Author:

Marc Beishon

Date of publication: 18 March 2025
Last update: 18 March 2025

Abstract

The article explores the rise of interventional oncology as a potential "fourth pillar" of cancer care, alongside surgery, medical oncology, and radiotherapy. This emerging field, rooted in interventional radiology, offers minimally invasive, image-guided procedures that aim to treat localized tumors with reduced systemic toxicity and trauma. Traditionally associated with palliative care and procedures like biliary stenting or biopsy, interventional oncology is now entering the curative arena. Techniques such as radiofrequency and microwave ablation, cryoablation, chemo-embolisation, radio-embolisation (e.g., with yttrium-90 microspheres), and isolated hepatic perfusion are gaining traction, particularly for tumors in the liver, kidney, and lung. These procedures can be an alternative to surgery, especially for small, localized tumors or patients unfit for major operations. Experts like Brian Stedman in the UK and Thierry De Baere at Institut Gustave Roussy in France have been instrumental in advancing these techniques. De Baere notes that radiofrequency ablation is already considered a standard option for small hepatocellular carcinomas and could become more widespread in treating kidney and lung tumors. Despite promising results, interventional oncology faces several challenges: a limited number of trained specialists, a fragmented approach across centers, and a still-developing evidence base. Large trials such as FOXFIRE and SIRFLOX are underway to assess the efficacy of combining interventional methods with systemic treatments, particularly in metastatic colorectal cancer. To gain full recognition, interventional oncologists must be more integrated into multidisciplinary teams and recognized as full clinicians rather than technicians. As Liz Kenny, a radiation oncologist cited in the article, argues, the field’s potential is high, but without strong evidence of clinical benefit, quality of life improvements, and cost-effectiveness, it risks being sidelined. The article concludes that while interventional oncology holds great promise as a less invasive and highly targeted treatment option, it will take time, evidence, and collaboration to establish it as a core component of standard cancer care.

Article

The article is only available in PDF format and can be downloaded HERE.

Acknowledgement

The article was published in Cancer World, Issue n° 53, March/April 2013. We would like to thank the editor for kindly granting permission to republish the article.