What is tumor ablation?

Tumor ablation is a procedure to shrink a liver tumor. It may be done in several ways, such as by sending heat, cold, or chemicals into the tumor.

The doctor will insert a special needle called a probe into your skin on the right side of your belly near your ribs. You may feel pain in your shoulder for a few seconds when the probe goes into your liver. This is called referred pain. It is caused by pain traveling along a nerve near the liver.

You may feel some pain in your belly when the doctor uses the probe. If the tumor is large, the doctor may repeat the procedure from a different angle. This is to make sure that all areas of the tumor are treated.

After the procedure, the doctor will remove the probe. The doctor or nurse will put a bandage over your skin where the probe was inserted. You will probably go home on the same day as the procedure.

The chemicals, heat, or cold make the tumor shrink. Bit by bit, the tumor will be replaced with scar tissue over the next few months. This should not affect your liver's ability to do its job.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
• For 2 to 3 days after the procedure, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
• You may shower 24 to 48 hours after the procedure, if your doctor says it is okay. Tape a plastic bag over the puncture site to keep it dry while you shower. Pat the puncture site dry. Do not take a bath for the first 5 days, or until your doctor tells you it is okay.
• Ask your doctor when you can drive again.
• Most people are able to return to work within 1 to 2 weeks after the procedure.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if acetaminophen (Tylenol) is safe for you. Also, ask how much you can safely take.
  • Do not take aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Care of the puncture site

• Keep a bandage over the puncture site for the first 2 or 3 days, or until your doctor says you can take it off.
• After the doctor says it is okay to take off the bandage, wash the area daily with warm water and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
• Keep the area clean and dry.
• Put ice or a cold pack on the area for 10 to 20 minutes at a time to help with soreness or swelling. Put a thin cloth between the ice and your skin. You can do this 2 or 3 times a day.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Your doctor will tell you which medicines to take or stop before your procedure. You may need to stop taking certain medicines a week or more before the procedure. So talk to your doctor as soon as you can.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

These are two ways to treat certain types of tumors without using surgery. These treatments may be used alone or together. They may also be used with other treatments. They may be an option when surgery is not possible or is too risky.

Tumor embolization treats a tumor by cutting off its blood supply. Without blood, the tumor will shrink or at least grow more slowly.

The doctor puts a substance into the blood vessel that supplies or feeds the tumor. Several substances can be used to block blood flow. They may include particles, chemotherapy, or tiny beads. The tiny beads may contain chemotherapy or radiation.

Embolization is sometimes done to shrink a tumor before tumor ablation. It may also be done before surgery because it reduces bleeding. This makes the tumor easier to see.

Tumor ablation is a way to destroy tumors. It may be done using:

• Heat. Radio waves may be used to burn the tumor. This is called radiofrequency ablation. Other ways to apply heat include using microwaves, lasers, or ultrasound.
• Cold. A very cold gas is used to freeze the tumor. This is called cryotherapy or cryoablation.
• Chemicals. A chemical is injected into the tumor. This is called chemical ablation. Alcohol (ethanol) is often used.

Ablation may be a good option for smaller tumors. It may not work well in larger tumors.

You may be able to go home the same day. But in some cases, you might need to stay in the hospital overnight or longer.

You will have a bandage over your skin where the probe or catheter was inserted. This area may be sore for a day or two.

You will have tests in the months after the procedure to see how well the treatment worked.

Tumor ablation is a procedure to shrink a liver tumor. It may be done in several ways, such as by sending heat, cold, or chemicals into the tumor. The doctor put a special needle called a probe through your skin into the tumor in your liver.

The area where the probe was put into your skin (the puncture site) may be sore for a day or two after the procedure. You may have a bruise. You may also have a dull pain in your belly or right shoulder for a couple of days. This is called referred pain. It's caused by pain traveling along a nerve near the liver.

You will have tests in the months after the procedure to check the liver tumor to see how well the treatment worked.

For both procedures, the doctor uses ultrasound, a CT scan, or other imaging to guide the treatment.

Tumor embolization is usually done through an artery. This is called arterial or trans-arterial embolization. A thin tube called a catheter is inserted into a large artery, often one near the groin. Then the doctor moves the catheter into the smaller artery that supplies blood to the tumor. The substance that will block the blood supply is placed in the artery near the tumor. Then the catheter is removed.

Tumor ablation is done using a special needle called a probe. The doctor puts it through the skin and into the tumor. The probe sends heat, cold, or chemicals into the tumor. If the tumor is large, the doctor may repeat the process from a different angle. This is to make sure that all parts of the tumor are treated. After the treatment, the doctor removes the probe.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
• Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
• The procedure will take about 1 to 3 hours, depending on the number of treatments you need.