Overview

Cancer can affect different organs and tissues and may require several forms of treatment depending on the type, stage and location of the disease. In some situations, a tumour or cancer-related complication may be suitable for a minimally invasive, image-guided intervention.

Interventional cancer care may be considered when a tumour needs to be diagnosed, treated locally, or when cancer causes complications such as bleeding, vascular problems or difficult-to-manage pain.

At Supreme Vascular and Interventional Clinic in Singapore, Dr. Manish Taneja provides specialist assessment for selected cancer-related conditions and can determine whether an interventional approach may be appropriate as part of a patient’s overall cancer care.

Interventional Cancer at a Glance

• Cancer can affect different organs and may require different approaches depending on its type, location and stage.
• Some tumours and cancer-related complications can be assessed or managed using minimally invasive, image-guided approaches.
• Interventional care may be considered for selected tumours, cancer-related bleeding, vascular complications and cancer-related pain.
• An interventional approach may be used alongside surgery, chemotherapy, radiation therapy or other cancer treatments.
• Specialist assessment is needed to determine whether an intervention is appropriate for an individual patient.

What Is Interventional Cancer?

Interventional cancer refers to the use of specialist, minimally invasive approaches to address selected problems associated with cancer.

Rather than referring to one specific type of cancer, the term encompasses cancer-related conditions where an image-guided intervention may have a role in diagnosis, local tumour management or symptom control.

The role of an intervention depends on the individual cancer diagnosis and may include:

• Assessing or obtaining tissue from a tumour
• Treating selected tumours locally
• Managing blood flow to or from a tumour
• Controlling bleeding caused by cancer
• Addressing certain vascular complications
• Managing cancer-related pain or other symptoms

These approaches are not suitable for every cancer. The appropriate treatment depends on the patient’s diagnosis, imaging, overall health and wider cancer treatment plan.

Cancer Conditions That May Require Interventional Care

Different cancer-related problems may require different forms of specialist assessment.

Tumours That May Be Suitable for Local Treatment

Some tumours may be suitable for a local, minimally invasive approach rather than, or in addition to, other forms of cancer treatment.

Whether a tumour can be treated locally depends on factors such as its size, number, location and relationship with surrounding organs and blood vessels.

Tumours Requiring Image-Guided Assessment

Some suspicious or difficult-to-access lesions may require image-guided biopsy to obtain tissue for diagnosis.

The location of the lesion and nearby structures are considered when determining the safest and most appropriate approach.

Cancer-Related Bleeding

Some tumours can cause bleeding, either directly or by affecting nearby blood vessels.

Significant tumour-related bleeding may require urgent assessment. In selected circumstances, minimally invasive vascular intervention may be considered to help control the source of bleeding.

Cancer-Related Vascular Problems

Cancer can sometimes affect blood vessels through compression, invasion or other changes. Certain vascular complications may require specialist assessment and, in selected cases, an image-guided intervention.

Cancer-Related Pain

Cancer can cause pain by affecting bones, nerves, organs or surrounding tissues. The cause and location of the pain help determine the appropriate approach.

Some patients with persistent or difficult-to-control cancer-related pain may be considered for an interventional pain procedure as part of a broader pain-management plan.

Symptoms and Problems Associated With Cancer

Cancer symptoms vary considerably depending on the type and location of the disease.

Possible symptoms include:

• A new or enlarging lump or mass
• Persistent or unexplained pain
• Unexplained bleeding
• Unexplained weight loss
• Persistent fatigue
• Changes in bowel or bladder function
• Persistent cough or difficulty breathing
• Changes affecting the skin or other organs
• Symptoms caused by pressure on nearby nerves, organs or blood vessels

Some cancers may cause few or no symptoms during their early stages.

Symptoms alone cannot determine whether a person has cancer. Persistent or unexplained symptoms should be assessed by an appropriate healthcare professional.

How Are Cancer-Related Conditions Diagnosed?

The assessment of a cancer-related condition depends on the suspected diagnosis and the patient’s existing medical information.

Assessment may include:

• Medical history and symptoms
• Physical examination
• Blood tests
• Ultrasound
• CT scans
• MRI
• PET or other specialised imaging
• Image-guided biopsy
• Review of previous pathology and cancer investigations

Imaging can be particularly important when determining whether a tumour or cancer-related complication may be suitable for an interventional approach.

Where a biopsy or other image-guided procedure is required, the location of the lesion and surrounding structures are considered when planning the procedure.

Interventional Cancer Treatment Options

Depending on the type, stage and location of the cancer, minimally invasive and image-guided treatments may form part of a patient’s overall cancer care. The appropriate approach depends on the individual diagnosis, treatment goals and overall health.

Image-Guided Biopsy

An image-guided biopsy uses imaging to help obtain a tissue sample from a tumour or suspicious lesion to confirm and identify the type of cancer. The sample can then be examined to confirm the diagnosis and guide further treatment. 

Cancer Therapy Vascular Access

Portacaths (a smalld device is inserted into the chest) and PICC lines placement (a catheter that gives doctors access to central veins near the heart) provide reliable access to the bloodstream for patients receiving chemotherapy and other intravenous cancer treatments without the need for repeated peripheral needle injections.

