Novel treatment for liver cancer
The topnotch expertise, state-of-the-art technology, and proven track record of St. Luke’s
In January 2003, a team of hepatologists (liver experts) and other specialists at the St. Luke’s Center for Liver Diseases successfully performed the first Radio Frequency Ablation (RFA) of the liver in the country.
The center has been performing RFA for primary liver cancer and cancerous tumors that have spread to the liver (liver metastases) for more than four years now.
Because of the absence of obvious symptoms, most cases of liver cancer are diagnosed late and consequently chances of survival are significantly reduced.
In the past, radical surgery was the only treatment for liver cancer. RFA is a well-established and safe procedure with very few complications. Small tumors require only one session while larger tumors usually need two or more sessions.
RFA involves the insertion of a probe through the liver tissue into the tumor and the delivery of alternating electrical current (radio frequency energy) at the tip of the probe. Heat is then generated at the site of the lesion through agitation caused by the alternating electrical current. This heat produces coagulation and cellular destruction, resulting in the ablation of the target lesion. The tumor is literally “burned out.”
Specially trained interventional hepatologists or interventional radiologists can perform RFA percutaneously (through the skin) guided by ultrasound or CT scan, enabling them to see, and place the probe on, the exact location of the lesion without an operation; laparoscopically (through several small incisions); or through open abdominal incision.
“RFA’s mode of action is similar to that of a microwave oven — heating from the inside out. The liver reabsorbs the destroyed cells over a period of time,” says Dr. Juliet Gopez-Cervantes, a hepatologist who heads St. Luke’s Center for Liver Diseases.
The internationally trained Cervantes has performed the most number of RFA procedures in the country. Utilizing the country’s only liver databank (St. Luke’s Liver Diseases Databank), Cervantes and her team analyzed the medical records of all St. Luke’s patients who underwent RFA from January 2003 to October 2006. Their analysis showed that RFA for primary liver cancer and liver metastasis:
• Improved patient survival to up to three years compared to
• Can be safely done even for large tumors; and
• Reduced tumor size when combined with other treatment modalities.
“RFA offers almost the same efficacy as surgery, but without the associated surgical risks and complications,” says Dr. Dennis Villanueva, a consultant vascular and interventional radiologist at St. Luke’s
Villanueva is one of only a few local specialists who have completed oncologic interventional radiology training on percutaneous tumor ablation of various solid cancerous tumors such as lung, bone, kidney, adrenal gland, breast and thyroid gland. The St. Luke’s
“The standard treatment for cancer of these organs is still surgery. However in patients who have co-existing diseases that make surgery too risky, RFA provides an excellent alternative,” explains Villanueva.
“In metastatic bone cancer patients, RFA provides pain alleviation not possible with surgery. Other patients request for RFA simply because they want to be spared the pain and risk of complications associated with surgery,” he says.
Villanueva notes that although surgery remains the gold standard in the treatment of isolated tumors, most patients are not good surgical candidates.
“I believe that RFA will play an important role in complementing established cancer therapies, such as chemotherapy, radiotherapy and surgery,” he says.
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