Dr Professor Tze Min Wah
Clinical Lead for LTHT IO Programme, IOUK Chair (British Society of Interventional Radiology), Consultant Interventional Radiologist
Interventional radiology offers cancer patients and alternative form of treatment that may reduce risk, pain and recovery time.
The field of oncology continues to change rapidly and tremendous progress has been made in the past decade in interventional oncology. The term describes minimally-invasive techniques whereby a radiologist uses image-guiding technology to place fine needles into a tumour, through which they can fire heat, cold or, most recently, electrical energy to destroy the tumour.
Typically, cancer patients have benefitted from medical, surgical or radiation oncology, but Dr Tze Wah, Clinical Lead for Leeds Teaching Hospital Trust’s Interventional Oncology Programme, believes that interventional oncology has advanced to the point where it is now the fourth pillar of cancer care.
Pioneering nanoknife treatment
Just last year, the first patient in the UK successfully underwent electroporation, a technique that has been dubbed ‘nanoknife treatment’, to destroy a tumour in his kidney. Instead of using extreme heat or cold energy, potentially damaging surrounding tissue, electroporation uses image-guided technology to place tiny needles that fire electrical pulses into the walls of the cancer cell, creating microscopic holes.
“The technology has particular applications for patients where other forms of surgery are not an option, for example when the tumour is very small or near to other organs,” continues Wah. “It could really help to improve the quality of life for patients with liver, pancreatic and kidney cancer and especially patients with a single kidney.”
The technique requires the needles to be placed with pin-point accuracy, so not only is the tumour targeted directly, but surrounding organs, structures and blood vessels are unaffected. That, in turn, helps to shorten a patient’s recovery time and ensure they are back home much sooner.
Applications of interventional oncology
In addition to electroporation, there is a range of interventional oncology procedures that destroy tissue using extreme heat or cold temperatures. There are also vascular interventions that include using stents to stop bleeding and block blood flow to or from tumour tissue.
Interventional oncology is also supporting the palliative care of patients by helping to control symptoms. Image-guided techniques can help to block nerves and tackle pain; to place catheters that drain excess fluid; and to treat obstructions in the intestine or oesophagus with the insertion of feeding tubes or metal stents.
More research is required
Wah is quick to point out that, as with all new technologies, it will take time before the latest interventional oncology techniques are routine practice. “There is a need for proof that this is effective. As with any new intervention, there is limited data on its long-term efficacy,” says Wah. “Unlike drug trials, it is difficult to produce randomised controlled studies and we also have to consider patient preference.”
Wah is working hard to establish a centre in Leeds where specialists can get the training they need to be able to offer interventional oncology on a much broader scale. As technology continues to develop, it will be exciting to see how the application of interventional oncology can help to improve patient outcomes, while minimising discomfort, pain and recovery times.
