What are the Interventional Therapies for Liver Cancer?
Liver Cancers that are not operable and at high risk for surgical excision can be treated by various minimally invasive interventional ablative techniques. So various minimally invasive techniques have been developed to treat patients for cancer cure. An interventional radiologist, a specialist who has expertise in treating conditions utilizing minimally invasive techniques with imaging direction, generally performs ablation procedures.
Liver Cancer Treatment by interventional radiologists includes two treatment techniques, curative treatments, and disease-modifying treatments.
Curative treatments:
- Radiofrequency ablation (RFA)
- Microwave ablation (MWA)
- Ethanol injection
Disease-modifying treatments:
Ablation is a viable and effective treatment option if :
- Single tumors up to 5 cm in size or multiple lesions of 3 cm each in size
- If there is no feasibility of surgery because of comorbidities.
- Tumors should be accessible to needle placement under imaging guidance
Thermal Ablation methods RFA/Microwave ablation:
Ablation means to destroy. In ablation for liver cancers Interventional Radiologists use localized heat to destroy tumors in the liver. This heat is generated either from radio waves (radiofrequency ablation) or microwaves (microwave ablation). Utilizing an ultrasound or CT scan imaging as an aide, the specialist embeds the specialized ablation needle through the skin over the abdomen into the liver tumor.
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RFA Procedure:
In the RFA, needle electrodes are inserted through the skin into the tumor. Sedation is needed during the ablation procedure. A special generator sends therapeutic energy through the needle tips directly to the cancer tissue, to destroy the tumor tissue. The destroyed tissue isn’t eliminated, yet gradually shrinks and is replaced by scar tissue.
After RFA Treatment:
- RFA is for the most part all around endured with no pain after treatment.
- Certain individuals will experience a low-grade fever for a couple of days later the system.
- There is a very low risk of infection or bleeding after the treatment.
- Patient will usually be discharged on the same day or the next day.
Microwave Ablation (MWA):
Microwave Ablation (MWA), destroys liver cancers utilizing heat created by microwave energy using a probe. With microwave ablation, the specialist embeds a little laparoscopic port or open entry point to access the tumor. A CT Scan or ultrasonic direction is utilized to pinpoint the specific area of the tumor. A Thin Antenna, which emits microwaves, is then inserted into cancer. The test produces heat that removes tumor tissue, often within 10 minutes. Microwave ablation has advantages over RFA, as it generates faster energy the procedure is faster and more effective especially for tumors lying around the liver blood vessels, near the gall bladder. Similar to RFA procedure, the patient can be discharged on the same day.
What are the limitations of Radiofrequency and Microwave Ablation of Liver Cancer Tumors?
There is a breaking point to the volume of tumor tissue that can be disposed of by Ablation. This is because of limits with current equipment. Ideally, specialized advances will allow bigger cancers to be treated in the future. Ablation also cannot destroy microscopic-sized tumors and cannot prevent cancer from growing back.
About the Author:
Name: DR .SURESH GIRAGANI
INTERVENTIONAL RADIOLOGIST
DR. SURESH GIRAGANI CONSULTANT INTERVENTIONAL RADIOLOGIST at Yashoda group of hospitals, has more than fifteen years of clinical experience in vascular interventions with a special interest in neurovascular and peripheral vascular disease interventional procedures.