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Microwave ablation of the liver: how it works and who it suits | CION Cancer Clinics
Microwave ablation kills a liver tumour with heat delivered through a thin needle, without open surgery. For a small liver cancer in carefully chosen people, it can be a curative treatment. This page explains how it works, how the team decides whether it suits you, who it does not suit, and what happens on the day and afterwards. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- What is microwave ablation for liver cancer?
- How does the team decide whether microwave ablation suits me?
- What happens when you have microwave ablation?
- How does microwave ablation compare with surgery and TACE?
- Who is microwave ablation not right for?
- What this page cannot tell you
- Common questions about microwave ablation of the liver
The short answer
What is microwave ablation for liver cancer?
Microwave ablation destroys a liver tumour with heat, through a thin needle passed through the skin. For a small hepatocellular carcinoma (HCC, cancer that starts in the liver cells itself), it can be a curative treatment without open surgery.
How it works in one paragraph
A specialist called an interventional radiologist guides a needle into the tumour using ultrasound or CT. The tip of the needle gives off microwave energy, which makes the water inside the tumour cells vibrate and heat up. The cells cook and die. The dead tissue stays in place and slowly shrinks into a scar that the body leaves alone.
Who this page is about
This page is mainly about primary liver cancer, the kind that starts in the liver, often in a liver already scarred by hepatitis B, hepatitis C, alcohol or fatty liver disease. If your scan shows cancer that has spread to the liver from the bowel, breast or elsewhere, read ablation for liver metastases instead, because the decision is made differently.
Ablation is one option among several. Whether it suits you depends on the tumour, the health of the rest of your liver and your general fitness.Before anyone says yes
How does the team decide whether microwave ablation suits me?
Three things are weighed together at the tumour board. A small tumour alone is not enough.
The tumour
Ablation works best on a small tumour, or a few small ones, that the needle can reach safely. Larger tumours are harder to destroy completely in one go.
The team looks at
- How many tumours there are
- How big each one is
- Whether it has grown into a blood vessel
- Whether it sits next to the bowel, gallbladder or a large bile duct
The rest of the liver
Many people with HCC also have cirrhosis, meaning the liver is scarred and works less well. Ablation removes very little healthy liver, which is why it is often chosen when surgery would leave too little liver behind.
Your Child-Pugh score, a measure of how well the liver is coping, is part of this decision.Your general fitness
The procedure is shorter and gentler than an operation, but you still need to lie still under sedation or a general anaesthetic. Heart and lung health, blood clotting and platelet count are all checked first.
Why microwave and not another method
Microwave heats faster and reaches a larger zone than radiofrequency ablation, and is less affected by nearby blood vessels that carry heat away. The two are compared on RFA or microwave.
Not sure whether this applies to you?
Ask an oncologistFrom scan to scar
What happens when you have microwave ablation?
The tumour board reviews your scans
A triple-phase CT or MRI shows the tumour clearly. The team agrees that ablation is the right first step and that the needle has a safe path to it.
Blood tests and a fasting instruction
Clotting, platelets, kidney and liver tests are done beforehand. You are told when to stop eating and which of your usual medicines to pause, especially blood thinners.
The needle is placed under imaging
Under sedation or general anaesthetic, the radiologist passes the needle through a tiny cut in the skin and checks its position on the scan before switching anything on.
The tumour is heated with a safety margin
The aim is to destroy the tumour plus a thin rim of normal liver around it, so that no cancer cells are left at the edge. The track is often heated on the way out as well.
A follow-up scan checks the result
A contrast scan some weeks later shows whether the whole tumour has been destroyed. If a small part remains, it can often be treated again. See the follow-up scan after ablation.
Side by side
How does microwave ablation compare with surgery and TACE?
Microwave ablation
The usual alternatives
A needle through the skin, no large cut
Liver resection removes part of the liver through an operation
Often home within a day or two
Surgery needs a longer hospital stay and recovery
Can be curative for a small tumour
TACE usually controls a tumour rather than removing it
Spares almost all of the healthy liver
Resection needs enough healthy liver left behind
Less sure for larger tumours
TACE, or TACE plus ablation, may suit larger ones
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Did you know
A liver that has had one HCC is still at risk of growing a new one somewhere else, even after a successful ablation. That is why scans carry on long after treatment, and why a new spot is not always a sign that the ablation failed.
