The Best Interventional Oncology Therapy for the Patient

By James G. Caridi, MD, FSIR

It is a well known fact that interventional radiology is the sin quo non for “there is more than one way to skin a cat.” This is epitomized in interventional oncology. We are inundated with a menu of options for improving survival when treating the multitude of liver tumors. In the right hands it appears that it is not the tool but how one uses it to garner the best success and survival.

Therefore to separate the different tools and argue for their advantages and preferred employment our gurus have discussed the merits of secondary benefits such as price and ease of performance in addition to survival.

At one major meeting I heard one speaker remark that his method was better because of similar survivals at a much cheaper price with an increase in side effects of only a few percent. I gasped. For those that are the “1 to 2 percenters,” side effects and quality of life are key. Those extra days of survival that we tout are miserable if that precious time is mired in bed-ridden fatigue, unyielding neuropathy, cramps, bloating, or diarrhea. Not to mention additional potential need for testing and infusions as well as trips to the clinic and hospital. Is this really surviving? The potential for side effects should never be taken whimsically and for patients already plagued mentally and physically with illness it should be the priority to avoid these. When survival rates are similar, alternatives to treatment, on the basis of ease of performance or cost should not be considered at the expense of an increase in misery to the patient.