Ablative therapies are used to destroy a cancerous tumor. Ablative therapies currently in use with respect to colorectal cancer are:

• Radiofrequency Ablation
• Cryotherapy
• Microwave Ablation (MA)

Each of these techniques are used in patients that have a limited number of metastatic liver tumors. They are considered to be beneficial for patients with liver-only disease that is not operable who have tumors less than or equal to 3-4 cm.

These procedures are performed by a surgeon or interventional radiologist (IR) who specializes in oncology procedures.

For information about each treatment, see the other sections of this document.

Radiofrequency Ablation (RFA) uses an electrical current to destroy a tumor by creating heat in a tumor for a specific period of time. The result of this “super heating” is the death or destruction of the tumor.

There are various methods of performing a Radiofrequency Ablation:

• With a needle: RFA can be performed by inserting a needle through the skin under x-ray guidance (percutaneously ), then placing a probe through the needle and positioning it in the liver tumor.
  • The percutaneous procedure is usually performed by an interventional radiologist under local anaesthesia.
  • The patient can go home the same day.
• Laproscopically: RFA can be performed through small incisions in the skin (laparoscopically ). A laparoscope is inserted through a tiny incision in the abdomen.
  • A laproscopic procedure is performed by a surgeon
  • The patient is generally hospitalized overnight and can go home the day after the procedure.
• Open surgery: With open surgery, an incision is made in the abdomen.
  • The operation is performed under general anesthesia by a surgeon.
  • The stay in the hospital and overall recovery period will be longer. Your doctor can give you an idea of what to expect. (See the documents in “To Learn More” to maximize your stay in a hospital, to stay safe, and to not receive unwarranted billing).

RFA is safe, well tolerated and an effective treatment for patients with inoperable metastatic liver tumors.

RFA is most effective in liver lesions that are less than or equal to 3-4 centimeters in size.

Side Effects:

• Many patients experience a low grade fever for a few days following the procedure.
• There is a very low risk of infection, bleeding and skin burn.

Cyrotherapy destroys liver cancer tumors by using super cooled nitrogen or argon gas to freeze liver lesions by creating an “ice ball” in the tumor. Damage to surrounding tissue is limited.

Clinical and laboratory research suggest that hepatic cryotherapy is effective in patients with inoperable tumors which are located in a difficult section of the liver (near large vessels).

Like RFA, cryotherapy is most effective in liver lesions that are less than or equal to 3-4 centimeters in size.

The procedure can be performed either of two ways:

• Through the skin: Cyrotyherapy can be performed by inserting a needle through the skin into the liver tumor with guidance from an MRI or ultrasound (percutaneously ). A probe is then placed through the needle and positioned in the liver tumor.
  • The procedure is performed under local anesthesia.
  • The patient can go home the same day.
• Open surgery: With open surgery, an incision is made in the abdomen.
  • The operation is performed under general anesthesia by a surgeon.
  • The stay in the hospital and overall recovery period will be longer. Your doctor can give you an idea of what to expect. (See the documents in “To Learn More” to maximize your stay in a hospital, to stay safe, and not receive unwarranted billing).

Side Effects: Complications of cryotherapy may include bleeding, mild fever, increase in liver enzymes due to damage to the bile ducts, infection or abscess.

Microwave Ablation is an ablative therapy that produces coagulation of soft tissue during the procedure.

Microwave ablation (MA) uses microwave energy and an antenna to cause coagulation of tissue by creating heat through friction and vibration of water molecules in the cells.

The advantage of MA over other heating systems, such as RFA, is that the microwave technique is quicker and does not cause collateral damage. It can be completed in 10 minutes.

Microwave Ablation can be performed through a needle (percutaneously), through small openings in the skin (laparoscopically), or through an incision in the abdomen. For more information about these techniques, see RFA .

Side Effects: Many patients experience a low grade fever and pain for a few days following the procedure. Major complications include liver abscess , bile duct injury, infections, bleeding and skin burn.

Recovery: If the percutaneous method is used the patient will usually go home the same day. If a laparoscopic procedure is selected then the patient often goes home the following day. An open surgical procedure requires that an incision be made in the abdomen, general anesthesia is used, and the recovery time will be longer.