At a glance
Microwave ablation is a minimally invasive procedure that destroys tumour tissue by heating it with microwave energy delivered through a thin needle.
A radiologist guides a needle-like probe directly into the tumour, usually using CT or ultrasound imaging to see exactly where the tip sits. The probe then emits microwaves that cause water molecules inside the tumour cells to vibrate rapidly, generating heat that kills the cells. The destroyed tissue is gradually absorbed or scarred over by the body in the weeks that follow.
Medical Condition
Microwave ablation is used when a tumour needs to be destroyed but surgery carries too high a risk, or when the patient's overall condition makes an operation inadvisable.
- Primary liver cancer (hepatocellular carcinoma, a cancer that starts in liver cells)
- Secondary liver tumours, where cancer has spread to the liver from another organ such as the colon
- Kidney (renal) tumours that are small and localised
- Lung tumours, especially in patients who cannot tolerate surgery
- Thyroid nodules or tumours when surgery is not preferred
- Bone metastases (cancer that has spread to bone) causing pain that has not responded to other treatments
- Adrenal gland tumours in selected cases
Microwave ablation is generally not suitable in certain situations.
- Tumours larger than about five centimetres, where complete destruction is harder to guarantee
- Tumours located very close to major blood vessels, bile ducts, or the bowel, where heat could cause serious collateral damage
- Patients with uncontrolled blood clotting problems that cannot be corrected before the procedure
- Widespread disease throughout the body where local ablation would not change the overall treatment plan
- Active infection at or near the planned needle entry site
Risks & Complications
Microwave ablation is considered a low-risk procedure compared to open surgery, but like any intervention that enters the body, it carries recognised complications.
- Pain or discomfort at the needle entry site, usually mild and manageable with pain relief
- Fever and flu-like symptoms in the days after, as the body responds to destroyed tissue
- Bleeding at the probe insertion site or, rarely, inside the body
- Infection at the skin entry point or, in rare cases, inside the treated area
- Damage to nearby structures, such as the bile duct, bowel, or a major blood vessel, if the tumour sits very close to them
- Incomplete ablation, meaning some tumour cells survive and the tumour may regrow
- A small collection of air around the lung (pneumothorax) if a lung or chest tumour is treated
- Skin burns near the needle entry point
- Rarely, damage to nerves close to the treatment site
Preparation & Procedure
In the days before the procedure, the medical team will ask the patient to make several adjustments to reduce bleeding risk and help the body recover well.
Blood thinners such as aspirin, anticoagulants, and certain anti-inflammatory tablets are usually paused several days before the procedure, under the guidance of the treating doctor. Smoking and alcohol are best avoided for at least the week before, since both impair healing and anaesthesia response. The patient is typically asked to stop eating solid food six hours before the scheduled start time and to stop drinking even water two hours before.
Several tests are usually ordered beforehand to plan the procedure and confirm the patient is safe to proceed.
- Blood tests to check liver and kidney function, blood cell counts, and clotting ability
- CT or MRI scan to map the tumour's exact size, location, and relationship to nearby structures
- Ultrasound if the target is in the liver or kidney
- An electrocardiogram (ECG, a recording of the heart's electrical activity) if sedation or general anaesthesia is planned
- Chest X-ray in some cases
On the day of the procedure, the steps typically unfold in this order.
- The patient changes into a hospital gown and an intravenous (IV) line is placed in the arm to deliver fluids and medication.
- Vital signs are recorded and a sedative or, in some centres, general anaesthesia is given so the patient is comfortable and still.
- The skin over the target area is cleaned and a sterile drape is placed around it.
- Local anaesthetic (numbing medicine) is injected at the planned entry point.
- The radiologist uses real-time CT or ultrasound imaging to guide the microwave probe through the skin and into the tumour.
- Once the probe tip is correctly positioned, microwave energy is switched on for a set period, usually several minutes per cycle.
- The probe is repositioned if the tumour is large enough to require overlapping treatment zones.
- A final scan confirms the treated zone covers the tumour adequately.
- The probe is withdrawn and a small dressing is applied to the skin entry point.
