David C. Madoff, MD
ASCO, ASTRO and SSO Embrace the Term "Interventional Oncology"
By David C. Madoff, MD
WCIO 2016 Workshop Chair
Weill Cornell Medical College
As an IR who practices Interventional Oncology almost exclusively, I have always felt a bit uneasy using the term “Interventional Oncology” with my medical and surgical oncology colleagues. This is similar to the issue that was faced years ago by the Society of Interventional Radiology when trying to establish a subspecialty name and brand. I remember many potential names such as “endovascular surgery,” “minimally invasive surgery” and “image-guided surgery” to name just a few. Since the overwhelming majority of Interventional Radiologists are not board-certified surgeons and because surgeons would take major issue to our self-proclamation, we opted for keeping the status quo, albeit shortened from “Vascular and Interventional Radiology” to simply “Interventional Radiology.” Further, there was considerable reluctance by the SIR leadership to embrace the term ”Interventional Oncology,” preferring instead to use the term “Oncologic Interventional Radiology” or “Image-guided Oncologic Interventions.”
Over the years, we have been planting the seeds to become a universally recognized pillar of oncology and join the three long-established pillars of cancer care: medical oncology, surgical oncology and radiation oncology. We have not been included into the cancer pantheon based on perceptions related to the lack of comprehensive clinical patient management, limited major research funding with inadequately powered clinical trials, a less than robust research infrastructure (for basic, translational and clinical arenas) and a lack of specialized oncologic education. Fortunately, there has been trend recently towards major improvement in all of these areas such that minimally invasive, image-guided therapies have become a mainstay in the cancer treatment paradigm. To that end, Interventional Radiologists have taken leadership roles in leading cancer centers, serve on the editorial boards of high impact cancer-related peer-reviewed journals, serve on organizing committees of various national and international cancer meetings and serve as members of the National Comprehensive Care Network (NCCN) guidelines committees. Lastly, Interventional Oncologists are critical members of multidisciplinary tumor boards where decisions about the management of cancer patients are made on a daily basis.
For two of the past three years, I have served as a member of the Gastrointestinal Cancers Symposium faculty. This meeting, held in San Francisco annually at the end of January, is co-sponsored by the Society of Clinical Oncology (ASCO), the Society of Surgical Oncology (SSO), the American Society for Therapeutic Radiology and Oncology (ASTRO) and the American Gastroenterology Association (AGA). My role at this year’s meeting was to serve as a panelist in the 90 minute liver session which included a Hepatocellular Carcinoma Tumor Board. This Tumor Board included two liver surgeons, a GI medical oncologist, a hepatologist, a radiation oncologist and myself. To my surprise, I was listed in the meeting program as an “Interventional Oncologist,” not as an “Interventional Radiologist.” Interestingly, my subspecialty title was given by the meeting organizers, none of whom is a Radiologist, let alone an Interventional Radiologist. Needless to say, I was very happy to maintain this persona and consider myself a member of the 4th pillar of cancer care, “Interventional Oncology.” Further, an Expert Editorial written by my colleague, Dr. David Li, and myself was submitted in advance of the meeting for publication in the Gastrointestinal Cancers Symposium Daily News entitled
“Interventional Oncology as the Fourth Pillar of Cancer Care: Essential Role in Gastrointestinal Cancer Management.” I was thrilled to see our article placed on the front page of the newsletter on the meeting’s first day, and ASCO tweeted the article to its 45.5K followers. Given this, I believe the meeting co-sponsors now truly realize the importance of Interventional Oncology and in my opinion, have legitimized the subspecialty as the 4th pillar of cancer care. From here on, we must embrace this name of our subspecialty as “Interventional Oncology!”
