Ablation

Ablation is performed in the hospital, usually by a specially trained doctor called an Interventional Radiologist. It is usually performed as a day procedure, meaning you will come into the hospital, have the procedure done, and go home the same day. In some situations it could be performed in the operating room by a surgeon.

The Procedure:

Before the procedure begins, you will have an intravenous placed to give you medication. In the procedure room, you will lay on the procedure table and a nurse will set up monitors to measure your blood pressure, heart rate and oxygen levels. Depending on the type of the type of ablation, you may also have grounding pads placed under your thighs to allow electricity to exit your body. The doctor will go over the procedure and its potential risks and benefits.

The procedure will begin with you receiving sedation through your intravenous to make you more relaxed. In some cases you may be given general anesthesia. The doctor will clean your skin and inject freezing in the area over the liver where the procedure needle will be inserted.

After this, the doctor will use an ultrasound or a CT scan to guide the procedure needle through your skin, into the tumor. Once the needle is in place, the ablation can begin. There are three types of ablation that can be used to destroy the tumor.

• Radiofrequency Ablation (RFA): radio waves will be sent through the procedure needle, into the tumor. Radio waves create heat that destroys the tumor.
• Microwave Ablation (MWA): involves microwaves being sent through the procedure needle, into the tumor. Microwaves create heat that destroys the tumor.
• Percutaneous Ethanol Injection (PEI): ethanol is injected into the tumor through the procedure needle. Ethanol destroys the tumor by causing it to dry up. PEI can be used on its own, or in combination with RFA.

During the ablation procedure, you may feel mild discomfort including a feeling of heat or mild pain in the area being treated. After the ablation is complete, the procedure needle will be removed and you will be moved to a recovery area to be monitored before being discharged. The entire time you will be at the hospital is usually about 4 to 8 hours.

After the Procedure:

The tumor area that was destroyed with the ablation will turn into scar tissue.

After you go home, you should monitor yourself for symptoms. If you have severe pain or fever, please call your doctor or nurse or go to the nearest emergency department.

Your healthcare team will arrange a follow-up scan (like ultrasound, MRI or CT) which will involve taking pictures of the liver and using a special contrast dye to help make the tumor area more visible. This is usually done about 1-3 months after the ablation. Based on the results of your scan, your healthcare team will decide if any more treatment for your HCC is recommended and when more scans should be done. Scans are usually done more often in the first 2 years after treatment.

You should also continue to monitor yourself for development of any new symptoms and have blood work checked as recommended, so your health care team can monitor your liver.

Ablation procedures may be done just once or even several times on the same tumor. They can also be done in multiple spots if you have more than one tumor in your liver.