Katsuhiro Kobayashi, MD, reviews images of the patient’s liver prior to the microwave ablation procedure. (photo by William Mueller)
BY AMBER SMITH
Options are important when you have cancer of the liver.
Vascular and interventional radiologists at Upstate now offer microwave ablation, a technique that uses heat to destroy cancer cells. The minimally invasive procedure can be an alternative to surgery. It may be used in addition to chemotherapy or radiation therapy.
Katsuhiro Kobayashi, MD, says the Ethicon NeuWave equipment was purchased thanks to a grant from the Upstate Foundation. He appreciates that it can be used to ablate lesions — abnormalities — in a variety of shapes and sizes, and he finds it more precise than radiofrequency ablation, another method of destroying cancer with heat.
Microwave ablation is an option for cancers in organs that contain a high percentage of water, such as the liver and kidneys. It can also be used on bone lesions.
Here’s how it works:
An illustration shows the tip of the probe and the microwaves it generates. (courtesy of Ethicon)
The patient is sedated or anesthetized during the procedures, so he or she is not bothered by the burning sensation.
Kobayashi inserts a probe through the skin and into the tumor, periodically consulting medical images to make sure his trajectory is correct. Once the probe is in place, images confirm that it is in precisely the best location.
Depending on the shape of the tumor, the tip of the probe emits either a circular or elongated sphere of microwaves, whose widths are controlled by the amount of time the machine is activated. When microwaves force them to oscillate — move back and forth — water molecules within the tissue create heat, which disintegrates the cancer cells. Those dead cells are gradually replaced by scar tissue that shrinks over time.
Microwaves are not impeded by blood vessels, and their heat dissipates much less than it does from radiofrequency waves. It’s generally quicker and more accurate.
The ablation takes a few minutes. Afterward, Kobayashi examines three-dimensional images that look like ink drawings to see the area of destruction. “I think we got it all,” he says.
To guard against any remaining cancer cells spreading along the probe track as the doctor retracts the probe, the machine cauterizes the area on the way out.
He says microwave ablation is a good option for many patients, especially those who might have difficulty with traditional surgery.
Reach Vascular and Interventional Radiology bat Upstate by calling 315-464-5189.
Kobayashi inserts the 15-gauge probe into the patient’s liver. The microwave ablation, which disintegrates the tumor, lasts less than seven minutes. In the foreground is the Ethicon NeuWave equipment, which is loaded with images of the patient’s liver and surrounding organs. (photo by William Mueller)
This article appears in the spring 2018 issue of Cancer Care magazine.