PALLIATIVE CARE PROCEDURES
INCLUDING PAIN MANAGEMENT OR FLUID DRAINAGE
Many patients with cancer unfortunately deal with side effects of their tumors such as pain, or development secondary problems such as fluid in the abdomen or chest, local or systemic infection, malnutrition, and other issues. Interventional oncologists are often asked to help patients by performing procedures that can reduce pain and treat these secondary complications. Some specific examples of procedures performed by interventional oncologists in this category include:
Placement of Drainage Catheters in the Chest or Abdomen
With the patient sedated and using local anesthesia Interventional Oncologists are able to place small needles into fluid collections or abscesses using image guidance. A wire is then placed through the needle, needle removed, and drain placed over the wire. The drain can then be kept in place to allow continual drainage and help the likelihood of resolution.
Percutaneous feeding tube placement
Some cancer patients may develop malnutrition or lack of appetite due to their treatment or primary disease. Interventional oncologists are able to place a tube through the skin into the stomach that can then be used to give additional nutrition to help promote healing and boost the immune system.
With the patient sedated and using local anesthesia Interventional Oncologists are able to place a small needle into the stomach. A wire is then placed through the needle, needle removed, and feeding tube placed over the wire. The tube can then be kept in place to allow additional nutrition to be administered.
Nerve blocks, and other pain treatment procedures
Some cancer patients develop pain related to their tumors. Often times administering local anesthetic medication or steroids (to decrease inflammation) around the nerve extending from the tumor area can dramatically improve pain without the unwanted side effects that many oral pain medications have.
With the patient sedated and using local anesthesia Interventional Oncologists are able to place a small needle adjacent to the major nerve feeding a tumor. Local anesthetic and often times steroid medications are then given to bathe the nerve and decrease pain. Alternatively, the nerve can be permanently ablated by administering certain chemicals if this is the best course of action.
Percutaneous Vertebral Augmentation
Certain cancers and or their treatments can make patient prone to development of compression fractures in the spine (vertebrae). These fractures can be painful and can lead to decreased quality of life and deconditioning.
An advanced treatment for vertebral compression fractures is known as vertebroplasty, or more generally vertebral augmentation. Using X-ray guidance an interventional oncologist is able to place a needle from the patients back into the fractured vertebrae. Bone cement is then injected through this needle to stabilize the fracture. This cement also generates local heat when it sets which helps dampen the sensitivity of the local nerve endings in the fracture to improve pain levels. Most patients tolerate this procedure very well with moderate sedation and go home the same day.
When clinicians have a concern for cancer cells having spread to the brain, spinal cord, or the lining of these structures it is often necessary to gain a small sample of cerebral spinal fluid (CSF), the fluid that bathes the brain and spinal cord, for microscopic evaluation.
With the patient on their stomach and using X-ray guidance interventional oncologists are able to very accurately place a small needle into the CSF in order to obtain a sample. This is often quicker and takes fewer attempts for successful sampling when compared to performing the procedure without image guidance. Patients tolerate this procedure well and go home the same day.
333 N. Commercial Street, Suite 100
Neenah, WI 54956
Radiology Associates of the Fox Valley