Interventional radiology (IR) has emerged as a transformative force in musculoskeletal oncology, significantly impacting the clinical management of bone and soft tissue tumors. Recent advances in minimally invasive techniques provide safe, efficacious treatment options for patients who have often exhausted conventional therapies, extending survival and improving quality of life.
“Cancer treatments have dramatically improved and patients are surviving much longer, but this increased longevity means more time to develop bone metastases, pathological fractures and other oncologic and age-related skeletal changes that can weaken bones and tissues, causing severe pain and impacting daily living,” said Gina Landinez, M.D., a diagnostic and interventional radiologist with Miami Cancer Institute and Miami Cardiac & Vascular Institute, both part of Baptist Health.
Dr. Landinez, who spearheads innovative interventional radiology treatments at the Institutes, recently addressed an international audience of physicians and medical students as part of Baptist Health International’s Oncology Lecture Series. These educational programs are designed to disseminate cutting-edge advances to the global medical community and enhance awareness of novel therapeutic modalities that may not be readily accessible in all healthcare systems.
During the lecture, Dr. Landinez discussed a number of interesting cases. Among them:
- A 63-year-old woman with stage 4 metastatic breast cancer who presented with acute right lateral hip pain that radiated to the groin. She was diagnosed with posterior acetabulum. “She was unable to bear any weight on the right hip and if something was not done, she would be bed-bound forever,” Dr. Landinez explained. Using various modalities in the IR room, Dr. Landinez moved tiny cannulas through bone and the lesion with advanced imaging and robotic navigation to reduce and stabilize the fracture with microwaves and cement and screws. “Her pain is completely resolved.”
- A 59-year-old woman with stage 4 lung cancer who had a large lesion in her left arm and a fracture that required open reduction internal fixation. Because the tumor was located in a hypervascular area, the patient was brought to the IR suite for embolization. “We went branch by branch, eradicating the blood supply to the tumor for pain control and to prepare for surgery. She was able to go on to have an open reduction of the humerus with very little blood loss,” Dr. Landinez said.
The tools at the Institute to help in the treatment and diagnosis of bone and soft tissue lesions, allow for:
- Pain palliation
- Shorter hospital stays
- Continuation and/or rapid return to systemic treatment
- Reduction in opioid use
In addition to embolization, radioembolization, radiofrequency ablation, chemoembolization and pain management treatment, the IR team can provide image-guided needle biopsies, central venous access catheter placement, irreversible electroporation therapy, inferior vena cava filter placement and stent placement.
The Institute is also leading cutting-edge research, providing access to more than 200 clinical trials to patients.
It’s critical, however, that complex cases involve a multidisciplinary team. “To provide the best care, it really takes a village,” Dr. Landinez said. At Miami Cancer Institute, that may involve collaboration with oncology, orthopedic surgery, radiation oncology, palliative care and other specialties. “The good news is that for many patients who think they have exhausted all possibilities or those whose quality of life has deteriorated, there are new options. This is a growing field, and we are here to help.”
