What Is Tumor Ablation?
Tumor ablation is a minimally invasive treatment used to destroy cancerous tumors in organs such as the liver, kidneys, lungs, bones, and other areas of the body. The procedure works by delivering concentrated energy directly into the tumor to destroy cancer cells while minimizing damage to surrounding healthy tissue.
Tumor ablation is often recommended for patients who are not good surgical candidates, prefer a nonsurgical option, or require treatment in combination with chemotherapy or radiation therapy. In certain cases, tumor ablation may be used as a first-line treatment for liver cancers, including hepatocellular carcinoma.
Causes of Liver Cancer
- Hepatitis B or C
- Heavy alcohol use
- Diabetes (when combined with other risk factors)
- Obesity
- Certain chemical exposures
- Other diseases, including: Hereditary hemochromatosis
- Tyrosinemia
- Alpha-1 antitrypsin
- Porphyria cutanea tarda
- Wilson disease
- Glycogen storage diseases
Tumor Ablation Techniques
Radiofrequency Ablation
Radiofrequency ablation uses electrical energy to generate heat within the tumor. A probe is placed directly into the tumor, and the tissue is gradually heated to a high temperature, resulting in tumor destruction. This technique is commonly used for smaller tumors, particularly in the liver.
Microwave Ablation
Microwave ablation uses electromagnetic energy to rapidly heat tumor tissue. A probe is inserted into the tumor, where microwaves create an oscillating electromagnetic field that heats water molecules inside the tissue. This produces rapid and uniform heating, making microwave ablation highly effective for treating larger tumors. It is commonly used for liver, lung, and kidney tumors.
Cryoablation
Cryoablation destroys tumors by freezing them. One or more probes are inserted into the tumor, and extremely cold temperatures are generated using pressurized gas. Ice crystals form inside cancer cells, disrupting cellular function and causing cell death. Cryoablation is often used for tumors in the kidney, liver, bone, or skin and may preserve surrounding structural tissue.
Types of Liver Cancer
Hepatocellular Carcinoma
The most common form of liver cancer which accounts for four out of five liver cancers
Cholangiocarcinoma
Forms in the bile ducts of the liver. It accounts for 10% to 20% of all liver cancers.
Mixed hepatocellular carcinoma and cholangiocarcinoma
A rare and aggressive form of liver cancer.
Hepatoblastoma
A rare liver cancer usually found in children.
Angiosarcoma
Forms in the lining of the blood and lymph vessels of the liver.
Hemangioendothelioma
Grows in the cells that make up blood vessels.
FAQ
1. Is Tumor Ablation Right for Me?
Tumor ablation is commonly used to treat liver tumors that cannot be removed surgically, but it is also effective for cancers of the kidney, lung, prostate, bone, and other organs. Your physician may recommend tumor ablation if one or more of the following apply:
Tumors are located near critical structures or are difficult to reach surgically
Tumors are small and can be treated as effectively as with surgery
Chemotherapy or radiation therapy has not been effective
Tumors have returned after surgical removal
Overall health makes surgery too risky
Tumor ablation can reduce pain, improve quality of life, and extend survival with minimal downtime. It can also be safely combined with other cancer treatments, including chemotherapy, radiation therapy, chemoembolization, or surgery.
2. Is tumor ablation an outpatient procedure?
3. How long does a tumor ablation procedure take?
4. What happens during a tumor ablation procedure?
5. What side effects should I expect after tumor ablation?
Chemoembolization
If you have primary liver cancer, or liver cancer that has metastasized from elsewhere in your body, chemoembolization may be part of your treatment. we work closely with your referring physician to ensure you receive the best treatment to meet your needs. And, our clinical nurse coordinators assist you in planning, scheduling and following up after your treatment.
What is chemoembolization?
Chemoembolization is used for tumors that cannot be removed surgically because of their location or the number of tumors present. It is a palliative, not a curative, treatment, but can be extremely effective in treating primary liver cancers and some types of metastatic tumors especially when combined with other therapies. The treatment works to reduce or cut off the blood supply to your tumor. Your liver is unique because it has two blood supplies. The portal vein provides 75 percent of the liver’s blood supply and the hepatic artery supplies the remaining 25 percent. Tumors that grow in the liver typically receive their blood supply from the hepatic artery, which make chemoembolization possible. The procedure is usually done on an outpatient, same-day basis.
How chemoembolization works?
