What kind of treatment should I choose when I have a tumor? Nowadays, some cancers can be eradicated through reasonable treatment, and patients can be cured for life or survive for a long time. Many diseases are more difficult to treat when they reach advanced stages, especially cancer.
However, with the continuous improvement of treatment methods and the emergence of new treatments and drugs, some cancers that are not in the early stage can be cured. Some previously inoperable tumors such as cervical cancer and liver cancer can now be treated with interventional therapy to shrink and confine the tumor, creating the opportunity for re-excision, thus increasing the cure rate. However, many tumor patients are already in advanced stage when they are diagnosed and lose the chance of surgical treatment, what should be done?
The goal of minimally invasive treatment is mainly reflected in two aspects: firstly, to achieve the treatment purpose (radical or palliative) as much as possible, and secondly, to reduce the patient’s pain as much as possible, to protect the functional integrity of normal tissues and organs around the tumor as much as possible and to improve the quality of life.
Minimally invasive interventional treatment of tumors, such as interventional embolization, injection of anhydrous ethanol and other physicochemical ablation methods have solved many difficult problems of tumor treatment compared with traditional surgery, especially for patients with advanced stage or failed traditional treatment methods, and have become an important part of clinical tumor treatment.
And for some early small solid tumors such as small hepatocellular carcinoma, the use of minimally invasive ablation therapy can achieve the same effect as surgical liver resection.
Interventional diagnosis and minimally invasive treatment of tumors have the following characteristics.
Minimally invasive: through percutaneous puncture, tumor tissues can be obtained for pathological diagnosis and various ablation treatments at the same time; through physiological lumen, catheters or stents can be delivered into the bile duct, esophagus and airway to treat luminal narrowing caused by tumor invasion; through vascular puncture, tumor-related blood supply arteries can be diagnosed and treated accordingly.
2.Accurate positioning and clear therapeutic effect: All operations are performed under the precise guidance of various imaging equipment, so that the instruments can reach the tumor directly and strike the tumor precisely.
3.Good repeatability: The biological characteristics of tumor determine that its treatment needs to be repeated or multidisciplinary comprehensive treatment.
4. Small side effects and less complications: Since the treatment is mainly localized, the impact on the whole body is lower than that of medical and surgical treatment.
Minimally invasive interventional treatment of tumor is broadly divided into endovascular treatment, non-vascular interventional treatment, molecular targeted therapy and gene therapy of tumor.
Principle and efficacy of interventional embolization
Interventional vascular therapy is a special treatment given by inserting a catheter into the blood supplying artery of the lesion area under the guidance of X-rays.
Vascular interventional therapy for tumors is a special therapy for cancer treatment, a minimally invasive treatment without incision, which is welcomed by patients for its small trauma and good efficacy.
It has two main advantages.
On the one hand, high concentration of chemotherapeutic drugs are directly infused into the local blood supply artery of tumor to exert the maximum anti-tumor effect, i.e. “poisoning the tumor”, which reduces the toxic side effects of chemotherapeutic drugs on the whole body;
On the other hand, the chemotherapeutic drugs mixed with embolic agent will block the blood vessels of tumor supply, so that the tumor will be deprived of blood supply and nutrition and starve the tumor. This chemoembolization technique is especially suitable for malignant tumors of liver, lung, stomach, kidney, pelvis, bone and soft tissues that are inaccessible to surgery or not suitable for surgery, especially for patients with primary liver cancer, which can even replace surgery as the first treatment option to some extent due to the special characteristics of liver cancer blood supply.
The blood supply of normal liver is 30% from hepatic artery and 70% from portal vein, while the blood supply of hepatocellular carcinoma tissue is 90% from hepatic artery and 10% from portal vein. The hepatic artery cannulation chemoembolization (TACE) involves inserting a catheter through skin puncture into the hepatic artery or smaller hepatic artery or the branch of hepatic artery on the side of the cancerous tissue, and then slowly pushing the chemical and embolic agent into and around the hepatic cancerous tissue under X-ray fluoroscopy.
In this way, the concentration of chemical drug is maintained in the liver cancer tissue, which can kill a large amount of liver cancer tissue, and at the same time, the liver cancer tissue can be “starved to death” because the blood supply is cut off due to the embolization of hepatic artery. It has no effect on normal liver tissues or only hurts the “skin”.
According to statistics, the recent efficiency of treatment by this method can be as high as 80%. Since liver cancer is usually in the middle to late stage when it is detected, it cannot be cured surgically. By using this method, the cancer mass can be reduced in size so that it can be removed surgically. This method can also be used for patients with lung cancer, kidney cancer, stomach cancer and pelvic tumor.