Thanks to research, innovation, and advancements, many of today’s medical procedures can be done in a minimally-invasive way — typically on an outpatient basis — yet be as effective as major surgery.

“Aside from allowing hospitals to function more effectively, minimally-invasive procedures enable patients to resume normal activity, energy, and appetite levels with fewer side effects than one typically gets with big operations,” says Dr. Amol Mujoomdar, Division Head for Interventional Radiology at London Health Sciences Centre and Associate Professor of Radiology and Oncology at Western University.

Patients driving alternative care decisions

The field of interventional radiology offers minimally-invasive procedures to treat liver and kidney (renal) cancers, among others. Interventional radiologists use guided imaging to insert small needles into solid tumours — or inject chemotherapy beads or radiation beads into blood vessels — to help shrink tumours from the inside out. TheraSphere, a type of Y90 radio-embolization procedure used to treat liver cancer, for example, involves impregnating a microscopic glass bead (microsphere) with high dose radiation and injecting it directly into the blood vessel of a tumour. An angiogram through the groin or wrist is used to map out the patient’s anatomy so that the dosage and radioactive microsphere can be individually tailored to the patient, who can usually return home from the hospital the same day.

Patients who are not good candidates for regular surgery, such as the elderly or people with heart issues, are typically treated with interventional radiology. But as more scientific data becomes available to support the treatment’s efficacy, and as patient awareness increases, Dr. Mujoomdar says more of his younger patients are requesting it. “People go on the internet and research, so they’re driving their own care a bit more,” he says.

Although Dr. Mujoomdar cautions that interventional radiology may not be the right option for all, he believes the ideal scenario is to have the specialist team present all available options to the patient and design an approach that’s best suited for that individual. “In some cases, the less invasive option is the better one.”

“The Canadian Cancer Survivor Network supports access to new, minimally-invasive treatments that provide greater choice for patients,” says Jackie Manthorne, President and CEO of the Network. “Unfortunately, access to treatments is often restricted as some provinces do not yet fund some devices and medications.”

Greater advocacy required for change

While minimally-invasive technologies may be cost-effective to the health care system in the long run and provide long-term benefits, upfront investment in technology can sometimes prove a barrier to access. Unfortunately, Canada lags behind the other G7 nations — where interventional radiology is considered the standard of care — in funding these technologies. “This presents a huge challenge to patient access,” says Dr. Mujoomdar.

A further complication is that certain procedures, like Y90, are funded in some provinces but not in others meaning the need continues to grow, unmet. “Ontario doesn’t fund Y90, so it can be incredibly frustrating if you’re a physician and you know that your patients would be funded if they lived in another province,” says Dr. Mujoomdar. “This disparity between provinces can also result in patients not having access to what might be the right treatment for them at the right time,” adds Manthorne.

To improve patient access to these new technologies, patients and their families are encouraged to increase their own awareness of what’s out there and advocate for more government funding. “In this Google era we should be as informed as possible and know our options, especially in oncology,” says Dr. Mujoomdar. “In certain instances, our treatment options are extremely limited and a minimally-invasive procedure becomes the only treatment option or one of a few.”
In addition to asking medical professionals, patients may want to lobby their MPPs and contact different cancer advocacy agencies to help propel greater uptake of this new approach across the board.