Tumour Ablation

Tumour ablation uses minimally invasive techniques to destroy selected tumours locally, terat tumours, or alleviate symptoms. Depending on the tumour and its location, techniques may include radiofrequency, microwave or cryoablation.

Tumour Embolisation

Tumour embolisation involves selectively affecting the blood supply to a tumour and, in some cases, delivering treatment directly to the tumour. This is a targeted treatment with minimal impac ton healthy tissues and reduced side effects. Different approaches may be considered including chemoembolisation, radioembolisation (selective internal radiation therapy [SIRT], and DC beads chemoembolisation and bland embolisation, depending on the cancer and treatment objectives.

Cancer-Related Vascular Interventions

Some cancers can cause bleeding or affect nearby blood vessels. In selected situations, minimally invasive vascular interventions may be used to manage these complications or relieve related symptoms. The treatments can stop tumour bleeding or to open blockages of normal blood vessels by growing tumour cells. They are usually palliative procedures.

Cancer-Related Pain Management

Cancer can cause persistent pain by affecting bones, nerves, organs or surrounding tissues. Selected patients may benefit from interventional pain management, including targeted injections or nerve blocks, as part of their wider cancer care. They can be used to provide relief from cancer-related pain.

How Are Treatment Options Chosen?

The most appropriate approach depends on the cancer type and stage, tumour size and location, imaging findings, previous and planned treatments, overall health and the goals of care.

A specialist assessment can help determine whether an interventional treatment may be appropriate and how it could fit within the patient’s wider cancer care plan.

When May Interventional Care Be Considered?

An interventional approach may be considered when:

• A tumour requires image-guided biopsy
• A selected tumour may benefit from local treatment
• Cancer has caused significant bleeding
• A tumour or cancer-related condition is affecting blood vessels
• Cancer-related pain remains difficult to control
• A minimally invasive approach may be appropriate alongside other cancer treatments
• A patient requires specialist assessment to determine whether an interventional option is suitable

Interventional treatment is not automatically appropriate simply because a tumour is present. The potential benefits, limitations and alternatives should be considered in the context of the patient’s overall cancer diagnosis and treatment plan.

How Is the Right Approach Determined?

Choosing an appropriate approach requires an understanding of both the cancer and the patient’s overall circumstances.

Factors that may be considered include:

• Type of cancer
• Stage of disease
• Size and number of tumours
• Location of the tumour
• Relationship with surrounding organs and blood vessels
• Symptoms and complications
• Previous treatments
• Planned surgery, chemotherapy or radiation therapy
• General health and organ function
• The overall goals of treatment

Relevant imaging and medical records may be reviewed as part of the assessment.

For some patients, an interventional procedure may be appropriate. For others, surgery, systemic therapy, radiation therapy, supportive care or another approach may be more suitable.

Interventional Cancer and Your Overall Cancer Care

Interventional care does not necessarily replace conventional cancer treatment.

Depending on the diagnosis, an interventional approach may be considered alongside:

• Surgery
• Chemotherapy
• Radiation therapy
• Immunotherapy
• Targeted therapy
• Hormonal therapy
• Supportive and palliative care

The role of an intervention can vary. It may be intended to help diagnose a tumour, treat a specific tumour or complication, control symptoms, or support another aspect of cancer care.

Treatment decisions should therefore be made based on the overall clinical picture rather than on a single procedure.

When Should I See a Specialist?

Consider specialist assessment when:

• You have been diagnosed with a tumour that may require local treatment
• Your cancer has caused significant bleeding or a vascular complication
• A tumour requires an image-guided biopsy
• You have persistent cancer-related pain despite other treatment
• Your cancer team has recommended assessment for a minimally invasive procedure
• You would like another opinion about whether an interventional approach may be appropriate

A specialist assessment can help clarify whether an intervention has a potential role and how it may fit into the wider treatment plan.

When to Seek Urgent Medical Attention

Some cancer-related symptoms require urgent medical attention.

Seek urgent care for symptoms such as:

• Significant or uncontrolled bleeding
• Sudden difficulty breathing
• Severe or rapidly worsening pain
• New weakness, numbness or other neurological symptoms
• Sudden confusion or loss of consciousness
• High fever or signs of serious infection
• Any rapidly worsening symptom associated with a known or suspected cancer

If symptoms are severe or potentially life-threatening, seek emergency medical attention rather than waiting for a specialist consultation.

Interventional Cancer in Singapore

Patients in Singapore who are considering minimally invasive options for a cancer-related condition can seek specialist assessment to determine whether an interventional approach is appropriate.

At the Supreme Vascular and Interventional Clinic, Dr. Manish Taneja provides specialist assessment for selected cancer-related conditions and image-guided interventions. Assessment may include reviewing the patient’s diagnosis, imaging, previous treatments and treatment objectives. Where appropriate, the available options and their potential role within the wider cancer care plan can then be discussed.

Frequently Asked Questions