Liver cancer.
Information on current developments in both regular and alternative or complementary treatments and resources for primary liver cancer and leveruitzaaiïngen at all stages.
Experiences of cancer patients with complementary approaches can be found by experience stories on our website and there are also some videos of experiences of cancer patients with complementary approaches to see. To click on video button top left of this page. Or visit the website of the SNFK information where movies are shown on complementary approaches to cancer.
RFA.-Radio Frequency Ablation in Medisch Centrum Leeuwarden with additional information about how RFA is applied and who is eligible for this.
See for much more information Radio Frequency Ablation under about RFA
update 22 november 2011: the information below shows still more or less topical. I have one and other custom in the information below. The full study protocol of a phase III study which examined what is the difference between classical approach and RFA in liver tumors. Including all addresses of participating hospitals etc.
In the Medical Center Leeuwarden is worked with Radio Frequency Ablation in R.F.A. = darmkanker patients with tumors in the liver.
On the Web site (click on RFA) of the Medical Center Leeuwarden have the doctors Dr. Pierie and Dr. Meijerink (e-mail address of Dr. Meijerink State on the website) the following information about put. R.F.A. I got the request of Dr. Meijerink also known this information via my site. So what I do with this. I am not limited to a link to their website because I also have some notes the information that they give. My supplementary information is submitted by Dr. Solbiati from Italy. Below are the information such as that the Web site (click on other medical information) of the Medical Center Leeuwarden R.F.A such as those on..
Website source: Medical Center Leeuwarden
The optimal therapy for primary liver tumors, or metastases (metastases) is a complete surgical resection. Unfortunately many patients did not undergo this surgery. Reasons for this include:
-Too little remaining liver tissue after resection
-Metastases outside the liver
-The number and position of the liver abnormalities
-The type of the original tumor in case of liver metastases
-The condition of the patient
For a part of this RFA would patients a solution.
RFA is a promising surgical treatment of abnormalities in the liver, where the tumors "fire away". The short term results in selected patients with good and comparable a surgical resection. Because the technique is still relatively new are the long term results (> 5 years) is not yet known.
In our clinic we provide treatments for liver Metastases of colorectal malignancies RFA (colon and rectum cancer), primary hepatocellular tumors (HCC) and Neuroendocrine tumors (endocrine glands tumors).
Technique:
The RFA method is by us via the "open" method applied provisionally, where through an operation the needles are made in the liver. On cover of a ECHOgrafisch image is the needle in the center of the metastasis pricked. Then is the point of the needle as a kind of paralpu expanded in the metastasis.
If the needle is well-positioned, a special generator a high frequency alternating current between the electrodes excited. This power gives an effect similar to an ordinary microwave. The tissue within the range of the feet of the needle is heated and therefore killed. The generator delivers not only the AC power, but also measuring the resistance of the tissue and that is when the "combustion" of the tumor is ready.
The combustion process is for the surgeon good to follow on the ECHO image. In this way can then be punctured the any other metastases. (Editorial Note: according to Dr. Solbiati and Dr. Vogl gives the skin a treat with open extra risk of complications. Often patients who are treated somewhat weaker by the cancer and by then a major surgery to undergo the risks are just bigger. While if the RFA is applied correctly by the echo guidance just as accurate as in an open operation. An open operation is thus Dr. Solbiati. just an extra unnecessary risk)
Small tumors (either growths or metastasis) can be burned with a time poking.Larger tumors can, such as on the picture opposite shows step-by-step, be burned. The light-colored "polka dot" indicate the area of "burning again".
The heating should be just in the healthy tissue by walk to make sure that all malignant cells are destroyed.
The expectation is that we in the near future in some patients also apply the "percutaneous" technique, where an ECHO or CT guided puncture of the metastasis can occur. The radiologist pricks the skin in the liver under local anesthesia by. In cases where percutaneous puncture is not possible we want from next year, after the establishment of our laparoscopic operation rooms, apply a laparoscopic approach. You can find more information on this website in due course.
Criteria
Criteria to qualify for RFA treatment:
-The original malice must be removed in its entirety. That means that there is no evidence that there are malignant cells remain in the operation area.
-The tumours (metastases) in the liver may not exceed 4 inches (restriction of theequipment) and in principle up to 4 in number.
(Dr. Solbiati and Dr. Vogl is 5 cm. in diameter held-in America is already experimented with tumors up to 10 cm.-and with Dr. Solbiati and Dr. Vogl can tumors with a length of 10 cm. but only 2 cm thick or very well be burned. In addition, a scientific study-see elsewhere on this page-that repetition of a RFA treatment very well without adverse effect on success).
· No indication for metastases outside the liver.
If a patient meets these criteria and a liver (' normal ' operation) resection is not possible, RFA would be a solution.
