Tumor ablation for primary liver cancer
For 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). Using an ultrasound or CT scan as a guide, the doctor inserts a fine needle through the abdomen into the liver tumour. The needle sends out radio waves or microwaves that produce heat and destroy the cancer cells.
Thermal ablation may be done using a local anaesthetic in the x-ray department or under a general anaesthetic in the operating theatre. 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 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. 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.
Video: What is tumour ablation?
Podcast: Making Treatment Decisions
Download a PDF booklet on this topic.
Dr David Yeo, Hepatobiliary/Transplant Surgeon, Royal Prince Alfred, Chris O’Brien Lifehouse Cancer Centre and St George Hospitals, NSW; Dr Lorraine Chantrill, Head of Department Medical Oncology, Illawarra Shoalhaven Local Health District, NSW; Michael Coulson, Consumer; Dr Sam Davis, Interventional Radiologist, Staff Specialist, Royal Brisbane and Women‘s Hospital, QLD; Prof Chris Karapetis, Network Clinical Director (Cancer Services), Southern Adelaide Local Health Network, Head, Department of Medical Oncology, Flinders Medical Centre and Flinders University, SA; Dr Howard Liu, Radiation Oncologist, Princess Alexandra Hospital, QLD; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Lina Sharma, Consumer; Dr Graham Starkey, Hepato-Biliary and General Surgeon, Austin Hospital, VIC; Catherine Trevaskis, Gastrointestinal Cancer Specialist Nurse, Canberra Hospital and Health Services, ACT; Dr Michael Wallace, Western Australia Liver Transplant Service, Sir Charles Gairdner Hospital, WA.
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