Minimally Invasive Oncology
The Center for Minimally Invasive Oncology and Precision Medicine is a collaborative effort between surgeons, interventional radiologists, medical oncologists, and radiation oncologists to create individualized treatment plans. Through advances in research, education, technologic advancement, and clinical skill we seek to embark on a new era of medicine in which doctors, researchers, and patients work together to develop individualized care plans for each person’s specific needs.
What is minimally invasive oncology?
Innovative minimally invasive techniques are used to diagnose and treat many types of cancer including gastrointestinal, lung, brain, gynecologic, head & neck, liver, breast and prostate cancers.
What is precision medicine?
Treatment using precision medicine carefully examines the unique molecular signature or “personality” of your cancer in order to tailor treatments that activate your immune system and target the mutations that cause your cancer. Using this approach, we personalize the attack against your cancer with cutting-edge precision and it’s a less toxic approach to treating your cancer. Many of these treatments are also being studied in clinical trials.
What are the benefits of minimally invasive diagnostic and treatment techniques?
- Less pain – Studies indicate that patients undergoing less invasive diagnostics and treatment experience less pain and require fewer pain medicines
- Short hospital stays – Many minimally invasive procedures require minimal or no hospital stays and can be performed on an outpatient basis. Of those requiring hospitalization, patients are able to return home faster and resume normal activity sooner.
- Less damage to normal tissue – Traditional procedures including biopsies, surgeries and radiation expose normal tissue to unnecessary damage. Minimally invasive approaches are targeted with less collateral damage.
- Higher accuracy – Through video-assisted, image-guidance, and robotic methods, physicians are better able to target the specific area to be treated.
Radiation oncology is a specialty that uses advanced technology to provide non-invasive treatments for most cancers. Through advanced technology, doctors can deliver a specialized and targeted radiation therapy.
- Stereotactic radiosurgery: This is a form of precision radiation delivered in 1-5 treatments to small areas within the brain or skull base. The selection of the amount of radiation and number of treatments depends on the size and location of the tumor. This treatment is delivered through a radiation platform called Cyberknife, which is a robotic delivery system used to track the exact tumor location. Patients are placed in a mask for immobilization. This is a non-invasive procedure with no surgery needed.
- Stereotactic body radiation therapy (SBRT): This is another form of precision radiation therapy used to target tumors outside of the brain and consists of 1-5 treatments typically lasting 30-90 minutes depending on the person’s tumor size, shape and location. This technique can be used to treat most cancers including: brain, lung, prostate, liver and pancreas. Multiple treatment platforms are available for this treatment including Cyberknife, TrueBeam and Tomotherapy.
- Calypso: This device is similar to a GPS for the body. Radiation oncology clinicians are able to keep the target in the path of the radiation beam at all times. Tumor tracking becomes even more significant when using escalated doses for treatment. By detecting the slightest tumor movement and guiding the therapist in repositioning the patient if necessary, physicians are able to specifically target tumors while avoiding normal tissue. Device implantation is minimally invasive, typically under ultrasound or CT guidance.
- Intra-operative radiation: This therapy can be used at the time of a surgical procedure to provide highly-focused treatment and minimize normal tissue exposure to radiation. This technique is used primarily for breast cancers, intra-abdominal tumors, and some head and neck cancers.
Minimally invasive surgery is an effective approach to removing some cancerous tumors and lymph nodes – all while sparing the patient from unnecessary tissue damage, pain, and scarring. Our surgeons are also using minimally invasive techniques to collect tissue for biopsy and to perform accurate "staging" studies to determine the best cancer treatment plan.
Learn more about our minimally invasive surgery options for cancer patients:
Minimally invasive approaches occur through the integration of image-guidance (ultrasound, CT, MRI) and procedural techniques. Interventional radiology specializes in cancer diagnosis and treatment through outpatient, minimally invasive approaches.
- Biopsies: Using ultrasound and CT guidance, we can guide small needles to obtain tissue samples throughout the body. The imaging allows for precise needle placement, and the small needle size reduces the risk of complication. The tissue is then reviewed at the time of biopsy by a pathologist to make sure it is adequate for diagnosis.
- Tumor Ablation: When a patient has a small tumor in organs such as the liver or kidney that cannot be removed with surgery, tumor ablation may be an option. This involves placing a small needle or probe into the tumor with ultrasound and/or CT guidance and using heat to cause irreversible tissue damage or ethanol to cause immediate tumor death. Patients are typically able to be discharged on the same day of the procedure.
- Chemoembolization: Tiny beads mixed with chemotherapy are delivered through a small catheter in the groin or wrist directly into the arteries feeding liver tumors. These beads block blood supply to the tumor and deliver chemotherapy directly to the tumor to cause tumor death. Our brand new GE angiography suite allows us to use the latest technology for accurate delivery. Most of our patients can be discharged on the day of therapy, but occasionally overnight observation for pain control may be needed.
- Radioembolization: For patients with a larger amount of tumor within the liver, small beads loaded with radiation (the isotope Yttrium-90) can be delivered through a small catheter in the groin or wrist into the arteries feeding the tumors. This involves two outpatient procedures. The first procedure is a planning procedure to help us determine where to treat and that the treatment will be safe. The second procedure is the actual treatment. Patients are usually with us in the morning and are discharged mid-afternoon. Some patients may feel like they have the flu after the procedure, but this typically lasts for only 3-5 days.
- Pain Palliation: Pain management is an essential part of cancer management, and there are a variety of procedures we can offer to reduce pain and limit pain medications. For patients with painful tumors within bones, tumor ablation and reinforcement of the bone with cement can offer almost immediate relief. Also, we can use image guidance to inject medications through a tiny needle to block pain nerves. Our pain procedures typically take less than an hour and are outpatient procedures
Learn more about our team of radiologists
Examples of precision medicine include the following:
- Infusion therapy – Treatment is delivered through an IV, such as chemotherapy.
- Targeted therapy – Treatment that works based on a patient’s genetics.
- Immunotherapy – Treatment that activates a patient’s immune system to attack the mutations causing the cancer.
- Oral cancer therapies – Treatment taken by mouth at home, making treatment more convenient and accessible.