What are the patient criteria?
Radiofrequency ablation is a viable and effective treatment option if you:
- Are not a good candidate for surgery because your tumor is difficult to reach.
- Have other medical conditions that make surgery risky.
- Would not have enough liver tissue left for the organ to function adequately following the surgical removal of a tumor.
- Have liver tumors that have not responded to chemotherapy or that have recurred after being removed surgically.
- You have several small liver tumors that are too spread out to be removed surgically.
What are the advantages of radiofrequency Ablation?
- Effective treatment for small cancers
- Minimally invasive, with no large skin incision
- Minimal risk to patient
- Typically little or no pain
- Minimal hospital stay
- Can be repeated if new cancer appears
What can the patient expect?
Image-guided, minimally invasive procedures such as radiofrequency ablation are most often performed by a specially trained interventional radiologist in our interventional radiology suite. Radiofrequency ablation is often done on an outpatient basis. Radiofrequency ablation is performed using a small needle electrode that is inserted through the skin and into the tumor.
Using imaging-guidance, the interventional radiologist will insert the needle electrode through the skin and advance it to the site of the tumor.
Once the needle electrode is in place, radiofrequency energy is applied. For a large tumor, it may be necessary to do multiple ablations to ensure no tumor tissue is left behind.
Will I be "put out" (be under general anesthesia) for a radiofrequency ablation?
No. This procedure is done under local anesthesia. Most of the patients also receive intravenous sedation, which makes the procedure easier to tolerate. The amount of sedation given generally depends upon the patient tolerance. It is necessary for you to be awake enough to communicate easily with the physician during the procedure. However, some patients receive enough sedation that they have amnesia and cannot always remember parts or all of the actual procedure.
What is the recovery time?
Pain immediately following radiofrequency ablation can be controlled by pain medication given through intravenous (IV) or intramuscular (IM) injection. Afterward, any mild discomfort can be controlled by oral pain medications. The patient should be able to resume usual activities within a few days. Only about two percent of patients will still have pain a week following radiofrequency ablation.
Will your physician recommend you for this procedure?
The Interventional Radiologist may recommend that you have several tests, including liver function blood tests, and a CAT scan or an MRI of your liver prior to the Chemo-embolization procedure. Your doctor (Interventional Radiologist) needs to check these test to make sure the procedure can be done safely. Your doctor may not recommend you to have the procedure for your own safety.
How do you prepare for the procedure and what is it like?
The evening before the exam you may not eat or drink anything (NPO) after midnight. You’re allowed to take your normally scheduled medications with sips of water. You will arrive at the hospital early in the morning. Once here, you will relax in your room for several hours while an intravenous (IV) line, placed in your arm, allows IV fluids to drip into your body. These fluids consist of antibiotics, and other medications that are needed prior to your TACE procedure. Based on your situation, you will have conscious sedation or general anesthesia. Once the procedure begins, the doctor (Interventional Radiologist) will place a small catheter (a small tube) in an artery in your groin and perform an arteriogram which will specifically look at the arteries in your liver. After these arteries are identified, A micro catheter is directed into the branch of the artery supplying blood to the tumor, and the Chemo-embolization material is injected. Once this is completed, you will be sent back to your room where you will lie flat in bed for six hours. You will stay overnight in the hospital, and more IV fluids are given to you overnight and any medications needed.
Are there any side effects or complications?
Following the procedure you may have varying degrees of pain, fever and nausea. These symptoms may last a few hours to a few days, and are easily treated by various medications. You may also notice slight hair loss, rarely perceived by anyone other than yourself.
Serious complications from TACE are rare. In less than 3% of the procedures, the liver tumor that is killed by the procedure may become infected and develop into an abscess. The risk of serious liver failure is about 1%, but largely based on your pre-existing liver function and individual health status.
Will TACE help me?
Remember, TACE is a palliative treatment, not a cure. Depending on the type of liver cancer, it may improve your survival.