|Ask The Expert: Treating Liver Cancer |
I have heard that there is a new way to treat liver
cancer by killing the tumors rather than by surgically removing them.
How is this done, and what are the advantages of this type of treatment?
Surgical oncologist David Pearlstone, MD, FACS (Fellow,
American College of Surgeons), responds:
David Pearlstone, MD,
Yes, there are several new methods to treat liver tumors
that do not require actually removing the tumor from the liver.
Until the 1990s, the only way to surgically treat a
tumor in the liver was to open the patient’s abdomen and cut away the
part of the liver containing the tumor. Removing a portion of the liver
can have risks, and long-term success was rare. Since the ‘90s, open
liver surgery has become safer, but—even better—new techniques have been
developed to treat the tumor without actually cutting it out.
One of the most recent developments is RFA:
radiofrequency ablation. (Ablation = destruction.) With RFA a surgeon
places a small probe—smaller than the diameter of a pencil—into the
liver, guided by ultrasound images. The tip of the probe heats up and
the heat causes the tumor cells and a small surrounding area of liver
tissue to die. The dead cells are then reabsorbed by the liver and
eventually the liver re-grows new cells to replace the lost tissue.
Multiple tumors can be treated at one time, and the procedure can be
repeated multiple times.
The abdomen is often surgically opened to permit
placement of the probe into the liver. In certain cases, however, RFA
can be done without opening the abdomen. It can be done laparoscopically
(laparo = abdomen, scope = instrument for observing): A few very small
incisions are made to insert the probe and a tiny video camera.
RFA can also be done percutaneously (per = through;
cutis = skin): Just the probe is placed into the abdomen through a small
slit in the skin, and the probe placement is guided by an imaging system
called a CT (computerized tomography) scan.
Percutaneous and laparascopic RFAs mean less discomfort
and a faster recovery for the cancer patient. Both of these procedures
are performed at Bridgeport Hospital.