Interventional Oncology – The Fourth Pillar of Cancer Care

Interventional oncology (IO) is an emerging subspecialty of interventional radiology that “uses image-guided procedures to enhance cancer care,” according to a recent paper published in The Oncologist.¹ IO has advanced over the past few years as improved hardware, imaging technologies and new procedures are being developed. IO aims at using minimally invasive techniques to diagnose/ treat tumors. Its role in the management of cancer has been growing and has now established itself as the fourth pillar of Modern Oncology care” (the other three being medical, surgical, and radiation), as is evident by its increasing role in cancer treatment guidelines.Most of the IO procedures require only local anesthesia or mild sedation and the patient can be discharged the next day.

More patient centered and personalized treatment approaches have also led to further development of IO.²IO is focused on three main areas in cancer management: diagnosis, therapy, and symptom palliation.¹ A major advantage of IO is localized effect on the tumor or a single organ in the body with minimal systemic side effects.³ Numerous studies have shown that cancer patients treated in multidisciplinary environments benefit greatly from the combined expertise. Interventional Radiologists are seen as playing a major role in multidisciplinary cancer teams where they provide innovative solutions to improve combined therapies and to treat complications.⁴ IO has evolved in the treatment of liver malignancies, both primary and secondary in the form of liver directed therapies including chemoembolization / radioembolization and ablative therapies. The ablative therapies have  further advanced with increasing role in lung, kidney and bone neoplasms as well.

Over the past few years, as the scope of IO has expanded and many hospitals across the world are establishing subdivisions of IO and our institute, Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC) has always been a pioneer when it comes to Oncology care, and it holds true for the establishment of the sub-division of IO and our institute has an exclusive IO Cath Lab that is providing services to the hospital round the clock. On January 29, 2021 a new milestone was achieved with support from the Management, RGCIRC and under the chairmanship of Dr. Arvind K. Chaturvedi, a grand virtual launch event was organized for the launch of “Interventional Oncology” in association with Oncology Forum. The Indian Society of Vascular and Interventional Radiology (ISVIR) and the Society of Interventional Oncology (SIO) were the launch partners. World renowned experts in the field of IO gave the opening remarks and the event was a great academic feast with most important IO topics discussed by the world authorities.

The Society of Interventional Oncology (SIO) is a global non-profit association that supports and promotes the field of IO. The mission of SIO is, “To advance IO by developing evidence supporting IO therapies, educating IO practitioners, and improving patient access to IO therapies.”

As we move into the era of artificial intelligence and robotic technologies, the scope and utility of IO is only going to increase further.

• Schoenberg, S.O., Attenberger, U.I., Solomon, S.B. and Weissleder, R.. Developing a Roadmap for Interventional Oncology. The Oncol. 2018: 23: 1162-70.
• Bpst, Blanche & Lagadec, Matthieu&Breguet,Romain & Vilgrain, Valerie & Ronot, Maxime. Cone Beam Computed Tomography (CBCT) in the Field of Interventional Oncology of the Liver. Cardiovasc intervent Radio.2015.38:1180-6
• Helmberger. Interventional Oncology – where are we now? – And where we should head for? Radiología (English Edition). 2019. 61: 1-3.
• Adam, Andreas; Kenny, Lizbeth M. “Interventional oncology in multidisciplinary cancer treatment in the 21st century”. Nature Reviews Clinical Oncology. 2015: 12(2): 105–13.

Dr. Abhishek Bansal
Consultant – Interventional Oncology