. This is located at the large desk at the hospital’s main entrance (across from Stanza’s Café).
  
• You will be taken down to your room where you will meet your nurse and be asked to change into a patient gown. An IV will be started and blood drawn for lab tests.
  
• The nurse will ask you for your medical history. If possible, bring a list of all the medications you take and when you take them.
  
• The nurse will also ask you about allergies. If you are allergic to radiology/contrast dye please let them know.
  
• If there is a possibility that you’re pregnant, please let the nurse know. You will be asked to sign a form if you are a female of childbearing age (12-57).
  
• Before the procedure, the interventional nurse will meet with you and your family to review the procedure and answer any questions you might have.
  
• The nurse or tech will clean and shave, as necessary, an area around the catheter’s point of entry. You will be covered with sterile drapes from your shoulders to your feet.

What to Expect During the Procedure

• The procedure takes from 1-3 hours. You will meet the interventional radiologist who will go over the consent form and answer any questions you might still have.
  
• You will receive sedation medication during the procedure to help you relax.
  
• During the procedure the nurse will be monitoring your heart, blood pressure and the oxygen level in your blood.
  
• The radiologist will numb the insertion site in your groin and a small catheter will be inserted via a puncture through the skin into the artery in your groin. The catheter will then be threaded up the artery and into the hepatic artery that supplies blood to your liver.
  
• During this procedure you might feel warmth, tingling or flushing when you are given the contrast dye so the doctor can see precisely where the catheter is located. This usually lasts about 10 seconds.
  
• Chemotherapeutic drug(s) are then delivered through the catheter along with a blood vessel occluding agent right at the site of the tumor.
  
• The result is that a very highly concentrated dose of anti-tumoral drug is delivered (without the normal dilution that occurs with a standard intravenous infusion) and the blood vessels are partially blocked with the occluding agent to starve the tumor of its blood supply.
  
• Once the procedure is over you will be transferred back to your room. You may have a small catheter still in place in the artery in your groin.

What to Expect After the Procedure

• The nurse or tech will remove the small catheter and hold pressure for at least 15 minutes. You will be told to lie flat for up to 6 hours and to keep your leg straight. This is to prevent any bleeding or swelling.
  
• Your blood pressure, pulse and puncture site will be monitored very frequently by the nurse.
  
• You will be encouraged to drink a lot of fluids to help wash the contrast out of your system. You will need to continue to drink fluids for the first 24 hours after your procedure, unless your physician has limited your fluid intake.
  
• You might be kept in the hospital for a 24-hour period for observation. Otherwise, you will be discharged in 6-8 hours.
  
• You will be given written instructions and a phone number to call if you have any questions or concerns.
  
• One of the interventional nurses will do a follow-up call the next week-day after your discharge. Write down any questions you might have for them.
  
• To speak to an interventional nurse, please call 425-688-5005. It is best to call between 8AM and 4PM Monday thru Friday. You can leave a message on the voicemail, and a nurse will return your call as soon as possible.
  
• If you are on Coumadin and have been told not to take it before your procedure, you need to check with your physician, and/or the Anti-Coagulation Clinic for instructions.
  
• If you are on Metformin/Glucophage, withhold taking it for 48 hours post procedure. Check with the physician who ordered the medication on when to restart it. Additional blood work may be required.
  
• If you an insulin-dependent diabetic, restart your regular dosing when you get home. Check your sugar regularly and if you have a concern, contact your diabetic doctor.
• You may resume taking all of your normal medications once you are home.

Relief of Obstructions

Cancerous growths can become large enough to obstruct the normal flow of urine or bile, causing these fluids to build up in the body. These obstructions, if left untreated, can cause pain, infection, and in severe cases, liver or kidney failure.

OIA interventional radiologists 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.

For more information on stenting and the procedural guidelines, please see the Angioplasty & Stent Placement page of this website.

Tumor Biopsy (Needle Biopsy)

A tumor biopsy, also called needle biopsy, is used to diagnose many cancers. Compared to conventional surgical biopsy procedures, needle biopsies are not as painful, have minimal or no scarring, and result in a shorter recovery time.

For more information on needle biopsy and the procedural guidelines, please see the Needle Biopsy page of this website.