When interventional radiologists and other physicians team up, patients receive ‘the pinnacle’ of personalized care

With the developments in technology … there’s been a transition from surgery to nonsurgical treatment, and there are many patients these days treated with procedures in [interventional] radiology without surgery, who five or 10 years ago would have been taken for surgery instead.

Dr. Edward Kim’s favorite day of the week is Wednesday. That’s when the interventional radiologist at New York’s Mount Sinai Hospital holds office hours with his colleague, Dr. Myron Schwartz, a liver surgeon.

The two physicians have been working together on liver cancer cases for about a decade, and over the years they’ve developed a team-based model of care to support patients with a convenient, one-stop consultation with a panel of specialists, including interventional radiology.

Interventional radiology is a specialty that uses medical imaging to guide targeted treatments in the body. In Kim’s case, he accesses the liver via a small puncture in the wrist or groin. Then, he uses the arteries as “roadways” and maneuvers small tubes and wires to the organ to destroy tumors. Interventional radiology can also be used to treat other cancers, such as kidney and lung, as well as a wide range of medical conditions.

For Schwartz, bringing Kim in on a case is especially helpful when surgery is not an option for a patient because the liver is too damaged for a major operation. Schwartz said interventional radiology is also great for patients who have a healthy functioning liver and small tumors that need to be treated, or for patients who are waiting for a liver transplant. And because the interventional radiology treatments are minimally invasive, patients recover quicker and with less pain, compared to traditional surgical methods.

“With the developments in technology … there’s been a transition from surgery to nonsurgical treatment, and there are many patients these days treated with procedures in [interventional] radiology without surgery, who five or 10 years ago would have been taken for surgery instead,” Schwartz said. “I think this is a natural progression; it’s happening in many subspecialties where technology-based approaches are replacing surgery as the primary treatment for patients.”

“If we can have a patient come in and have a procedure and go home the same day and have their tumor destroyed, as opposed to coming in for five days to have an operation, it’s hard to argue against that,” Schwartz said.

Partnerships between surgeons and interventional radiologists are not unique. Still, Kim and Schwartz say many more physicians and patients could benefit from a team-based model, like the one they’ve established.

Kim said the multidisciplinary collaboration, which he calls “the pinnacle of personalized medicine,” is one that is replicable across a range of specialties: It just comes down to keeping an open line of communication. Furthermore, it’s a model that can be reproduced at community hospitals and smaller care centers, as well as major hospitals and academic institutions.

“We have to become doctors who take care of problems, not just radiologists who do ablations or surgeons who do surgeries. Without having a broader view, you can’t make the best decisions,” Schwartz said.

Building a program like the one Schwartz and Kim have at Mount Sinai starts small, but becomes self-sustaining once it gets going, “because the rewards are immediately obvious,” Schwartz said.

“There’s a general awareness in cancer care these days, that doctors working together … provide the best outcomes, regardless of the type of cancer. This is where cancer care is in 2019,” he added.

 

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