Being honest about limits
Who is microwave ablation not right for?
Ablation does not suit everyone with a small liver cancer. A tumour that has grown into the portal vein, the main vessel bringing blood into the liver, is usually treated differently. So is cancer that has already spread outside the liver.
When the position is the problem
A tumour pressed against the bowel, the gallbladder or a major bile duct can be hard to heat safely, because the heat can injure those structures. Sometimes a different needle path, or a different treatment, is safer. Why position can rule it out explains this in more detail.
When the liver is failing
If cirrhosis is very advanced, with fluid in the belly, jaundice or confusion, the tumour may not be the main threat. A transplant assessment or supportive care may matter more than treating the tumour itself. Uncontrolled bleeding tendency is another reason to wait or choose differently.
Being told ablation is not right for you is not the end of treatment. It means another route fits your liver better.Being straight with you
What this page cannot tell you
It cannot tell you whether microwave ablation is right for your tumour. That depends on the exact size and position on your scan, your liver function and your fitness, and it is decided by a team that has looked at your images, not by a description.
Where CION fits in
At CION, the tumour board and your oncologist review your scans and reports and decide whether ablation, surgery, TACE or another treatment is the right first step. CION coordinates ablation through accredited partner hospitals with interventional radiology teams, and your team will tell you where the procedure takes place. Medicines, follow-up and surveillance planning continue with your CION oncologist afterwards.
It cannot give you a price
Microwave ablation costs vary by hospital, the number of tumours and the needles used. Ask for a written, itemised estimate before the day. The ablation cost page explains what goes into the bill.
Questions we are asked
Common questions about microwave ablation of the liver
Can microwave ablation make liver cancer go away completely?
For a single small HCC, ablation is treated as a curative option, with results that can be close to surgery in carefully chosen people. It is not a promise. The liver can grow a new tumour later, which is why regular scans continue after treatment.
Is microwave ablation painful?
You are sedated or under general anaesthetic during the procedure, so you should not feel the heating. Afterwards there is often a dull ache under the right ribs or in the right shoulder for a few days, which ordinary pain relief usually manages. Tell the team if pain is getting worse rather than better.
How long will I stay in hospital?
Many people go home the same day or the next morning. Some stay a little longer if the liver is weak, if more than one tumour was treated or if fever or pain needs watching. Your team will tell you what to expect for your case before the day.
What is the fever I got after ablation?
Mild fever, tiredness and aches in the days after ablation are common and are called post-ablation syndrome. They come from the body clearing the dead tissue. High fever, shivering, worsening pain or yellowing of the eyes are different and need a doctor the same day.
Is microwave ablation better than RFA?
Both use heat through a needle. Microwave heats faster and is less affected by nearby blood vessels, so it is often preferred for slightly larger tumours or those near vessels. For a small tumour in a good position, both can work well. The radiologist's experience matters as much as the machine.
Can it be done if I have cirrhosis?
Yes, and that is often why it is chosen. Ablation spares nearly all of the healthy liver, so it can suit people whose cirrhosis makes surgery too risky. If cirrhosis is very advanced, with fluid, jaundice or confusion, the team may advise a different approach.
What if the scan shows some tumour left behind?
This is called incomplete ablation. A small leftover area can often be treated again with a second ablation, or with TACE. It is not unusual and does not mean the plan has failed. Your team will explain what the scan shows and the choices.
Does CION do microwave ablation itself?
CION's tumour board decides whether ablation suits you, and CION coordinates the procedure through accredited partner hospitals with interventional radiology teams. Your CION oncologist stays in charge of follow-up and surveillance. Call the helpline to have your scans reviewed.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- American Cancer Society — Liver Cancer Ablation: RFA, MWA, Cryotherapy, PEI, Histotripsy
- Cancer Research UK — Treatment for liver cancer
- EASL — EASL Clinical Practice Guidelines: management of hepatocellular carcinoma
- American Cancer Society — Treatment of Liver Cancer, by Stage
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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Could ablation work for my liver tumour?
Send us your latest scan and reports, and the CION tumour board will look at whether ablation, surgery or another route fits your liver. We will explain the options in plain words. One helpline serves every CION centre.