Zeroing in on Liver Cancer Treatment

Selecting the best treatment for liver cancer depends on the physician being able to precisely identify the type, location, size and borders of the tumor or tumors. By matching that information to a variety of treatment possibilities and considering the benefits and limitations of each, the physician can select the best course of action. Key to this decision is the patient's condition and anticipated ability to tolerate the treatment.

Surgical removal of liver cancer tumors is considered to be the most effective treatment for liver cancer. Unfortunately, about 70% of patients cannot have this surgery due the size or location of the tumors or other health factors. Other local treatments (those targeted specifically at the tumors) are less effective or have higher risks. Systemic treatments such as biologic therapy, hormonal therapy or chemotherapy are less precise in their attack; as a result, these therapies may have effects on the patient ranging from major discomfort to damage of healthy tissue.

For situations in which surgical removal of tumors is not possible, there is a new option that can increase the physician's ability to target the lesion more precisely, focusing the effect on the cancerous or unwanted tissues and minimizing the destruction of healthy tissues. The advent of this new procedure, called radiofrequency ablation (RFA), promises to increase the options for eradicating lesions while reducing the risks and side effects associated with other options or procedures.

Two technologies come together in RFA. With CT or ultrasound imaging, the physician can precisely identify the lesions. High frequency radio waves, produced by alternating current, are then used to apply heat to destroy the lesion cells with great accuracy. It is this combined technological precision that allows the physician to more accurately target the lesion, and at the same time, reduce collateral damage to healthy tissue.

The RFA procedure is performed in the radiology or operating room, either percutaneously (through the skin), laparoscopically (through a scope) or with an open incision. In either case, the patient experiences minimal discomfort and most can go home the same day. After the patient is sedated and given a local anesthetic, the physician uses CT or ultrasound to visually guide a needle into the lesion. An array of wires, guided through the needle, spread out into the lesion in a starburst form to infiltrate the lesion. Some of these wires contain a tiny thermometer by which the temperature of the surrounding tissue can be measured. These wires are attached to a generator that produces alternating current in the controllable range of radio waves. Radiofrequency ablation provides patients with liver cancer new hope. The minimal risks and side effects are welcome relief from the apprehension patients face with many other options. The prospect of a minimally invasive procedure combined with greater accuracy in targeting and destroying cancer cells, presents a more promising outlook for patients with liver cancer.