Want to learn more about what ablation is for liver cancer? You’ve found the right place. Radiofrequency Ablation (RFA) is a minimally invasive procedure that uses radio waves to destroy tissue for pain management. A precisely placed needle guides radio waves to the affected area creating a current. The heat from the current destroys the nerve tissue around the area, preventing it from sending pain signals to the brain similar to ablation for prostate cancer. Radiofrequency Ablation Therapy can relieve chronic pain and other unmanageable long-term pain conditions using other methods.

Radiofrequency Ablation of Liver Tumors

The most prevalent type of liver cancer is hepatocellular carcinoma which starts in the primary liver cells or hepatocytes. Other types of Liver Cancer, including hepatoblastoma and intrahepatic cholangiocarcinoma, are less common.

Primary Liver Cancer is among the world’s top three contributors to cancer deaths. Survival rates of Liver Cancer depend on several factors, including the cancer stage during discovery and the liver cancer treatment offered.

 We recommend RFA as an alternative therapy for hepatocellular carcinoma patients where we cannot perform resection or for cases where we cannot perform a transplant in a timely manner. RFA is a low-risk and minimally invasive procedure with great success when applied correctly. Read on to learn more about RFA Therapy for the treatment of primary and secondary liver tumors.

Technique

Radiofrequency Ablation Therapy aims to destroy cancerous liver tumors without damaging the surrounding tissue. It destroys tissue by thermal injury-induced through electromagnetic energy deposition. The most common clinical RFA configuration is the monopolar RFA.  In this setup, the liver ablation patient is part of the closed-loop consisting of an RF generator, a needle electrode, and dispersive electrodes or grounding pads.

 RFA uses computed tomography (CT) or ultrasound to guide the hollow needle electrode towards the cancerous liver tumor. A high-frequency electrical current passes through the needle electrode to the grounding pads placed on the patient’s body. The resulting alternating electric field creates focused heat destroying cancer cells around the electrode. While the electrode focuses heat energy on the target cells, the grounding pads disperse extra energy over large surface areas to avoid burns.

 Radiofrequency Ablation can treat multiple types of cancers and other liver masses. Therapists hail it as the most effective for small tumors less than one and a half inches in diameter.

 One of the most critical determinants of the success of RFA is the total ablation of the viable tumor tissue plus an adequate tumor margin. RFA should ablate one-centimeter thick tumor-free tissue around the tumor to achieve local recurrence rates similar to those of hepatic resection. This usually requires multiple overlapping ablations. Therefore, the diameter of the ablation must be two centimeters larger than that of the tumor. Tissue density differences between tumors and the surrounding tissue may alter thermal conductance interfering with thermally induced coagulation. This may result in either inadequate or non-uniform ablation. 

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How to Prepare for RFA Therapy

Before the procedure, your doctor will take you through several preparatory checks and confirmations. Your doctor will ask you to know any prescription medication you take, including herbal supplements. You are also supposed to declare any allergies to anesthesia or contrast materials. Your doctor will advise on any medication you are not supposed to take leading up to the treatment, such as aspirin, a blood thinner, and non-steroidal anti-inflammatory drugs.

 Other checks include a blood test to establish your kidney function and confirm your blood clots normally. Women should also disclose if they are pregnant. We may not perform RFA Therapy on expectant mothers to avoid exposing the fetus to radiation. Finally, your doctor will give fasting instructions and advice on medicines to take on the day of your treatment. It is also advisable to come with a driver as you may be so drowsy to drive yourself home after the procedure.

What Happens During RFA Therapy for Liver Cancer?

You go to the hospital on the eve of your treatment or the morning of your treatment day. Depending on your doctor’s arrangement, they will treat you in the operating theater or the hospital scanning department. RFA Therapy for liver cancer takes a few hours and may follow the following steps.

  • Lying on the exam table, your healthcare team will connect an (IV) intravenous line to your arm. You will receive medicine through this line.
  • The healthcare team will also track your heart rate, pulse, and blood pressure.
  • The treatment may be done under anesthesia or while you are still awake. If you are awake, your doctor will numb the part where they will do the procedure.
  • Your doctor or interventional radiologist will make an incision to insert the needle electrode. They will then use an imaging scan to guide the electrode towards the liver tumor.
  • Once the setup is complete, an electrical current will pass through the closed-loop creating heat to destroy the tumor. The electrode’s position may need to be changed to reach the whole tumor.
  • Upon completion of the procedure, your healthcare provider will dislodge the electrode and take out the IV line. They will also cover the incision sites with dressing and move you to a recovery room.

What Happens After Ablation?

After RFA Therapy, you are taken to a recovery room where whoever accompanied you to the hospital can join you. You may feel pain and nausea after ablation. However, both effects are usually mild and manageable with medicine. Your doctor will give you a detailed recommendation for medication, diet, and follow-up.

 You may have to stay in bed for a few hours after the procedure. Once you are fully awake, you can eat it and have a drink if you are up to it. You may go home on the same or the following day and should be back to normal within a week of the procedure. 

