Ablation of liver tumours (heat treatment) (Radiofrequency / microwave ablation of liver tumours)
A scan-guided treatment that uses heat from a fine needle-like probe to destroy small liver tumours without removing them, used when surgery is not the best option.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Ablation uses heat from a scan-guided probe to destroy small liver tumours without removing them.
- It is mainly for smaller tumours (often up to about 3cm) and may not be possible if a tumour is large or sits next to big blood vessels, the bowel or the bile ducts.
- It is usually a day case or one overnight stay, with many people back to normal in around a week.
- It treats only what is targeted — a follow-up scan checks the result, and the cancer can still come back, so it is part of a wider plan agreed by a specialist team.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Can destroy small liver tumours without removing part of the liver
The tumour is large (often more than about 3cm) or there are many tumours, where ablation alone is less likely to clear the cancer.
You rest and are monitored. Pain over the liver is common and is treated with painkillers. You can usually eat and drink once the sedation or anaesthetic...
A named contact and clear instructions on who to call if you feel unwell after going home.
You rest and are monitored. Pain over the liver is common and is treated with painkillers. You can usually eat and...
Most people go home the same day or after one night. You should not drive, sign legal documents or be alone if you...
Aching and a flu-like feeling with a mild temperature are common (post-ablation syndrome). This usually eases over...
Most people are back to normal activity. A follow-up scan is usually arranged at around 4–6 weeks to check whether...
What is ablation of liver tumours?
Ablation is a way of destroying a tumour inside the liver using heat, without cutting it out. A doctor called an interventional radiologist passes a thin needle-like probe through the skin and into the tumour, using an ultrasound or CT scanner to guide it. The probe then heats the tumour until the cancer cells are destroyed. Radiofrequency ablation (RFA) makes the heat using a radio-wave electrical current; microwave ablation (MWA) uses microwave energy. They work in a similar way and your team will choose the one they think suits your tumour best.
Ablation is mainly used for small tumours, often those up to about 3cm, when removing part of the liver with surgery is not the best choice — for example because of where the tumour sits, or because surgery would be too much for your body to cope with. It can be used for cancer that started in the liver, and for some cancers that have spread to the liver from elsewhere, such as bowel cancer.
Ablation can destroy the tumours it targets, but it does not treat cancer cells the scans cannot see. It is one part of a wider cancer plan, and the decision is made by a specialist liver cancer multidisciplinary team (MDT) after scans and staging. It does not, on its own, guarantee that the cancer will not come back.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Ablation compared with liver surgery
| Ablation | Liver surgery (resection) |
|---|---|
| No large cut; needle through the skin | Cut to remove part of the liver |
| Best for small tumours (often up to ~3cm) | Can remove larger tumours |
| Day case or one night | Several days in hospital |
| Quicker recovery, often about a week | Longer recovery, several weeks |
| Higher chance of regrowth at the site for larger tumours | May give a better chance of clearing larger tumours |
Which is right depends on the tumour, your liver and your general health. The liver cancer team weighs this up for you.
Preparing for your procedure
- You will usually have up-to-date scans (such as CT or MRI) so the team can plan the safest route to the tumour.
- Tell the team about all your medicines, especially blood thinners, as some need to be paused beforehand.
- Blood tests check how your liver and blood clotting are working.
- You will be asked not to eat (and sometimes not to drink) for a few hours beforehand if you are having sedation or a general anaesthetic.
- Arrange a lift home and someone to stay with you that night, as you should not drive after sedation or anaesthetic.
- Tell the team if you might be pregnant, as scans and the procedure may need to be reconsidered.
- Ask what the plan is if the tumour cannot be reached safely on the day.
What happens
You will usually have a small tube (cannula) placed in a vein for fluids and medicines. Most people have either sedation with local anaesthetic to numb the skin, or a general anaesthetic so they are asleep.
Using an ultrasound or CT scanner to see inside, the interventional radiologist passes one or more fine probes through the skin and into the tumour. The probe is then heated for a set time to destroy the tumour and a small rim of tissue around it, which helps reduce the chance of regrowth. More than one probe, or more than one heating, may be needed for larger or awkwardly placed tumours.
The probe is removed and a small dressing is placed over the skin. The whole procedure usually takes from about 30 minutes to a couple of hours. You will be monitored afterwards, and most people go home the same day or after one night.
Is this procedure right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- The tumour is large (often more than about 3cm) or there are many tumours, where ablation alone is less likely to clear the cancer.
- The tumour sits very close to the bowel, gallbladder, large bile ducts or major blood vessels, where heat could cause injury.
- Blood clotting is too poor to pass a probe safely, or it cannot be corrected.
- The cancer has spread widely, so destroying one liver tumour would not change the overall plan.
- Liver function is too poor to cope with the treatment.
Delay or rearrange if…
- You have an active infection or are generally unwell.
- Blood thinners have not yet been safely paused, or clotting needs correcting first.
- Up-to-date scans are not available to plan a safe route.
- You might be pregnant and this has not been discussed.
