Radiofrequency Ablation (RFA) of Liver Tumors

Why might I need RFA of liver tumors?

RFA is often used to treat cancer in the liver when surgery isn’t a good option. It is most often used to treat liver tumors that are small in size.

RFA may be used if you have either of these:

• Hepatocellular carcinoma, a cancer that starts in the liver
• Colon cancer that has spread (metastasized) to the liver

RFA is often used instead of surgery to remove the tumors when:

• Surgery would be high-risk because of other health issues
• The liver tumors are small
• Small tumors are spread across the liver
• The tumor is in a place that makes it hard to reach with surgery
• Surgery to remove the tumor would destroy too much of the liver
• You have had liver tumors grow back after surgery
• Your liver is not working well

This treatment may not be a cure. But survival rates from RFA may be just as good as those in people with small tumors who had surgery.

RFA for liver tumors may not be advised if you have either of the below:

• A large tumor. This is a tumor that is more than 5 cm (about 2 inches) wide.
• A tumor close to blood vessels. RFA may cause damage to the vessels.

What are the risks of RFA of liver tumors? 

All procedures have some risks. The risks of RFA of liver tumors include:

• Infection
• Injury to organs near the liver
• Gallbladder inflammation
• Damage to the bowels or bile ducts
• Extreme pain
• Pus-filled infection (abscess) at the cut in the skin
• Flu-like symptoms that start 3 to 5 days later (post-ablation syndrome)
• Bleeding
• Damage to blood vessels
• Risks of radiation exposure if a CT scan is used

Your own risks may vary according to your age, your general health, and the reason for your procedure. Talk with your healthcare provider to find out what risks may apply to you.

How do I get ready for RFA of liver tumors?

Talk with your healthcare provider how to prepare for your procedure. Tell him or her about all the medicines you take. This includes over-the-counter medicines, vitamins, and other supplements. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin. If you smoke, you may need to stop before your procedure. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.

You may need some tests before the procedure, such as blood tests. These may be done to see how your kidneys and liver are working and make sure your blood clots well.

Tell your healthcare provider if you:

• Have had any recent changes in your health, such as an infection or fever
• Are sensitive or allergic to any medicines, latex, tape, and anesthetic agents (local and general)
• Have a history of bleeding disorders
• Are taking any blood-thinning (anticoagulant) medicines, aspirin, ibuprofen, or other medicines that affect blood clotting
• Are pregnant or think you may be pregnant

Also, make sure to:

• Ask a family member or friend to take you home from the hospital. You can’t drive yourself if you are given sedation during the procedure.
• Follow any directions you are given for not eating or drinking before your surgery.
• Follow all other instructions from your healthcare provider.

You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully. Ask questions if something is not clear.

What happens during RFA of liver tumors?

RFA of liver tumors may take a few hours. The procedure will likely follow these basic steps:

• You’ll lie on an exam table. You’ll receive an IV (intravenous line) in your hand or arm. Your healthcare team will give you medicine through this tube.
• Your healthcare team will track your blood pressure, heart rate, and pulse.
• RFA may be done while you’re awake or under general anesthesia. If you’re awake, your healthcare provider will numb the place on your body where he or she will do the procedure.
• Your healthcare provider will make a small cut in your skin. This is done to insert the needle electrode. He or she will use an imaging scan, such as a CT, MRI, or ultrasound to guide the needle electrode into the liver tumor.
• An electrical current will pass through the electrode to destroy the tumor. The electrode may need to be moved around to other parts of the tumor to reach all of it.
• Once the procedure is done, your healthcare provider will take out the electrode and the IV line. A bandage will be put over the site.

What happens after RFA of liver tumors?

You may have pain and nausea after RFA. These side effects are often mild and can be controlled with medicines. You should be able to go home the same day, a few hours after the procedure.

Within about a week, you should feel back to normal and be able to return your daily activities. Call your healthcare provider if you have any problems after the procedure. He or she will tell you about tests after the procedure to see how well it worked.

Next steps

Before you agree to the test or the procedure make sure you know:

• The name of the test or procedure
• The reason you are having the test or procedure
• What results to expect and what they mean
• The risks and benefits of the test or procedure
• What the possible side effects or complications are
• When and where you are to have the test or procedure
• Who will do the test or procedure and what that person’s qualifications are
• What would happen if you did not have the test or procedure
• Any alternative tests or procedures to think about
• When and how will you get the results
• Who to call after the test or procedure if you have questions or problems
• How much will you have to pay for the test or procedure