The current standard treatment of colorectal liver metastases is chemotherapy resectabele not (Editorial Note: usually if chemo nine months long 5-FU by infusion every so many days/weeks, but now is clear that adding capecitabine or Xeloda, that home is in tablet form to take a minimum of just such good results and much less side effects and even cheaper for the hospitals see cancers-intestinal cancers).Am curious what the Medical Center Leeuwarden) apply.
Since R.F.A. treatment is very encouraging, is a EuropeanEORTC trial 40004)(study(also the Radboud Nijmegen does with this open study, phase III randomised and so) where RFA + chemotherapy compared to chemotherapy alone (the current standard treatment). At this moment there is still no randomised comparative research into the effectiveness of RFA. Click here for the full study of the EORTC trial 40004)
( Medical journal Cancer In the leading is touted as a very good treatment R.F.A. method and look elsewhere on this page to scientific studies, so there is indeed much scientific research available to RFA. Search but on Radio-Frequency Ablation in bv R.F.A. or. pubmed or google. Our Center does participate in this research, so if you have selected will be invited to participate here.
Frequently asked questions
RFA Is possible if there are uitzaaiïngen elsewhere?
Often we are asked via email whether it would not make sense or is possible, to remove the tumours in the liver, even though there are metastases present elsewhere in the body, e.g. in the lungs. Even though the RFA with the puncture method via a needle for a small surgery, the patient is a hefty surgery. The resistance of the body is in the phase after surgery weakens properly by, inter alia, all waste arising by the burnt liver tissue. Backward metastases have precisely the chance to grow faster. This would correct the operation backfire. Only if the chance is very great that you all metastases can get away, is a surgery or a RFA treatment makes sense.
(In America and Japan is already done extensive research in lung cancer, kidney cancer, also with RFA breast cancer etc. See results of some studies on this page. The restriction that RFA can only if there are no metastases elsewhere seems understandable, on the other hand, unfortunate that no research is done to. By a number of metastases away is the condition of the patient temporarily only what less, but because many metastases are removed can the immune system may use more energy for the cleanup of the other metastases? Or can be irradiated or otherwise treated. But yes I am not a doctor and have it might be completely wrong)
What are the complications of this technique?
Using the R.F.A. technique is a part of the liver by local heating "burned" where a metastasis is located. On the ground creates a cavity filled with necrotic (dead) tissue. This dead material is slowly cleaned up by the body.
In the first days after the treatment, there are many waste R.F.A. free. This goes hand in hand with (usually) temporary hepatic disorders, a significantly increased sedimentation and increased inflammatory values in the blood. The temperature may be the first days after the operation increased.
An infection of the cavity is a tedious and dangerous complication. Because the cavity infection by blood is no longer, is a difficult to treat with antibiotics. That means that, by means of an operation or by using a needle (puncture) a drain in the cavity must be placed to the infected material outside the body to be made redundant. (Editorial Note: to prevent infections and to your resistance-immune system-stronger Wood smuller diet to make it look like (or Gerson), with the addition we strongly recommend that certain food supplements. But do this under guidance of a knowledgeable physician orthomoleculair. Useful addresses)page addresses.
Why is there often a few months delay between the discovery of metastases in the liver and the RFA treatment?
The uitzaaiïngen that are discovered in the liver during or after treatment of the original malice, the tip of the iceberg. It might just be that there are already multiple uitzaaiïngen in the liver, which can be with investigations not yet discovered, because they are still too small. Therefore, usually after 3 months a new CT scan or ECHO created. Is the number of then remained stable, can do a surgery or R.F.A. take place. Prove there in the meantime more metastasesbe visible, then has a surgery or usually no longer makes sense. R.F.A. As already described above, is a surgery or R.F.A. treatment only useful if all metastases can be deleted.
(For me, this is incomprehensible. There is always said that the quicker you clean out how tumors better. Now a patient a whopping 3 months wait. All time so to grow the tumor of an interoperable form to a inoperabele form and therefore another 3 months of uncertainty with a bomb in your body. Scientific research has shown-see elsewhere on this page-that a repetition of surgical removal of liver tumors (including via RFA) without difference in chances of success can be repeated a number of times. If R.F.A is applied to the skin closed. than very sensible R.F.A. as soon as possible, to apply to keep the patient under control and if there are metastases later show than the R.F.A. repeat one more time. The uitzaaiïngen that there are still small later recover, especially if there is a frequent control and can be removed again as with closed skin. So does Dr. Solbiati and Dr. Vogl)
RFA can be combined with chemotherapy?
There is no objection chemotherapy with surgery or the RFA technique to combine. It can in some cases very meaningful. If the size or number of metastases in too large, can be tried in the first instance the uitzaaiïngen with chemotherapy to treat. If it turns out that there is a good response to chemotherapy and there is a decrease in size or number, an operation or a R.F.A. treatment still occur.
