Surgery: The Minimally Invasive Approach
Laparoscopic (minimally invasive) liver resection is currently possible in about 25% of patients who are able to have surgery. “The majority of liver surgeries in the U.S. are done open [with a wide incision],” explains Dr. Kuvshinoff. “Roswell Park was one of the early centers to adopt the laparoscopic approach. With minimally invasive surgery, we can shorten the patient’s hospital stay and decrease recovery time afterward.”
Along with surgery to remove liver tumors, Roswell Park offers these treatments for patients with colorectal cancer that has spread to the liver:
*Radiofrequency ablation (RFA): A probe, inserted into the tumor, springs open like an umbrella and then emits radio waves that heat the tissue, killing the cancer cells. RFA is a minimally invasive technique, performed as an outpatient procedure. The FDA notes that “RFA may be better than other ablative techniques because it is fast, easy, predictable, safe, and relatively cheap.” It is generally performed as an outpatient procedure.
*Microwave ablation: Similar to RFA (see above), this minimally invasive procedure uses an antenna, inserted into the tumor, to emit microwaves that heat and kill tumor cells.
*Selective Internal Radiation Therapy (SIRT): SIRT may be an option for patients with extensive metastatic tumors in the liver. Millions of microscopic, radioactive beads are sent through the large artery in the liver to the tumors, where the beads are trapped, log-jam style, in the narrow blood vessels that surround the tumors. There they emit very high doses of radiation, which gradually fades away over several days. SIRT is used either with chemotherapy or after chemotherapy has failed.
SIRT is used to extend the patient’s survival, with limited side effects. Clinical research studies in Australia and Asia have documented cases in which SIRT, used along with chemotherapy, shrank tumors enough to make surgery—and a cure—possible.