In cancer care, each treatment method has its own advantages and disadvantages. The aim of the cancer team must be to use these treatments in a way to maximize their benefits and minimize their side effects. In most patients, a single treatment method is not sufficient and it is mandatory to use various treatments sometimes at the same time and sometimes one after another. For instance, in a patient with colon cancer, the tumor can be made smaller with chemotherapy and then it can be surgically removed. If the tumor recurs at the same location after surgery, it can be treated with radiotherapy or chemotherapy. In this way, different conventional treatment methods are used in the correct order to maximize benefits and minimize side effects.
Similarly, interventional cancer treatments can also be used in combination with conventional treatments in some patients. For example, a large tumor which is not suitable for percutaneous ablation, can be made smaller with conventional therapies such as chemotherapy or radiotherapy and then it can be destroyed with percutaneous ablation. Conversely, a tumor which is too large for surgery, can be made smaller with interventional therapies such as chemoembolization, radioembolization or intraarterial chemotherapy, and then it can be removed with surgery.
In some situations, it may be also necessary to use interventional treatments in combination, sometimes one after another, sometimes in the same session. For instance, a large lung or liver tumor not suitable for ablation, can be made smaller with intraarterial chemotherapy, and then it can be successfully treated with percutaneous ablation. Or, a large hepatocellular carcinoma that can not be ablated, can be successfully treated with combined use of chemoembolization and percutaneous ablation in the same session.
In conclusion, cancer treatment must be performed by a team of doctors who have sufficient knowledge and experience in the most recent treatments not only of their own specialty but also of other specialties involved in cancer management. Each member of this team must know the advantages and disadvantages of these treatments even if they do not belong to their own area of expertise. For example, an oncologist or general surgeon must have sufficient knowledge on the potential benefits and side effects of interventional treatments. Similarly, an interventional radiologist must also know the benefits and complications of surgery, chemotherapy and radiotherapy. The best possible treatment at any stage of cancer disease can only be determined with such a team approach.