Cancer Care

VIS of CORA provides cutting-edge options for cancer care. Our minimally invasive procedures can deliver chemotherapy or radiation treatments directly to cancer cells, destroy tumors with extreme cold or extreme heat, and make cancer treatment more comfortable. The doctors at CORA are pleased to be able to offer innovative and compassionate treatment options for people with cancer.

Transarterial Chemoembolization (TACE) for Liver Tumors

TACE is an interventional radiology procedure designed to treat inoperable tumors of the liver. TACE may be used as a palliative treatment or in conjunction with other treatments as a curative measure. A CORA interventional radiologist inserts a tiny tube through a nick in the skin and uses X-ray fluoroscopy to guide the tube to the arteries feeding the tumor. Next, tiny beads are introduced directly into the tumor. These beads treat the tumor in two ways: by delivering chemotherapy medications directly into the tumor and by blocking off blood flow to the tumor.

Benefits of TACE:
● Offers a minimally invasive treatment for large, invasive, or numerous liver tumors that cannot be surgically removed
● An option for patients who cannot undergo surgery
● Delivers high doses of chemotherapy directly to the tumor while maintaining a relatively low systemic dose
● Stops growth of or shrinks liver tumors in two-thirds of cases for an average of 10 to 14 months
● Helps preserve liver function and provides palliative pain relief for patients with liver cancer
● Can be repeated if tumors return
● Can be used in conjunction with other cancer therapies

Radiofrequency Ablation (RFA) for Cancer

Radiofrequency ablation destroys cancer cells using electrically-induced heat. It is often used to treat inoperable tumors or small metastatic tumors that are causing pain or other symptoms. A CORA interventional radiologist inserts an electrode into the tumor using CT or ultrasound imaging guidance. Once the electrode is in place, it is activated, creating intense heat that destroys cancer cells. RFA can successfully treat small tumors in the lung, liver or kidney as well as metastatic bone lesions. RFA and a similar procedure called microwave ablation (MWA) have an 85% success rate in treating small tumors of the liver.

Benefits of RFA for Cancer
● Minimally invasive with few side effects
● Effective at eliminating small tumors that may be causing pain or other symptoms
● The heat from RFA closes blood vessels, reducing bleeding
● Only takes about 30 minutes
● Compatible with other treatments
● An option for patients who cannot undergo surgery

Preoperative Embolization of Tumors

Before tumors are removed via surgery, they can be shrunk with an interventional radiology procedure called preoperative embolization. This minimally invasive procedure blocks blood flow to the tumor by filling its feeder artery with an embolizing agent. This not only causes the tumor to shrink, but also makes the surgical removal of the tumor safer with less risk of blood loss.

A CORA interventional radiologist gains access to the tumor through an artery in your wrist or groin and uses X-ray fluoroscopy to guide a thin, flexible tube into place. An embolizing agent is injected through the tube, causing the artery to permanently close off. Without its blood supply, the tumor will shrink rapidly. Preoperative embolization is usually performed a few days before surgery.

Benefits of preoperative embolization of tumors
● Shrinks tumors before surgery for safer, easier resection
● Reduces risk of blood loss
● Can be performed before surgery or as a standalone procedure
● Minimally invasive

Microwave Ablation (MWA) for Tumors

Microwave Ablation is a minimally invasive procedure that uses microwave-induced heat to destroy cancer cells. It is an effective treatment for large or small tumors of the liver, lung, or kidney as well as metastatic bone tumors.

A CORA interventional radiologist uses X-ray or ultrasound guidance to insert a thin needle with an antenna tip directly into the tumor. Microwave energy is delivered through the antenna to create an intense heat that destroys cancer cells. MWA is very quick, taking only minutes to ablate even large tumors. MWA and a similar procedure called radiofrequency ablation (RFA) have an 85% success rate in treating small tumors of the liver.

Benefits of microwave ablation for tumors
● Minimally invasive with few side effects
● Treatment for inoperable tumors
● Quick (only takes a few minutes to perform the actual ablation)
● Can treat multiple tumors in one procedure
● Compatible with other treatments
● An option for patients who are not candidates for surgery

Thermal Ablation for Spinal Tumors

Interventional radiology provides an effective, minimally invasive option for patients with painful, inoperable spinal tumors. The tumor is accessed through a tiny nick in the skin, and a flexible probe is navigated through the vascular system using X-ray fluoroscopy. Once in place, radiofrequency energy is delivered directly into the tumor, destroying cancer cells and relieving pain by taking pressure off of spinal nerves. Once the tumor has been treated, the remaining cavity is filled with a medical-grade glue to strengthen and stabilize the bone.

