Gastrointestinal Stromal Tumor (GIST)

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Treating Gastrointestinal Stromal Tumor (GIST) TOPICS

Ablation and embolization to treat gastrointestinal stromal tumors

Treatments such as ablation and embolization are often used to treat cancers that start in the liver, but they can also be used to treat areas of cancer spread in the liver.

Ablation

Ablation can be used to destroy tumors in the liver caused by the spread of gastrointestinal stromal tumor (GIST). This technique can be used if there are a few small tumors in the liver. Because ablation often destroys some of the normal tissue around the tumor, it might not be a good choice for treating tumors near major blood vessels, the diaphragm (the muscle under the lungs), or major ducts in the liver.

Usually, you will not need to stay in the hospital for this type of treatment. Often, ablation can be done without surgery by inserting a needle or probe into the tumor through the skin. The needle or probe is guided into place with ultrasound or CT scanning. Sometimes, though, to be sure the treatment is aimed at the right place, it is done during surgery.

There are several types of ablation:

  • Radiofrequency ablation (RFA), which uses high-energy radio waves to heat the tumor and destroy cancer cells.
  • Ethanol (alcohol) ablation, where concentrated alcohol is injected directly into the tumor to kill cancer cells.
  • Microwave thermotherapy, where microwaves transmitted through a probe placed in the tumor are used to heat and destroy the cancer cells.
  • Cryosurgery (cryotherapy), which destroys a tumor by freezing it using a thin metal probe. This method sometimes requires general anesthesia (where you are deeply asleep and not able to feel pain).

Possible side effects after ablation therapy include abdominal pain, infection in the liver, and bleeding into the chest cavity or abdomen. Serious complications are uncommon, but they can happen.

Embolization

Embolization is a procedure that injects substances to try to block or reduce the blood flow to cancer cells in the liver.

The liver is unusual in that it has 2 blood supplies. Most normal liver cells are fed by branches of the portal vein, whereas cancer cells in the liver are usually fed by branches of the hepatic artery. Blocking the branch of the hepatic artery feeding the tumor helps kill off the cancer cells, but it leaves most of the healthy liver cells unharmed because they get their blood supply from the portal vein.

Embolization does reduce some of the blood supply to the normal liver tissue, so it may not be a good option for some patients whose liver has been damaged by diseases such as hepatitis or cirrhosis.

The main type of embolization used to treat gastrointestinal stromal tumors that have spread to the liver is arterial embolization (also known as trans-arterial embolization or TAE). In this procedure a catheter (a thin, flexible tube) is put into an artery through a small cut in the inner thigh and threaded up into the hepatic artery in the liver. A dye is usually injected into the bloodstream at this time to help the doctor monitor the path of the catheter via angiography, a special type of x-ray. Once the catheter is in place, small particles are injected into the artery to plug it up.

Typically, you will not have to stay in the hospital for this treatment.

Possible complications after embolization include abdominal pain, fever, nausea, infection in the liver, gallbladder inflammation, and blood clots in the main blood vessels of the liver. Because healthy liver tissue can be affected, there is a risk that liver function will get worse after embolization. This risk is higher if a large branch of the hepatic artery is embolized. Serious complications are not common, but they are possible.


Last Medical Review: 04/04/2014
Last Revised: 05/09/2014