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Ablation is treatment that destroys liver tumors without removing them. These techniques can be used in patients with a few small tumors and when surgery is not a good option (often because of poor health or reduced liver function). They are less likely to cure the cancer than surgery, but they can still be very helpful for some people. These treatments are also sometimes used in patients waiting for a liver transplant.

Ablation is best used for tumors no larger than 3 cm across (a little over an inch). For slightly larger tumors (1 to 2 inches, or 3 to 5 cm across), it may be used along with embolization. Because ablation often destroys some of the normal tissue around the tumor, it might not be a good choice for treating tumors near major blood vessels, the diaphragm, or major bile ducts.

People getting this type of treatment typically do not need to stay in a hospital. Often, ablation can be done without surgery by inserting a needle or probe into the tumor through the skin. The needle or probe is guided into place with ultrasound or CT scan. Sometimes, though, to be sure the treatment is aimed at the right place, the ablation may be done in the operating room under general anesthesia (you are asleep) and may need an incision (cut) like the one for a partial hepatectomy .

Radiofrequency ablation (RFA)

Radiofrequency ablation is one of the most common ablation methods for small tumors. It uses high-energy radio waves. The doctor inserts a thin, needle-like probe into the tumor through the skin. A high-frequency current is then passed through the tip of the probe, which heats the tumor and destroys the cancer cells.

Microwave ablation (MWA)

Microwave ablation uses the energy from electromagnetic waves to heat and destroy the tumor using a probe.

Cryoablation (cryotherapy)

Cryoablation destroys a tumor by freezing it using a thin metal probe. The probe is guided into the tumor and then very cold gasses are passed through the probe to freeze the tumor which causes the cancer cells to die.

Ethanol (alcohol) ablation

This is also known as percutaneous ethanol injection (PEI). In this procedure, concentrated alcohol is injected directly into the tumor to damage cancer cells. Sometimes multiple treatments of alcohol ablation may be needed.

Side effects of ablation therapy

Possible side effects after ablation therapy include abdominal pain, infection in the liver, fever and abnormal liver tests. Serious complications are uncommon, but they are possible.

Newer ablation techniques in liver cancer are also being studied.