Interventional Oncology: A Practical Guide to Interventional Radiology’s Most Exciting Specialty

The book Interventional Oncology, published by Thieme in December 2015 and co-edited by Ripal Gandhi, MD, and Suvranu Ganguli, MD, is intended to be a useful text in its field — a resource suited for both seasoned practitioners and those with a growing interest in the field. This text, a practical guide to treatment of cancer patients, offers 13 chapters by a selection of the best experts in their given subspecialties. Interventional Oncology 360 spoke to both editors for a look into the book. 

Refining a Wealth of Knowledge

Between clinical practice, research, and the other demands facing Gandhi and Ganguli, the time to edit a 227-page textbook was not easy to come by. But for these physicians, a passion for the field eased the task — and that fascination is easy for readers to catch. “I love interventional radiology as a whole. It is the most interesting and exciting field in medicine, and on top of that, interventional oncology is the most interesting and exciting part of interventional radiology,” Ganguli said. “It is a field that is always evolving — one of the reasons I was drawn to it in the first place — and interventional oncology is the current best example of this. In my group and practice, we are seeing interventional oncology procedures and clinic patients as our largest area of growth. As the field is always changing, my co-editor and I believed that a resource such as this book would both be extremely valuable and also well received.”

Gandhi echoed the sentiment, noting that interventional oncology is not just one of the fastest growing specialties in interventional radiology, but in medicine as a whole. “Interventional oncology has truly become an independent specialty which utilizes image-guided techniques to treat cancers in a targeted and minimally invasive way,” he said. “Given the rapidly advancing field we are in, Dr. Ganguli and I envisioned a textbook that would be succinct, clinically focused, and image rich. Our product is a text that can be used by both trainees and seasoned interventional oncologists who are starting or expanding an interventional oncology practice.” 

Clinical Pearls

“When we decided to create the book,” Gandhi said, “we looked at other texts out there to see what we wanted to achieve. Our goal was to create something that was easy to read but also extremely relevant to clinical practice, instead of burdening readers with too much minutia and impractical facts. Our ultimate goal was to create the most practical book available on interventional oncology.”

In regard to the physicians who authored each chapter of the book, Gandhi said selections were made thoughtfully, after looking at literature and conferences to find authors who were knowledgeable in the specific area of each chapter. “What we compiled was a group of international leaders and experts in the field,” he said. “In addition to including seasoned authors, of which we have quite a few, we also included some up-and-comers who we believe are going to make a substantial contribution to the field.”

Ganguli added that in addition to the knowledge of chapter authors, the book’s layout makes it easy to read and quickly reference. “We laid it out so each chapter addresses a disease entity and/or interventional oncology procedure — ablation of colorectal metastases or radioembolization of hepatocellular carcinoma, for example. Each subject is laid out in a practical way to comprehensively review the indications/contraindications, patient selection, technique, and post-procedure care and complications.” 

In addition, each chapter offers pearls and references, allowing for high-yield preparation prior to seeing an oncology patient and in preparing clinical recommendations, Gandhi said. “We will help you know what to expect and look for regarding management from first meeting a patient to following completion of the procedure,” he said.

A powerful reference resource for practitioners, “The intended audience would largely be trainees, such as residents and fellows, as they are the ones learning the procedures and disease processes, and practical chapters on a procedure they are learning will benefit them,” Ganguli said. “But that being said, any seasoned interventional radiologist starting an interventional oncology practice or brushing up on a certain procedure they are already performing could also gain knowledge from the book.” Gandhi added, “This text is an overall great resource for anyone interested in the field – it covers the basics and more advanced information as well. For medical students interested in interventional oncology, it provides a great introduction – but it also delves into more advanced topics for those further along in the field.” 

Ganguli added that as the field is always changing, reading the chapters written by experts in the field of that particular procedure or disease process is extremely valuable. “Even the most seasoned interventional radiologist will pick up some information or tips, and the high-yield layout is very amenable to the seasoned interventional radiologist, whose time is valuable,” he said. 

Chapter by Chapter

“We covered essentially the full range of interventional oncology procedures in this all-encompassing text,” Gandhi said. “The chapters include information on renal cell carcinoma, ablation, chemoembolization, radioembolization, lung cancer including pulmonary metastatic malignancy, colorectal cancer, carcinoid endocrine tumors, bone tumors, portal vein embolization, to name a few. It’s comprehensive,” he said. “There are discussions on navigational systems, which are becoming more commonly used and will be more important in the future, and areas that have potential for significant growth in the final chapter on emerging technologies.” 

On the point of emerging technologies, which Ganguli said is an area of personal interest, some of the topics covered in the final chapter include irreversible electroporation and viral oncolytics, technologies under development or in early clinical use. “We will have to see if these techniques are going to warrant their own chapter in the next edition as they will become standard therapies. This is the beauty of this ever-evolving specialty,” he said.

Supporting Growth

“Interventional oncology growth seems like a runaway train at the moment, and it’s interventional radiologists who are the drivers,” Ganguli said. “The research we are all doing to push the field is one part of that, but real growth comes from the interventional radiologists who have answered the calling to treat this group of complex patients, and bring the expertise that only they can.” He continued, “Treating these patients can be challenging, as many of the procedures are palliative, and that means often being the main physician treating a patient until the end of his or her life. But in the same regard, this can make it the most rewarding part of your practice. This book can help serve as a resource in caring for these patients.”

“It really is the most up-to-date textbook that has been published on the topic, as it’s the most recent publication,” Gandhi said. “We have the most advanced information in this textbook, and for those practicing in the field or those just coming into it to be exposed to the newest literature and techniques, tips and pearls which are not typically discussed or described in writing, is invaluable. What we’ve included here will be beneficial to practitioners with the ultimate goal of improving patient care, and thereby supporting growth in the field,” he said.

“This is a field that has really developed into its own entity during my career,” Ganguli said. “Early in my residency, an interventional oncology procedure was maybe a procedure being done once a month in the interventional radiology suite, to the current state of multiple interventional oncology procedures each day, and being recognized as its own subspecialty. There has really been a tremendous amount of growth, knowledge and expertise in the area, and I foresee that continuing to grow.” He continued, “That being said, the most rewarding aspect I find is [interacting with] the patients themselves, something that can’t be minimized — the relationships, the appreciation, and the knowledge that you are bringing valuable expertise to the treatment of these patients is really rewarding — it makes you feel lucky to be an interventional oncologist.”

Suggested citation: Wolfgang K. Interventional Oncology: a practical guide to interventional radiology’s most exciting specialty. Intervent Oncol 360. 2016;4(2):E21-E23.