For liver tumours smaller than 3 cm, you may be offered tumour ablation. This destroys the tumour without removing it and may be the best option if you cannot have surgery or are waiting for a transplant. Ablation can be done in different ways, depending on the size, location and shape of the tumour.
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This uses heat to destroy a tumour. The heat may come from radio waves (radiofrequency ablation) or microwaves (microwave ablation).
Thermal ablation may be done with a local anaesthetic in the x-ray department or under a general anaesthetic in the operating theatre. A fine needle is inserted into the tumour through the skin, using a CT or ultrasound scan as a guide. The radio waves or microwaves are sent into the tumour through the needle.
Treatment takes 1–2 hours, and most people stay overnight in hospital. Side effects may include pain, nausea or fever, but these can be managed with medicines.
This involves injecting pure alcohol into the tumour. It isn’t available at all hospitals, but is used occasionally if other forms of ablation aren’t possible. The needle is passed into the tumour under local anaesthetic, using an ultrasound as a guide. You could need more than one injection over several sessions.
Side effects of alcohol injection may include pain or fever, but they can be managed with medicines.
Cryotherapy (or cryosurgery)
Also known as cryosurgery, cryotherapy kills cancer cells by freezing them. This treatment is not widely available, but is offered occasionally. Under a general anaesthetic, a cut is made in the abdomen. The doctor inserts a probe through the cut into the tumour. The probe gets very cold, which freezes and kills the cancer cells.
Cryotherapy takes about 60 minutes. It usually involves a faster recovery than liver resection, but there is still a risk of bleeding and damage to the bile ducts.