Liver cancer is a malignant disease that develops in the liver, an important organ responsible for filtering toxins from the blood, aiding digestion, and regulating various metabolic processes in the body. The most common type of liver cancer is hepatocellular carcinoma (HCC). This condition often occurs in individuals with chronic liver diseases, such as cirrhosis.
In its early stages, liver cancer often does not cause clear symptoms. As a result, many patients are only diagnosed when the disease has already progressed to an advanced stage, making treatment more complex.
With advances in medical technology, a modern therapy known as High-Intensity Focused Ultrasound (HIFU) is now available at Mandaya Royal Puri Hospital as one of the treatment options for liver cancer, particularly hepatocellular carcinoma (HCC), including in patients with cirrhosis. This therapy is performed by dr. Sugianto Santoso, Sp.Rad., (K)RI, a radiologist with a subspecialty in interventional radiology.
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What Is HIFU?
HIFU is a minimally invasive procedure that does not require surgical incisions. It uses high-intensity ultrasound waves to destroy tumor tissue. The ultrasound energy is precisely focused on the cancerous area, producing heat that damages tumor cells.
Through this method, cancerous tissue can be gradually destroyed without open surgery, while helping preserve the healthy tissue surrounding the tumor.
How HIFU Works for Liver Cancer
In general, HIFU therapy works by directing focused ultrasound energy directly at tumor tissue. The process can be explained simply as follows:
1. Incision-free procedure
HIFU therapy is performed without open surgery. The HIFU device is placed on the surface of the skin, and ultrasound waves are transmitted from outside the body toward the tumor located in the liver.
2. Ultrasound waves are directed at the tumor
Ultrasound energy with a specific frequency is precisely focused on the cancerous tissue so the tumor can be accurately targeted.
3. Temperature in the tumor area increases
When the energy is concentrated at that point, the temperature of the tumor tissue can rise to more than 60°C.
4. Destruction of cancer cells through thermal ablation
This very high temperature causes permanent damage to cancer cells. The process, known as thermal ablation, gradually leads to tumor cell death.
5. Protecting healthy liver tissue
Because the heat energy is focused only on the tumor area, the surrounding liver tissue remains relatively protected. This is particularly important for patients with cirrhosis, whose liver function is already compromised.
Criteria for Liver Cancer Patients Who May Undergo HIFU Therapy
HIFU therapy can be considered as a treatment option for liver cancer in certain conditions. In general, this method may be recommended for patients with the following characteristics:
1. Patients with primary liver cancer (HCC)
HIFU is most commonly used for hepatocellular carcinoma (HCC), the most common type of primary liver cancer. This method allows tumor destruction without major surgery.
2. Patients with advanced liver cirrhosis
In some cases, patients with severe cirrhosis, including those with fluid buildup in the abdomen (ascites) or fluid around the lungs (pleural effusion), may still be considered for HIFU therapy. However, the decision depends on a comprehensive medical evaluation by the doctor.
3. Tumors clearly visible on ultrasound
HIFU procedures are performed with the assistance of medical imaging. Therefore, tumors that can be clearly seen through ultrasound are generally easier and more optimal to treat using this method.
4. Tumors located in difficult areas
Some liver tumors are located in challenging areas, such as near the diaphragm, ribs, stomach, intestines, gallbladder, heart, major blood vessels, or bile ducts. With special techniques and careful planning, HIFU therapy can still be performed safely and precisely in these situations.
Clinical Study Results on HIFU for Liver Cancer
Several studies show promising results from the use of HIFU in patients with HCC and cirrhosis.
1. Very low risk of serious complications
In a study involving 55 patients with large liver tumors (average diameter around 8 cm) and cirrhosis, HIFU therapy did not result in serious complications during or after the procedure.
2. High tumor destruction success rate
Among patients who underwent follow-up evaluation, about 69.2% showed complete tumor destruction (complete ablation) after therapy.
3. Favorable survival rates
The study also reported patient survival rates of about 61.5% at 12 months and 35.3% at 18 months after undergoing HIFU therapy.
4. Combining HIFU and TACE may improve outcomes
Other research indicates that combining HIFU with TACE (Transarterial Chemoembolization) can produce better survival outcomes compared with TACE alone in patients with advanced liver cancer.
These findings suggest that HIFU, whether used as a primary therapy or combined with other methods, has strong potential as an effective alternative treatment for hepatocellular carcinoma (HCC) in patients with cirrhosis.
Interventional Radiology Specialist for HIFU at Mandaya Royal Puri Hospital
HIFU therapy at Mandaya Royal Puri Hospital is performed by dr. Sugianto Santoso, Sp.Rad., (K)RI, a radiology specialist with a subspecialty in interventional radiology who has extensive experience in minimally invasive procedures for cancer diagnosis and treatment, including liver cancer.
In his practice, dr. Sugianto utilizes various medical imaging technologies such as ultrasound, CT scan, MRI, and fluoroscopy to ensure procedures are performed accurately and safely. In addition to HIFU therapy, he is also experienced in performing other interventional procedures such as TACE, Radiofrequency Ablation (RFA), and Microwave Ablation to destroy tumor tissue without major surgery.
dr. Sugianto completed his medical degree at Maranatha Christian University in Bandung, and later pursued his specialization in Radiology at the University of Indonesia.
Practice Schedule at Mandaya Royal Puri Hospital
dr. Sugianto Santoso, Sp.Rad, (K)RI is available for consultation at Mandaya Royal Puri Hospital on:
- Tuesday: 16:00 – 20:00 WIB
- Thursday: 16:00 – 20:00 WIB
To make your visit easier, you can use the WhatsApp Chat, Book Appointment feature, or the Care Dokter application, available on Google Play and App Store, to schedule appointments, check queue numbers, and access other service information.