The interventional radiologists insert a catheter into your liver’s blood supply to attack the cancer in two ways. First, chemotherapy drugs are injected directly into the blood supply of the tumor. This gives the drugs more time and contact with the tumor to work and destroy the cancerous cells. Because the chemotherapy is delivered directly to the tumor, stronger doses can be given than would be possible during standard chemotherapy, which is injected through a vein in your arm. Second, a blocking agent, called an embolizer, is used to stop the blood supply to the tumors. This starves the tumor of oxygen and nutrients, causing them to shrink. Combining chemotherapy with an embolizer has a more powerful effect than if either was given alone. Chemoembolization requires a one to two day hospital stay.
Benefits
- Injecting chemotherapeutic drugs into the cancer site lessens side effects, as only a small amount of the medicine enters your bloodstream.
- This procedure can help prevent the growth of the tumor or tumors in your liver, while potentially shrinking them, preserving liver function and allowing you to have a relatively normal quality of life.
- This treatment can be repeated every four to eight weeks or used in combination with other types of therapy to control your liver cancer.
Risks
- Fever (short-term in 10 percent of patients)
- Nausea and vomiting (nausea can last up to two weeks, vomiting for a few days)
- Fatigue
- Upper right abdominal discomfort (can last from a few days up to a week)
- Infection or bleeding
- Small chance of the embolization material or particles becoming lodged in the wrong place and depriving normal tissue in your body of its blood supply
- Allergic reaction to the contrast dye used for the X-ray
- Kidney damage for those with diabetes or pre-existing kidney disease
* Potential effects vary for every patient. Medications are given to help prevent or relieve most of these side effects. In addition, steps can be taken to prevent allergic reactions to contrast dye and lessen the chance of kidney damage for those at risk.
Radioembolization (Selective Internal Radiation Therapy) - SIRT
If you have primary liver cancer, or liver cancer that has metastasized from elsewhere in your body, radioembolization may be part of your treatment. we work closely with your referring physician to ensure you receive the best treatment to meet your needs. In addition, our clinical nurse coordinators assist you in planning, scheduling and following up after your treatment.
What is radioembolization?
Radioembolization is a minimally invasive treatment that uses tiny radioactive beads, called microspheres, to deliver radiation directly to cancerous tumors in your liver. The beads are extremely small, measuring about one-third the diameter of a human hair, and are placed directly inside the tumor. Over a period of 10 to 12 days, the beads emit high radiation, causing the tumor to shrink. Radioembolization may also be called intra-arterial brachytherapy, selective internal radiation therapy or Y-90. Radioembolization is a palliative treatment used to treat liver cancer that cannot be removed with surgery. Radioembolization has the potential to shrink tumors or downstage them, so you are eligible for other treatments, surgery or a liver transplant. Radioembolization has been shown to help you live longer and improve your quality of life.
Initial evaluation
Your physician will discuss all your treatment options with you before scheduling you for a treatment. You will meet with us. we will review your health history, current list of medications, labs, CT scans, MRI or PET scans. You may not be a candidate for radioembolization for several reasons:
- Abnormal liver function
- Abnormal or no arteries near your liver tumors
- A very large portion of your liver is covered by tumors
- Your bilirubin, albumin or other lab values are out of normal range
If you are not a candidate for the treatment, your physician will work with your medical oncologist to help you choose the best options for you.
Benefits
- Minimal injury to the surrounding healthy liver tissue.
- Decreased side effects from the radiation.
- Once you have received the radioactive microspheres, the external radiation exposure to other individuals is very low and highly unlikely to cause harm. To be cautious, minimize contact (within a yard) with children under the age of 10 and pregnant women for three days following therapy.
- Radioembolization is the only treatment approved in the United States to treat primary liver cancer in patients with portal vein thrombosis.
- The recovery period after radioembolization is generally short.
Risks
- Fatigue (usually lasts 10 to 12 days)
- Mild abdominal discomfort and bloating
- Due to sedation medications, nausea and vomiting may occur one to two days following your procedure
- Fever (10 percent of patients)
- Infection or bleeding
- Allergic reaction to the contrast dye used for the X-ray
- Kidney damage for those with diabetes or pre-existing kidney disease
Even after a safety planning session, there is a very small risk (less than one percent) that radiation could be delivered to your lungs and/or digestive tract. Lung damage might occur causing swelling, scarring or shortness of breath. Irritation of the gastrointestinal tract could result in chronic pain, nausea, vomiting, ulcers, bleeding or pancreatitis. Side effects vary for every patient. Medicines are given to help prevent or relieve most of these side effects. Also, steps can be taken to prevent allergic reactions to contrast dye and lessen the chance of kidney damage for those at risk. If you have any questions on these risks, discuss them with your physician.