Tumour ablation for liver cancer

Tumour ablation means destroying the tumour by applying heat, cold or alcohol directly to it. For liver cancer ablation can be used to treat small tumours, usually smaller than 4cm across.

It may be used:

  • instead of surgery for small tumours
  • if you cannot have surgery, or choose not to have surgery
  • after other treatments such as surgery and chemotherapy.

Tumour ablation can be done:

Your liver specialist will explain whether this type of treatment may be suitable for you. If your doctor thinks ablation may help you, they can refer you to a hospital that does this treatment. Ablation treatments are only available in some specialist hospitals, so you may have to travel for treatment.

Types of ablation

Types of ablation include:

  • microwave ablation
  • radiofrequency ablation
  • cryotherapy
  • laser ablation
  • percutaneous ethanol injection
  • irreversible electroporation (IRE).

We have more information about radiofrequency ablation, microwave ablation and cryotherapy.

What happens during ablation?

Ablation is usually done under a general anaesthetic. The doctor puts a fine needle through the skin over the liver and into the centre of each tumour. They use an ultrasound or CT scan to guide them to treat the tumours using ablation:

  • Radiofrequency, microwave or laser ablation produces heat, which passes through the needle and into the tumour.
  • Irreversible electroporation uses a high voltage current to destroy tumours. It does not heat the nearby tissue and so is useful for tumours that are close to vessels or bile ducts.
  • Cryotherapy produces very low temperatures, which freeze the tumour.

You may need to stay in hospital overnight. Afterwards, you will have 1 to 3 tiny holes in your tummy area (abdomen). These usually heal quickly. You usually have a CT scan a few weeks after ablation to see how well it has worked.

Percutaneous ethanol injection (PEI)

This is another type of ablation that works in a different way. The doctor injects pure alcohol (ethanol) through the skin and into the tumour. The alcohol destroys the cancer cells.

You have this done in the scanning department. The doctor gives you a local anaesthetic to numb the area. They use an ultrasound scan to help guide the needle into the tumour. You usually need several treatments, depending on the number of tumours and their size. If the tumour grows again, you can have the treatment again.

Side effects of liver cancer ablation

The side effects of ablation are usually mild and may last up to a week. You may have pain in the liver area. You can control this by taking regular painkillers. Other side effects include:

  • a fever (high temperature)
  • tiredness
  • feeling generally unwell.

These side effects happen because the body is getting rid of the cells that have been destroyed. Try to drink plenty of fluids and get enough rest. Your doctor or nurse may ask you to contact the hospital if your temperature:

  • does not go back to normal after a few days
  • goes above 38°C.

These may be signs that you have an infection.

About our information

  • References

    Below is a sample of the sources used in our primary liver cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    Melloul E, Hübner M, Scott M, et al. Guidelines for perioperative care for liver surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations. World J Surg. 2016; 40: 2425–2440. Available from: doi.org/10.1007/s00268-016-3700-1 [accessed Feb 2020] 

    NICE. Lenvatinib for untreated advanced hepatocellular carcinoma: Technology appraisal guidance (TA 551) [Internet]. 2018. Available from: www.nice.org.uk/guidance/TA551 [accessed Feb 2020] 

    NICE. Liver disease. Quality standard (QS 152) [Internet]. 2017. Available from: www.nice.org.uk/guidance/QS152 [accessed Feb 2020] 

    NICE. Liver cancers overview [Internet]. 2019. Available from: pathways.nice.org.uk/pathways/liver-cancers/liver-cancers-overview [accessed Feb 2020]

    NICE. Regorafenib for previously treated advanced hepatocellular carcinoma. Technology appraisal guidance (TA555) [Internet]. 2019. Available from: www.nice.org.uk/guidance/ta555 [accessed Feb 2020]

    Vogel A, Cervantes A, Chau I, et al. Hepatocellular carcinoma: ESMO Clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2018; 29 (S4): iv238–iv255. Available from doi.org/10.1093/annonc/mdy510 [accessed Feb 2020]    


  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Dr Paul Ross, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.