Cancer is the second most common cause of death in developed countries, and many modern treatment methods are now available. Most cancer patients fear surgery almost as much as the cancer itself. Image-guided treatments have become one of the most important steps in cancer management, offering significant advantages in patient comfort while effectively destroying cancerous cells. Tumors in the liver, kidney, lung, and some bones can be treated using ablation methods. Interventional Radiologist Prof. Dr. Adem Uçar from Liv HOSPITAL Radiology Clinic explains these techniques.
For patients with tumors in the liver, kidney, lung, soft tissue, or certain bones who are ineligible for surgery or cannot safely undergo an operation, tumors can be treated by heating, freezing, or applying electrical currents without making a surgical incision. Patients can often be discharged the day after the procedure and return to their normal activities within a few days.
Which Specialists Decide Interventional Treatment?
All these treatments are decided through a multidisciplinary approach that involves not only the interventional radiology specialist but also a team of doctors who diagnose and manage the treatment. This team includes medical oncologists, radiation oncologists, general surgeons, nuclear medicine specialists, urologists, chest disease specialists, and gastroenterology specialists.
What Methods Are Used?
These methods can be classified in two: ablation and embolization. Ablation methods include radiofrequency, cryo, microwaves and electroporation. By using digital image-guided tomography or ultrasonography, special needles are placed inside the tumor tissue. Tumor tissue is completely destroyed by heating (in radiofrequency and microwave techniques) or by freezing (in cryoablation technique). And in electroporation procedure, a recent method, electrical current is applied to the tumor by using needles.Electrical current damages the tumor tissue by destroying the cell membranes. This treatment is especially used for cancers that are adjacent to vital tissues. The tumor can be completely destroyed while preserving the vessels, bile ducts and urinary canals. These ablation methods are performed in major cancer centers in the USA and provide similar results with surgical operations in tumors less than 5 cm in diameter.
There are embolization methods that extend the life expectancy and quality of life of liver cancer patients who are not eligible for surgery. Embolization is the process of slowing or stopping the tumor growth by occluding the vessels that feed the tumor. This method can be combined with chemotherapy drugs and its efficiency can be increased. In addition, life expectancy can be increased by combining with locally irradiating atoms in patients who are not responsive to chemotherapy. This method is very well tolerated.
It can be performed as ambulatory, without hospitalization.
How Is It Performed?
During the ablation procedure, local anesthesia and pain medications are administered before a needle is guided to the tumor using tomography or ultrasonography, allowing the tumor to be destroyed. The embolization procedure is performed in an angiography room, where access is gained through the pelvic artery. Thin tubes are navigated to the section of the liver artery that supplies blood to the tumor, and then occluding particles, chemotherapy drugs, or locally irradiating atoms are injected.
What Should Patients Expect After The Procedure?
Patients are typically monitored in the hospital for one day after the procedure. Most are able to resume their normal daily activities within a few days.
Which Patients Are Eligible For This Procedure?
These procedures can be used to treat tumors in the liver, kidney, lung, soft tissue, and certain benign bone tumors, such as osteoid osteoma.
Who Are Most Suitable For The Treatment?
Only about 15“20% of liver cancer patients are eligible for surgery. This is mainly because many patients have tumors that are too large or numerous for surgical removal, or they have other health conditions”such as cirrhosis, lung disease, or heart disease”that make surgery too risky. Ablation methods are typically used for up to five tumors less than 4 cm in diameter. Larger tumors generally require embolization techniques. These treatments can destroy the tumor or shrink it to a size that makes surgical removal possible.
What Are The Advantages of These Methods?
- No general anesthesia required
- No large surgical incision or wound
- Short procedure duration
- Quick return to daily activities
- Minimal pain
- Lower cost compared to conventional surgery
- No large surgical incision or wound
- Short procedure time
- Patients return their daily life after the procedure
- No severe pain
- Lower cost in comparison to conventional surgery
This content was prepared with contributions from the Liv Hospital Editorial Board.
The information provided on this page is for informational purposes only. Please consult your physician for diagnosis and treatment. This content does not include guidance on medicinal healthcare at Liv Hospital.