Aftercare
Most patients are monitored in hospital for several hours after the procedure, and some stay overnight depending on which organ was treated and how the recovery goes.
- Vital signs, pain levels, and the entry site are checked regularly in the hours immediately after the procedure.
- A follow-up scan, usually CT or MRI, is typically done within four to six weeks to see how well the tumour has been destroyed and whether any active tissue remains.
- Pain at the treatment site is common for a few days and is usually managed with tablets rather than strong medication.
- Fever and fatigue in the first week are normal responses to the body clearing destroyed tissue; the care team will advise on when these warrant a call to the clinic.
- Heavy lifting, strenuous exercise, and driving are usually restricted for one to two weeks, though the exact period depends on the organ treated.
- The small skin wound needs to be kept clean and dry; the care team will provide specific instructions on dressing changes.
- Alcohol should be avoided for at least several weeks after treatment to the liver.
- Regular follow-up imaging, often every few months in the first year, allows the oncology team to monitor for any regrowth.
- Lifestyle changes such as quitting smoking and maintaining a healthy weight are part of the longer-term management plan for most patients.
Cost & What Determines It
The cost of microwave ablation varies widely from one patient to the next, because the procedure is highly tailored to the individual tumour, the organ involved, and the setting in which it is performed.
- Tumour complexity: the number, size, and location of tumours directly affect how long the procedure takes and how many treatment cycles are needed.
- Hospital class and country: a university hospital, a private specialist centre, and a public hospital in different countries price the same procedure differently based on infrastructure and staffing costs.
- Type of imaging guidance used: CT-guided ablation typically carries different facility fees than ultrasound-guided ablation.
- Anaesthesia type: local anaesthesia with sedation costs less than general anaesthesia, which also requires an anaesthesiologist's fee.
- Length of stay: an overnight admission adds room, nursing, and catering charges that a same-day discharge does not.
- Consumables: microwave probes are single-use, and the number of probes required for a session depends on tumour size and shape.
- Pre-procedure imaging: CT or MRI scans ordered specifically for planning the ablation may or may not be bundled into the procedure cost.
- Post-procedure follow-up scans: imaging done at four to six weeks and at later intervals is usually billed separately.
- Oncology consultations: fees for the radiologist, the oncologist supervising care, and any other specialists involved are sometimes separate line items.
Hospital packages often include the procedure room, the probe, imaging guidance during the ablation itself, the recovery room, and a standard length of stay. Pre-procedure blood tests, planning scans, anaesthesiologist fees, post-discharge medications, and follow-up imaging are frequently invoiced separately, so reviewing an itemised quote is the clearest way to understand what is covered.
BPJS Kesehatan does not cover treatment received abroad, and most Indonesian private health insurance policies also exclude overseas care. Patients travelling for this procedure typically pay out of pocket or hold an international private health insurance policy that explicitly covers oncology procedures abroad. Before travelling, requesting a written, itemised cost estimate from the hospital avoids unexpected bills on arrival and allows a fair comparison between options.
Frequently Asked Questions
How many sessions of microwave ablation will I need?
Most patients need only one session, though some tumors require a second treatment depending on their size and location. Your doctor will review imaging results after the procedure to decide whether any follow-up ablation is needed.
What does microwave ablation feel like during and after the treatment?
During the procedure you are sedated or given local anaesthesia, so most patients feel little to nothing at the time. Afterward, it is common to experience mild soreness, a low-grade fever, or fatigue for a few days, which doctors call post-ablation syndrome. These feelings usually ease on their own within a week.
How soon will I know if microwave ablation worked?
Doctors typically schedule a follow-up scan, usually a CT or MRI, about four to six weeks after the procedure to assess how the treated area has responded. Tumors do not disappear immediately; instead, the treated tissue gradually breaks down over weeks to months. Your care team will track progress through repeat imaging at regular intervals.
How much does microwave ablation cost?
The cost depends on several factors specific to your case, including the number and size of tumors being treated, the imaging guidance used during the procedure, the hospital class, and the length of any hospital stay required. A written estimate from the hospital, based on your scans and medical records, is the most reliable way to get a real figure.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
