Ablative therapies as a treatment option to colorectal metastatic disease

Receive our quarterly lifestyle research updates Email:

Surgery is the standard treatment modality for metastatic liver cancer.  However only a small number of patients are good candidates for surgical resection of the liver. The distribution and number of lesions, as well as their relation to major vascular structures, restrict the number of patients for whom surgery is indicated. For example, bilobar lesions are seldom resected. As result, only about 10% of patients with colorectal metastases are candidates for hepatic resection.

In an effort to expand the group of patients who might benefit from focal therapy, a number of alternatives to surgery have evolved. These therapies use a chemical agent or energy to destroy the tumour. They are called ablative therapies and include radiofrequency ablation, alcohol ablation, embolization and cryosurgery. While alcohol ablation has had success, especially against hepatocellular carcinoma, cryosurgery comes closest to surgery in terms of overall efficacy. The other new therapies have a very limited history and are compromised by shortcomings in our ability to monitor their destructive effect on the tumour, making them impractical for treatment with curative intent. Ablative therapies can either be used alone or in combination with surgical removal of the tumour.

One of the way to control the liver metastases  is a procedure using very low temperatures to freeze the tumour. This process is called cryosurgery. This technique does not involve invasive surgery. A metal probe is inserted through the skin and placed into the center of a tumour. Liquid nitrogen or argon gas flows through the freezing probe and initiates the creation of an ice ball in the center of the tumour which gradually expands outward. When the ice ball overlaps the margins of the tumour by one centimeter, the tumour tissue is destroyed with  minimal impact on the normal liver tissue.

Another way to control the tumour is a technique using high temperatures to destroy the malignant tissue. Radio waves are passed through the tumour tissue, generating heat at the site of the tumour that destroys the cancerous tissue. This technique is called radiofrequency ablation.

Embolization is a procedure that cuts off the blood supply to the tumour by blocking the main artery that carries blood to the livers. Thus the tumour is deprived of the life-giving oxygen which leads to its destruction.

Alcohol ablation is a means of destroying the cancerous tissue by using toxins. These are injected directly into the tumour. This technique is usually used with patients who are not good candidates for surgery.

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.