- Your cancer plan is still being decided by the multidisciplinary team.
Alternatives to discuss
- Surgery to remove part of the liver (resection), especially for larger or accessible tumours.
- Treatments given through the liver's blood supply, such as embolisation or selective internal radiotherapy.
- Systemic treatments such as chemotherapy or targeted therapy.
- Stereotactic (focused) radiotherapy in selected cases.
- Active monitoring, or best supportive care, depending on the situation.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Can destroy small liver tumours without removing part of the liver
- Avoids a large operation, with a shorter stay and quicker recovery
- May be an option when surgery is not possible or would be too risky
- Can be repeated if a new small tumour appears later
- Spares most of the healthy liver, as the heat only travels a short distance
Risks & complications
- Pain or aching over the liver area for a few days
- Flu-like feeling with a mild temperature (often called post-ablation syndrome), usually settling within a week or two
- Bruising or soreness where the probe went in
- Pain felt in the shoulder tip from irritation near the diaphragm
- Bleeding around the liver
- Infection, sometimes forming a collection of pus (abscess) that needs draining
- A collection of fluid or air around the lung if the tumour is high up
- The tumour not being fully destroyed, needing repeat treatment
- Injury to nearby structures such as the bowel, gallbladder or bile ducts
- Damage to a bile duct causing a leak or narrowing
- Tumour cells seeding along the needle track
- A serious complication needing emergency surgery or, very rarely, that is life-threatening
The main risks depend on where the tumour sits — tumours close to the bowel, gallbladder, bile ducts, large blood vessels or the surface of the liver are harder to treat safely. Ask how many of these procedures the team does, what they will do if the tumour is in a difficult spot, and how they will check the tumour has been fully treated.
Published figures to discuss
Reliable figures vary widely with tumour type, size, number and position, the technique used, and how fit the patient is, so single numbers can be misleading. In general, serious complications after liver ablation are uncommon, but tumours in difficult positions carry higher risk, and the chance of the tumour regrowing at the treated site rises with tumour size. Comparisons between radiofrequency and microwave ablation show broadly similar safety, with some studies suggesting microwave ablation may reduce regrowth for certain tumours.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Serious complications overall | Uncommon — low single figures in percentage terms in many series | Higher when tumours sit near the bowel, bile ducts, gallbladder or major vessels; ask about your specific tumour. | Microwave vs radiofrequency ablation for liver metastases — systematic review (PMC)pmc.ncbi.nlm.nih.govSource-linked context |
| Tumour regrowth at the treated site | Varies widely; higher for larger tumours and those near big blood vessels | A clear rim of destroyed tissue around the tumour lowers this risk; follow-up scans look for it. | Microwave vs radiofrequency ablation for liver metastases — systematic review (PMC)pmc.ncbi.nlm.nih.govSource-linked context |
| Need for repeat ablation | Not fixed — depends on tumour size, position and follow-up findings | Small tumours can often be re-treated if they regrow or if a new one appears. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Recovery from ablation is usually much quicker than from liver surgery. Most people are sore for a few days and back to normal activities within about a week, though this varies with your general health and the size of the treated area.
- Aching or soreness over the liver for a few days
- A mild temperature and tiredness in the first week or two
- A small bruise or tender spot where the probe went in
- Shoulder-tip discomfort that settles
- Waiting several weeks for the follow-up scan that shows the result
Aftercare
- Take painkillers as advised; paracetamol is often enough but tell the team if pain is severe or worsening.
- Keep the small skin wound clean and dry as instructed.
- Rest for a few days and avoid heavy lifting or strenuous activity in the first week.
- Drink enough fluids and eat normally unless told otherwise.
- Restart any paused medicines, including blood thinners, only when your team says it is safe.
- Go to your follow-up scan and clinic appointment so the result can be checked.
- Know who to contact if you feel unwell, and keep that number to hand.
- Lift home and someone to stay overnight arranged
- Painkillers (such as paracetamol) at home
- Clear instructions on restarting blood thinners
- Follow-up scan and clinic appointment booked
- Clinic or out-of-hours number saved
- A few light days planned off work
Scars and how they heal
Ablation through the skin leaves only a tiny puncture mark, not a surgical scar. There may be a small bruise or tender spot for a week or two, which usually fades. If ablation is done during keyhole or open surgery, the scars relate to that operation rather than to the ablation itself.
⚠ Get urgent help if…
- Severe or worsening tummy pain that painkillers do not control
- A high temperature, shivering or feeling very unwell (possible infection)
- Yellowing of the skin or eyes, or pale stools and dark urine (possible bile duct problem)
- Increasing breathlessness or chest pain
- Vomiting blood, black tarry stools, or feeling faint and dizzy (possible bleeding)
- Bleeding or spreading redness at the skin wound
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result means the follow-up scan, usually after about 4–6 weeks, shows that the whole tumour and a small rim around it have been destroyed, with no living tumour left at the site. Your team will explain what your scan shows.