Benefits of thermal ablation:

• Provides rapid pain relief to patients with inoperable spinal tumors or radiation therapy-resistant tumors
• Can be used before surgery, radiation therapy, or chemotherapy to give patients a more comfortable experience
• Minimally invasive in-office procedure
• Compatible with other cancer treatments
• Safe for people who have reached their cumulative radiation limit

Radioembolization (Y-90) for Liver Cancer

Radioembolization, sometimes called selective internal radiation therapy (SIRT) is an interventional radiology procedure that delivers radiation therapy directly into liver tumors. It is also referred to as Y-90 because the type of radiation used is Yttrium-90.

A CORA doctor will guide a thin, flexible tube through a tiny nick in your skin into the artery that feeds the liver. Tiny beads filled with the radioactive isotope yttrium-90 are delivered directly into the blood supply of the tumor, where they begin to emit radiation that kills cancer cells. Radioembolization is considered safer than external radiation therapy because the radiation is so specifically targeted that healthy surrounding tissues are mostly unaffected. The precise targeting of the tumor also reduces the side effects associated with radiation therapy. The radiation in the particles depletes naturally over time, so the beads do not need to be removed.

Benefits of Y-90

• Palliative treatment option for inoperable liver tumors
• An option for patients who are not fit for surgery
• Provides symptom and pain relief
• Safer than other forms of radiation therapy
• May extend life expectancy from months to years
• May enable patients to undergo future surgery or liver transplantation

PICC and ports

When patients must receive repeated intravenous doses of chemotherapy medications, it can be more comfortable to insert a port rather than accessing the vein each time. A port is a thin tube with one or two disc-shaped reservoirs attached to one end. It is entirely implanted under the skin just beneath your collarbone. When you receive treatment, the needle will be inserted into the disc, which will hold the medication before it is delivered via the tube into your bloodstream. CORA interventional radiologists use advanced imaging technology to safely place ports using minimal anesthesia.

Benefits of Port Placement for Chemotherapy

• Eliminates the need for multiple vein sticks for cancer patients undergoing chemotherapy
• Provides a delivery method for medications that can damage peripheral veins
• Makes chemotherapy more comfortable
• Can be safely implanted with minimal anesthesia by an interventional radiologist

Spinal Tumor embolization

Before tumors are removed via surgery, they can be shrunk with an interventional radiology procedure called preoperative embolization. This minimally invasive procedure blocks blood flow to the tumor by filling its feeder artery with an embolizing agent. This not only causes the tumor to shrink, but also makes the surgical removal of the tumor safer with less risk of blood loss.

A CORA interventional radiologist gains access to the tumor through an artery in your wrist or groin and uses X-ray fluoroscopy to guide a thin, flexible tube into place. An embolizing agent is injected through the tube, causing the artery to permanently close off. Without its blood supply, the tumor will shrink rapidly. Preoperative embolization is usually performed a few days before surgery.

Benefits of preoperative embolization of tumors

• Shrinks tumors before surgery for safer, easier resection
• Reduces risk of blood loss
• Can be performed before surgery or as a standalone procedure
• Minimally invasive

Biopsy

Image-guided interventional radiology offers the unique opportunity to obtain samples of suspicious masses deep inside the body without damage to surrounding tissues or subjecting patients to invasive procedures. For example, liver biopsies can be done much more safely by accessing the organ through the vascular system, rather than an open incision. An interventional radiologist makes a tiny nick in the skin of your neck or groin and uses real-time imaging to guide tools to the biopsy site where the sample is taken.

An interventional radiology biopsy offers the following advantages:
● Safer and less invasive than other biopsy options
● No incisions necessary
● Interventional oncology procedures can usually be performed on patients who aren’t well enough to undergo traditional surgery

PleurX Catheter

The PleurX Catheter is a device used to drain pleural effusions or malignant ascites. Using real-time imaging, an interventional radiologist can ensure correct placement of the catheter for optimal performance. A PleurX Catheter can greatly improve quality of life for patients with chest fluid build-up due to pleural effusions or abdominal fluid build-up due to malignant ascites.

Benefits include:
● Patients or caregivers can drain painful fluid build-up at home, reducing the number of emergency doctor visits and hospital stays
● Catheter placement is safe and relatively quick
● Patients have more control over their symptoms