What is Radiofrequency Ablation?
Radiofrequency ablation (RFA) is a treatment for tumors found in the liver, lung and kidney and is being studied in breast and bone tumors. In some cases, tumors cannot be destroyed by chemotherapy, radiation or surgery. RFA uses heat to attack these tumors, destroying them without hospitalization and with few side effects.
RFA is performed by placing a small needle into the center of the tumor being treated. This specially designed needle is connected to a radiofrequency generator, which heats the needle tip, and in turn, the tumor cells, killing them. It is possible to have more than one tumor heated during the procedure. It takes approximately 30 minutes per tumor. This procedure damages the tumor only, sparing surrounding healthy tissue.
Is RFA an appropriate treatment for me?
RFA only treats tumors in the area where the needle is placed and will have no effect on any other cancer in your body. For this reason, RFA may be used in conjunction with other treatments that can reach cancer cells in other areas of the body. Tumors that may be treated by RFA include:
- Hepatoma (primary liver cancer).
- Kidney tumors.
- Metastasis (spread) to the liver from solid tumors (i.e. lung, breast, colon cancers).
- Lung tumors (primary lung cancer or lung metastasis from cancer in another part of the body).
- Metastasis in the bones from cancer in another part of the body.
- Breast tumors.
- Prostate tumors.
- Pre-cancerous cells associated with Barrett's esophagus.
You may need to have a CT scan or MRI to determine if your tumor is a candidate for RFA. In some cases the tumor may be too large or there may be too many tumors, making RFA an inappropriate treatment option. In the case of liver RFA, your liver function will need to tested prior to the procedure.
How is the procedure done?
RFA is done in the interventional radiology department by an interventional radiologist. An interventional radiologist is a physician with advanced training in minimally invasive treatments that use radiology imaging to guide them. You may also encounter nurses, radiology technicians and nurse practitioners in this department.
The procedure is done as an outpatient, meaning you will go home a few hours after the procedure. You will receive some sedation, so you will need someone to drive you home. You will be told to not eat or drink after midnight the night before the procedure. In the interventional radiology (IR) department, you will have an IV placed and will be givena sedative and an anesthetic will be used to numb the skin where the needle will be inserted. The IR team will use ultrasound, CT scan or x-ray to locate the tumor and guide the insertion of the needle. Once inserted into the center of the tumor, the radiofrequency generator is activated, heating the tip of the needle. You may feel the "heating" - this can be painful, which is why you will receive sedation and numbing medications prior to the procedure. The procedure takes about 30 minutes for each tumor treated. You can have multiple tumors treated during the same procedure.
Once the RFA is complete, you will remain in the IR department for observation for several hours. Most patients can resume their normal activities the next day.
What are the side effects of RFA?
You may feel tired or experience soreness or fever for 1-2 days after the procedure, which can be treated with acetaminophen. More serious complications are rare, but include infection and bleeding.
How will RFA help me?
In most cases RFA is a palliative treatment, used to alleviate pain or relieve other distressing symptoms, improving quality of life. For example, it can be used to shrink a tumor obstructing the flow of bile that is causing jaundice. RFA can be used to relieve pain associated with bone metastases. For some types of cancer, RFA is a treatment that can improve survival.
Diagram shows a liver tumor being treated with RFA.