Ablation cannot prove there are no other cancer cells elsewhere in the liver or body, and it does not change the original cancer's behaviour. New tumours can appear later, and treated areas can sometimes regrow, which is why regular scans continue afterwards.
How long the benefit lasts depends on the type and stage of the cancer, the size and number of tumours, and the health of your liver. Small tumours that are fully destroyed may not come back at that site, but the underlying cancer or liver condition can still produce new tumours over time. Ablation can often be repeated for new small tumours, and it may be combined with other treatments as part of a longer-term plan.
Related tests, treatments or support
Ablation is often used alongside other treatments. It may be combined with chemotherapy, with treatments given through the liver's blood supply (such as embolisation), or with surgery for other tumours. For cancer that has spread to the liver from elsewhere, the original cancer is also treated under its own plan. Your multidisciplinary team decides how these fit together.
Follow-up & long-term care
You will have regular follow-up scans, starting at around 4–6 weeks and then at intervals decided by your team, to check the treated area and look for any new tumours. You will also be seen in clinic to discuss the results and the next steps, and to manage any side effects.
- Attend all follow-up scans, as new or recurrent tumours are often easiest to treat when small.
- Keep up any treatment for the underlying liver condition or original cancer.
- Tell your team promptly about new symptoms such as pain, weight loss or jaundice.
- Follow advice on alcohol and general liver health if you have liver disease.
Repeat, follow-on and what comes next
- If a follow-up scan shows living tumour left behind, repeat ablation or a different treatment may be offered.
- New tumours elsewhere in the liver are common with liver cancer and may be treated again rather than counted as a 'failure'.
- Some difficult tumours may turn out to need surgery or another approach instead.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A named contact and clear instructions on who to call if you feel unwell after going home.
- Written advice on pain relief, the expected flu-like feeling, and warning signs to act on.
- A booked follow-up scan (usually at about 4–6 weeks) and clinic appointment to discuss the result.
- A clear plan for ongoing scan surveillance and for treating any regrowth or new tumours.
- Coordination with the wider cancer team so ablation fits the overall treatment plan.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether the procedure is done through the skin or during keyhole or open surgery
- Whether sedation or a general anaesthetic is used, and the anaesthetist's fee
- The number of tumours treated and how many probes or sessions are needed
- The scans needed to plan and to check the result afterwards
- The interventional radiologist's fee and the facility or hospital charge
- Whether an overnight stay is needed
- Follow-up scans and clinic appointments
- The interventional radiologist's fee and the hospital or facility fee
- Sedation or anaesthetic costs
- Planning scans and the follow-up scan to check the result
- Follow-up clinic appointments
- What happens (and what it costs) if the tumour is not fully destroyed and repeat treatment is needed
- What happens if a complication needs further treatment or admission
- The cancellation policy
On the NHS? Ablation of liver tumours is provided on the NHS when a specialist liver cancer team decides it is appropriate; private care may be used for speed, choice or a second opinion, but the same team-based decision-making should apply.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Presenting ablation as a cure without explaining that it treats only what is targeted and that the cancer can come back.
- Not explaining that tumour position (near bowel, bile ducts or vessels) changes the risk.
- No plan described for what happens if the tumour is not fully destroyed.
- No mention of post-ablation syndrome, so the flu-like feeling afterwards comes as a surprise.
- Skipping the multidisciplinary team decision and offering ablation in isolation.
Marketing red flags
- Claims that ablation 'removes the cancer completely' or guarantees a cure.
- Describing it as 'no risk' or 'usually not painful' rather than usually lower-risk with real, if uncommon, complications.
- Offering ablation without a clear cancer diagnosis, staging and multidisciplinary team discussion.
- Downplaying the need for ongoing follow-up scans.
Choosing a specialist safely
- Check the surgeon is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the surgeon who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Why is ablation being recommended rather than surgery or another treatment for me?
- Will you use radiofrequency or microwave ablation, and why?
- Where is my tumour, and does its position make ablation more difficult or risky?
- How will you check the tumour has been fully destroyed, and what happens if it has not?
- How likely is the cancer to come back, and could ablation be repeated?
- How does this fit with my other treatments and overall cancer plan?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my procedure, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this procedure not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is ablation available on the NHS or only privately?
Is it painful?
How is this different from surgery?
Will it cure my cancer?
Can it be done more than once?
How soon will I know if it worked?
Find a verified surgeon for ablation of liver tumours (heat treatment)
Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.
No verified consultants list this procedure yet — browse the full directory.
How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NICE — Microwave ablation for treating liver metastases (IPG553) NICE — Microwave ablation for treating liver metastases (HTG409) Cancer Research UK — Heat treatment for liver cancer (thermal ablation) Cancer Research UK — Radiofrequency ablation (RFA) Macmillan Cancer Support — Ablation for liver cancer Microwave vs radiofrequency ablation for liver metastases — systematic review (PMC)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: CT scan · MRI scan · Ultrasound scan · Gallbladder removal (cholecystectomy) · Bowel cancer surgery