Liver cancer is a type of cancer that occurs when cells in the liver grow abnormally and form tumors. The liver itself plays an important role in the body, such as aiding digestion, filtering toxins from the blood, and regulating the metabolism of various essential substances. The most common type of liver cancer is hepatocellular carcinoma (HCC), which generally develops in patients with chronic liver disease, such as cirrhosis.
One of the challenges in treating liver cancer is that symptoms often do not appear in the early stages. Many patients only realize they have the disease after the tumor has grown quite large or when the disease has progressed to an advanced stage. This condition makes treatment options more limited and requires a more complex therapeutic approach.
Today, a modern non-surgical treatment option for liver cancer is available, known as High-Intensity Focused Ultrasound (HIFU). This technology is available at Mandaya Royal Hospital Puri and is performed by Sugianto Santoso, Sp.Rad, (K)RI and dr. Hendra Koncoro, Sp.PD-KGEH.
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Understanding HIFU Technology for Destroying Liver Tumors
HIFU is a therapeutic method that uses high-energy ultrasound waves to destroy tumor tissue. Unlike conventional surgery, this procedure is performed without any incision because the ultrasound energy is delivered from outside the body and focused directly on the tumor inside the liver.
When the ultrasound energy is concentrated on the tumor area, the temperature in the tissue increases to more than 60°C. This high temperature causes permanent damage to cancer cells, preventing them from growing further. This process is known as thermal ablation, which means destroying tumor tissue using heat.
Because the energy is directed with very high precision, the surrounding healthy liver tissue can remain protected. This approach is particularly important for patients who already have impaired liver function, such as those with cirrhosis.
Who Can Undergo HIFU Therapy for Liver Cancer?
Not all liver cancer patients have the same condition. Therefore, HIFU therapy is usually considered after a comprehensive medical evaluation by a doctor. In general, this therapy may be an option in the following conditions:
1. Patients with primary liver cancer (HCC)
HIFU is widely used in HCC cases because it can destroy tumors directly without the need for major surgery.
2. Patients with liver cirrhosis
Even in patients with relatively severe cirrhosis, including those who experience fluid accumulation in the abdomen (ascites) or fluid in the chest cavity (pleural effusion), HIFU therapy can still be considered as a treatment option.
3. Tumors that can be visualized through ultrasound
HIFU procedures are performed with the assistance of medical imaging such as ultrasound (USG). Therefore, tumors that can be clearly visualized through this examination are generally more optimal for treatment 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 can still be performed safely in these conditions.
How Is the HIFU Procedure Performed?
In general, the HIFU therapy process is carried out through the following stages:
1. The procedure is performed without surgery
The HIFU device is placed on the surface of the patient’s skin. From this device, ultrasound waves are directed toward the tumor inside the body.
2. Ultrasound energy is focused on the tumor tissue
Sound waves with a specific frequency are concentrated on a very small point within the cancer tissue.
3. Temperature increases in the tumor
When the energy accumulates at that point, the temperature of the tumor tissue rises to more than 60°C.
4. Cancer cells are destroyed by heat
The high temperature causes permanent damage to cancer cells so they can no longer survive.
5. Healthy tissue remains protected
Because the heat is focused only on a specific point, the surrounding liver tissue remains relatively safe. This is especially important for patients whose liver function has already declined.
Research Results on HIFU for Liver Cancer
Several studies have shown promising results regarding the use of HIFU for liver cancer patients, including those with cirrhosis.
- Low risk of complications: In a study involving 55 patients with large liver tumors (average size around 8 cm) and cirrhosis, HIFU therapy showed no severe complications during or after the procedure.
- High tumor ablation success rate: Among patients who were further evaluated, around 69.2% experienced complete tumor destruction after undergoing the therapy.
- Patient survival rates: The study also showed that patient survival rates reached approximately 61.5% after 12 months and 35.3% after 18 months following treatment.
- Combination with other therapies: In some cases, HIFU can also be combined with other methods such as TACE (Transarterial Chemoembolization). Research shows that this combination therapy can provide better survival outcomes compared to TACE alone in patients with advanced liver cancer.
These findings indicate that HIFU has strong potential as an effective therapeutic approach, either as a primary therapy or as part of combination treatment.
HIFU Specialists for Liver Cancer at Mandaya Royal Hospital Puri
The following doctors are part of the HIFU specialist team for liver cancer treatment at Mandaya Royal Hospital Puri:
1. dr. Sugianto Santoso, Sp.Rad, (K)RI
HIFU therapy for liver cancer at Mandaya Royal Hospital Puri is performed by dr. Sugianto Santoso, Sp.Rad, (K)RI, a radiology specialist with a subspecialty in interventional radiology.
In his practice, he uses various medical imaging technologies such as Ultrasound, CT Scan, MRI, and fluoroscopy to ensure procedures are performed with high precision. In addition to HIFU, he is also experienced in various minimally invasive procedures to destroy tumors without major surgery, such as TACE, Radiofrequency Ablation (RFA), and Microwave Ablation.
dr. Sugianto completed his medical degree at Maranatha Christian University Bandung and continued his radiology specialist training at the University of Indonesia.
dr. Sugianto Santoso, Sp.Rad, (K)RI is available at Mandaya Royal Hospital Puri on:
- Tuesday: 16.00 – 20.00 WIB
- Thursday: 16.00 – 20.00 WIB
2. dr. Hendra Koncoro, Sp.PD-KGEH
dr. Hendra Koncoro, Sp.PD-KGEH is an internal medicine specialist with a consultant subspecialty in gastroenterohepatology, focusing on the treatment of various digestive and liver diseases. He treats conditions such as liver cancer, gallstones, fatty liver, liver nodules, liver cirrhosis, and bile duct cancer.
dr. Hendra completed his medical degree at Atma Jaya Catholic University, then pursued a Master of Biomedical Science and internal medicine specialist training at Udayana University. He also earned his consultant degree in Gastroenterology and Hepatology from the University of Indonesia.
In his practice, dr. Hendra provides comprehensive internal medicine services, particularly related to digestive and liver health. Available services include internal medicine consultations, liver function tests, kidney function tests, lipid profile tests, urine tests, as well as supporting examinations such as CT Scan and MRI Scan to help establish a more accurate diagnosis.
dr. Hendra Koncoro, Sp.PD-KGEH is available at Mandaya Royal Hospital Puri on:
- Wednesday: 10.30 – 12.30 WIB
- Saturday: 10.30 – 12.30 WIB
To make your visit easier, you can use the Chat via WhatsApp, Book Appointment, or the Care Dokter application, which can be downloaded from Google Play and the App Store to schedule visits, check queue numbers, and access other complete information.