 Your doctor will recommend tests after RFA Therapy to confirm how efficient the treatment was and to check for tumor recurrence.  

What are the benefits of Radiofrequency Ablation Therapy?

  • RFA Therapy is an effective treatment for liver cancer in select patients whose tumors are unsuitable for surgical resection.
  • RFA Therapy has a success rate of up to 85% in eliminating small liver tumors. According to most studies, more than half of liver tumors treated do not recur.
  • RFA Therapy does not have any treatment-related severe complications, and the treatment is less discomfiting than surgery.
  • Patients can go back for ablation of recurrent liver tumors
  •  This ablation method is less invasive with minor discomfort and does not require prolonged hospital admission.
  • The procedure is quick, and recovery is almost immediate for many patients. Those who need chemotherapy can resume almost immediately.
  • RFA Therapy is less expensive compared to other treatment options.
  • No surgery is performed, so there is no need for stitching.

Side Effects of Radiofrequency Ablation Therapy

Most medical procedures come with several complications and side effects. Your doctor will always ensure that the procedure’s benefits outweigh the risks. Here are a few side effects associated with RFA Therapy.

Discomfort and pain

After the procedure, you will experience some discomfort or mild pain in the incision areas. Some people may also experience brief or rarely long-lasting shoulder pain. This is called referred pain, which travels along a nerve that touches the liver and shoulder.

Contact your healthcare provider if these symptoms last more than 20 weeks or if the pain worsens.

Damage to surrounding areas

During the procedure, there is a risk of destroying tissue and organs near the liver, such as the gallbladder, diaphragm, or bile ducts. However, this is pretty rare while using imaging scans to guide the electrode. It still occurs in 3% to 5% of cases and may require surgical correction.

Post-ablation syndrome

Some patients experience flu-like symptoms 3 to 5 days after the procedure. These symptoms can last up to a week and come with body aches and feeling unwell. Your doctor will probably explain post-ablation syndrome before you leave the hospital and prescribe medicine for the symptoms. 

Contact your healthcare provider if you experience these symptoms for longer or have a fever.

Bleeding

During the procedure, the needle electrode goes into your liver, causing the risk of bleeding. However, this rarely happens as the medical team closely monitors your progress during the procedure. Some cases have occurred where the bleeding stops on its own. In severe cases, you may need a blood transfusion if you lose a lot of blood. 

Risk of recurrence

There is always the risk that the procedure does not completely remove the cancer tumors. Tumors have also sometimes recur where they once were.  The good news is that you can have the tumor ablated again after just a few weeks.

Risk of Infection

Procedures that involve skin penetration carry a risk of infection.

The chances of infections resulting from RFA Therapy are less than one in a thousand. Some patients may develop abscesses or localized infection at the ablation area three weeks after treatment. A liver abscess requires antibiotics and tube drainage to cure. Tumors located too close to the bile duct have a higher chance of causing abscess after ablation.

Takeaway

Current Radiofrequency Ablation Therapy equipment only allows the elimination of small cancer tumors. Technical advances and inventions may allow for the elimination of larger tumors in the future. Ablation cannot destroy microscopic tumors and ablated tumors may recur. Continuous monitoring after the treatment ensures that tumors do not grow back and those that do are eliminated again.

 

Written By: Dr. Adolfo Carrillo

Dr. Adolfo Carrillo is a Board Certified Medical Doctor from Universidad Autónoma de Baja California.

Dr. Carrillo has been collaborating with Dr. Bautista for over 5 years as a treating physician at the Immunity the Immunity Therapy Center. Dr. Carrillo is a charismatic Doctor whose knowledge and commitment to patient care and bringing healing to patients is a valuable asset to our center.

 

 Sources:

  1. Gervais, Debra, and Shaunagh McDermott. “Radiofrequency Ablation of Liver Tumors.” Seminars in Interventional Radiology, vol. 30, no. 01, Feb. 2013, pp. 049–55, https://doi.org/10.1055/s-0033-1333653
  2. ‌”Ablation for Liver Cancer.” Cancer.org, 2019, www.cancer.org/cancer/liver-cancer/treating/tumor-ablation.html
  3. ‌RSNA, America. “Radiofrequency Ablation (RFA) / Microwave Ablation (MWA) of Liver Tumors.” Radiologyinfo.org, 2021, www.radiologyinfo.org/en/info/rfaliver
  4. ‌”Radiofrequency Ablation (RFA) of Liver Tumors.” UPMC | Life Changing Medicine, 2022, www.upmc.com/services/liver-cancer/treatments/radiofrequency#:~:text=Radiofrequency%20ablation%20(RFA)%20is%20an,the%20site%20of%20the%20tumor

 

At Immunity Therapy Center, our goal is to provide objective, updated, and research-based information on all health-related topics. This article is based on scientific research and/or other scientific articles. All information has been fact-checked and reviewed by Dr. Carlos Bautista, a Board Certified Medical Doctor at Immunity Therapy Center. All information published on the site must undergo an extensive review process to ensure accuracy. This article contains trusted sources with all references hyperlinked for the reader's visibility.