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Introducing the fourth pillar of cancer care

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Dr Peter Littler

Interventional Oncologist, Freeman Hospital, Newcastle Upon Tyne

Interventional oncology is a relatively new, technologically advanced field of medicine that’s been hailed as the ‘fourth pillar of cancer care’ – but what is it and how is it saving lives?


Interventional oncology (IO) is a relatively new and innovative area of medicine revolutionising the treatment of a range of cancers – particularly those of the liver.

Dr Peter Littler, Consultant Interventional Oncologist at Newcastle’s Freeman Hospital, said the field, which uses image-guided, minimally-invasive procedures, represented a new type of treatment.

Interventional oncology (IO) is opening more doors for patients

“Over the last 20 years – a short time period in medical terms – interventional oncology has established itself as a great option for many patients,” he explains.

“It is now considered the fourth pillar of cancer care, along with medical oncology, radiation oncology and surgery. It’s really exciting because it offers new and minimally invasive options for cancer patients.”

Interventional oncology treatments are usually delivered via a needle or tiny nick in the skin. They are well tolerated with patients able to go home the same or the following day. Such treatments are safe for a wide range of patient groups including the elderly and those with co-existing illnesses.

Minimal damage

IO is different because it targets and kills cancerous cells while protecting healthy tissue. This avoids the majority of unpleasant side effects associated with traditional chemotherapy and carries far lower risks than surgery.

Common methods include ablation, a potentially curative treatment, which uses an image-guided needle, to burn small tumours away, and intra-arterial procedures, such as transarterial chemoembolisation (TACE) and selective internal radiation therapy (SIRT).

During TACE, tiny, chemotherapy-containing ‘beads’ are delivered through blood vessels to block the cancer’s blood supply and deliver a highly targeted chemotherapy effect. SIRT is delivered in a similar way, but uses millions of tiny radiotherapy beads to seed and kill tumours.

Both approaches, which can be used in conjunction with other treatments, offer fresh hope to people facing a life-threatening liver cancer diagnosis, says Dr Littler.

The selective radiation treatment (SIRT) can shrink large and inoperable liver tumours, allowing the remaining healthy liver to grow enough to enable curative surgery. “It’s an amazing feeling, as a doctor, to know that your intervention can cure a cancer, extend a person’s life, or enable potentially curative surgery”, Dr Littler concludes.

Supported by Boston Scientific

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