Ep. 487 Musculoskeletal Tumor Embolizations with Dr. Gina Landinez
Oct 11, 2024
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Dr. Gina Landinez, an interventional radiologist at the Miami Cardiac and Vascular Institute, specializes in musculoskeletal tumor embolizations. She discusses how this innovative procedure can shrink tumors preoperatively and alleviate pain. Dr. Landinez highlights the importance of targeting hypervascular lesions and shares strategies for creating strong referral networks with orthopedic surgeons. Additionally, she addresses the challenges of managing post-embolization symptoms and emphasizes compassionate follow-up care to enhance patient outcomes.
Tumor embolization enhances surgical outcomes by reducing hemorrhagic risks and improving surgical margins during musculoskeletal tumor resections.
Building strong referral networks with orthopedic surgeons fosters effective communication and collaborative decision-making in managing musculoskeletal tumors.
Deep dives
The Importance of Communication in Musculoskeletal Tumor Management
Building strong relationships with referring orthopedic surgical oncologists is crucial in the management of musculoskeletal tumors. Effective communication allows for collaborative decision-making, where interventional radiologists contribute their expertise while working alongside surgeons. Establishing mutual understanding helps ensure that patients receive appropriate referrals for procedures like preoperative embolization, ultimately enhancing patient care. The intent is to foster an environment of teamwork, where discussions around patient management focus on collective input rather than one specialty dictating the approach.
Role of Preoperative Embolization in Tumor Procedures
Preoperative embolization has become a standard practice for managing patients with musculoskeletal tumors, particularly those needing surgical interventions. This technique significantly reduces hemorrhagic risks during surgery, which improves overall surgical outcomes. It helps surgeons obtain clearer margins and reduces operation duration by limiting blood loss during procedures. This evidence-based approach is crucial for enhancing patient safety and is often integrated into the treatment plans for both primary and metastatic bone tumors.
Pain Palliation for Tumor Patients
Pain management remains a paramount concern for patients with advanced musculoskeletal tumors, and effective treatment options are vital for improving their quality of life. Recognizing that embolization can serve as both a standalone and adjunctive method for pain palliation allows interventional radiologists to offer relief, especially when other treatments have been exhausted. The procedure aims at reducing tumor size to alleviate pressure on surrounding tissues, thereby minimizing discomfort. However, the existing clinical data on the long-term efficacy of embolization alone for curative intent remain limited, necessitating ongoing research and patient follow-up.
Innovative Techniques and Future of Musculoskeletal Tumor Treatment
The future of treating musculoskeletal tumors holds promise with advancements in techniques like transarterial radioembolization, which could enhance treatment efficacy. As more innovative approaches are explored, multidisciplinary collaboration between interventional radiologists, oncologists, and surgeons will be essential in delivering comprehensive care. Current practices reflect a commitment to evolving treatment modalities that can significantly impact patient outcomes. Continuous dialogue and research are needed to determine the most effective combinations of embolization, ablation, and emerging therapies in managing these complex cases.
Tumor embolization is a versatile procedure that can provide symptomatic and long-term benefits for patients. In this episode of BackTable MSK, host Dr. Michael Barraza discusses musculoskeletal tumor embolizations with Dr. Gina Landinez from the Miami Cardiac and Vascular Institute, where she is helping to grow the MSK interventions program.
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This podcast is supported by:
Accountable Physician Advisors
http://www.accountablephysicianadvisors.com/
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SYNPOSIS
Dr. Landinez explains that the main indications for embolization are preoperative tumor shrinkage and pain palliation. Embolization decreases hemorrhagic risk and procedure time during surgical resection and leads to better surgical margins. Pain palliation can also be achieved due to tumor size reduction and decreased pressure on surrounding nerves and tissue. Dr. Landinez explains that lesions well-suited embolization are hypervascular, large, not sensitive to radiation, and painful. She also describes the risks of off-target skin and muscle embolization and the importance of exercising caution with vertebral tumors.
Finally, Dr. Landinez shares valuable practice-building tips about developing relationships with orthopedic surgeons and providing adequate follow up care.
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TIMESTAMPS
00:00 - Introduction
03:51 - Indications for Embolization
08:08 - Building Referral Networks
13:45 - Preoperative Planning
18:34 - Technical Aspects of Embolization
27:25 - Challenges and Considerations
31:23 - Importance of Outpatient Follow Up
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