Cancer Treatments at Georgia Vascular Institute

Doctors treat most cancers with surgery, chemotherapy, radiation therapy, or some combination of these treatments, depending on the types and stage of a patient’s cancer. Interventional radiologists have developed procedures to treat many cancer patients and to improve quality of life. We work closely with clinical oncologists to plan and provide the best course of treatment for our patients.

Georgia Vascular Institute provides the following interventional procedures and treatments for our patients:

Biopsy

Tumor Biopsy

Many cancers are now diagnosed by needle biopsy. This is performed typically as an outpatient procedure with less risk and side effects compared to a conventional surgical biopsy. This is usually done using conscious sedation or local anesthetic. During the procedure the doctor uses imaging guidance (such as CT, X-ray, Ultrasound, or MRI) to insert a small needle into the tumor. A small amount of tissue is removed and examined by a pathologist to determine if cancer is present.

Port Placement

What is a Port?

What is a Port?

A port is a device that can be placed in the chest or arm that allows an easy way to give medicine (i.e. chemotherapy) and take blood samples from the veins. It is implanted underneath the skin by creating an incision about an inch long. You can feel it raised about a half inch thick and the size of a quarter. This is attatched to a piece of tubing that is tunneled under the skin to an area near the neck where it enters a vein. The tubing (catheter) ends up to the beginning of your heart. This allows the chemotherapy agent to be pumped efficiently throughout your body without damaging your veins.

The center of the port is made of a tough, self-sealing, rubber-like material that can be punctured through the chest skin with a needle many times by the nursing staff. Each time it will reseal instantly.The port and tubing are entirely underneath the skin.

What are the risks?

Infection

Once the port is in place and healed, there is very little chance of infection. The port is at risk for infection when the port is “accessed”. This is when a trained person iserts the proper needle into the middle rubber portion of the port. Only a healthcare provider experienced in port care should do this.

Bleeding

Because a small incision will be made in the chest skin there is a chance of bleeding in the form of bruising or oozing of blood from incision. However the bruising typically only lasts for a few days.

RFA
What is Radiofrequency Ablation (RFA)?

For inoperable tumors, radiofrequency ablation (RFA) offers a nonsurgical, localized treatment that kills the tumor cells with heat, while sparing the healthy tissue.  Many tumors including liver, lung, kidney and bone can be treated with RFA.  In this procedure, the interventional radiologist guides (using imaging guidance) a small needle through the skin into the tumor. From the tip of the needle, radiofrequency energy (similar to microwaves) is transmitted to the tip of the needle, where it produces heat in the tissues. The dead tumor tissue shrinks and slowly forms a scar.  This is typically performed under general anesthesia or conscious sedation. Patients usually are admitted for overnight observation and sent home the next day.

Most patients may experience some mild pain and discomfort at the insertion site, fatigue, and occasionally 24-48 hrs but generally resume normal activities within 72 hrs.

Efficacy

In a small number of cases, RFA can extend patient’s lives, but it is generally palliative. Depending on the size of the tumor, RFA can shrink or kill the tumor, extending the patient’s survival time and greatly improving their quality of life while living with cancer.

Because it is a local treatment that does not harm healthy tissue, the treatment can be repeated as often as needed to keep patient’s comfortable. It is a very safe procedure, with complication rates on the order of 2-3 percent, and has been available since the late 1990’s.

Chemoembolization

What is Chemoembolization?

Chemoembolization is a minimally invasive treatment for liver cancer that can be used when there is too much tumor to treat with radiofrequency ablation (RFA), when the tumor is in a location that cannot be treated with RFA, or in combination with RFA or other treatments.

Chemoembolization delivers a high concentration of cancer-killing drug (chemotherapy) directly to the organ while depriving the tumor of its blood supply by blocking, or embolizing, the arteries feeding the tumor. Using imaging for guidance, the interventional radiologist threads a tiny catheter up the femoral artery in the groin into the blood vessels supplying the liver tumor. The embolic agents keep the chemotherapy drug in the tumor by blocking the flow to other areas of the body. This allows for a higher dose of chemotherapy drug to be used, because less of the drug is able to circulate to the healthy cells in the body.

The procedure is done in the Interventional procedure suite utilizing x-ray guidance with local and conscious sedation. Patients are typically hospitalized one night and sent home the following day.

Chemoembolization is a palliative, not a curative, treatment. It can be extremely effective in treating primary and metastatic liver cancers, especially when combined with other therapies.

Ascites/Effusions

Why the Pleurx Catheter for malignant ascites?

The Pleurx Peritoneal Catheter and pre-packaged Pleurx Drainage Kits provide the symptomatic benefits associated with repeat paracentesis, without the discomfort and hassle associated with repeated facility visits.

The Pleurx system employs unique disposable 1000 milliliter vacuum bottles to actively draw ascitic fluid through an implanted Pleurx Peritoneal Catheter. Patients can manage their symptoms at home with minimal physician intervention.

Pleurx Catheter Placement

The Pleurx Peritoneal Catheter is typically placed via a minimally invasive procedure in a hospital or clinic setting. Placement is straightforward and usually performed on an outpatient basis.

Pleurx Home Drainage

Patients order and receive drainage supplies directly from the manufacturer one of their distributors, depending on insurance coverage. The Pleurx Drainage Kit contains all items necessary to perform a clean procedure in the home setting. Drainage, which is easy and quick, is typically done by the patient or a caregiver.

The same catheter is utilized for  treatment of recurrent  pleural effusions,  however this is placed in the chest  instead of the abdomen, for home drainage.

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Dr. Kevin Carson
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