The RFA stands for Radiofrequency Catheter Ablation, medical jargon for the use of highly localized heat to kill cells in tumors. Doctors use a heat generator and a metal probe that can be inserted directly into a tumor. They're able to see inside the liver using a type of ultrasound that produces a detailed map of where the tumors are. Dr. Daniel Albo is the chief of General Surgery and Surgical Oncology at the Veterans Affairs Medical Center.
"Once the array is in proper position, then we turn on the generator and what happens is that the localized electrical application produces a very well-circumscribed area of very intense heat right around the tip of these probes that essentially, for lack of a better term, cooks the tumor."
Because the heat is so localized, it doesn't damage the surrounding healthy portions of the liver and because of the small incisions, patients are often on their feet in a matter of days. Albo says VA doctors are treating more liver tumors, in particalar an aggressive form of carcinoma.
"It's one of the fastest, if not the fastest, rising form of malignancy in this country these days and a lot of it is associated with a sharp-rising incidence of hepatitus c and also b. Our patient population has a fairly high incidence of these problems and we're seeing these with an alarmingly high frequency and the frequency is increasing."
Doctors are also using a process called chemoembolization, in which the blood supply to liver tumors is cut-off and high-dose chemotherapy drugs are injected directly into the tumor. Albo says the combination treatment often creates more time for cancer patients waiting for transplanted livers.
"For a lot of these patients with more advanced forms of the disease we're using these chemoembolization and RFA combination treatments as a bridge to transplantation to control the disease until the time that the liver becomes available and they can be candidates for a liver transplantation."
Albo says although laparoscopic RFA and chemoembolization aren't cures for liver cancer, they do improve the quality of life for patients.