Radiofrequency ablation

Radiofrequency ablation is an option for kidney cancer patients whose cancer has spread to other tissue (metastatic). The goal is to remove as many cancer cells as possible. This therapy kills cancer cells by heating them. It can be done with medicine that numbs the area to be treated (local anaesthesia) or that makes you sleep (general anaesthesia).

Your doctor may suggest radiofrequency ablation (RFA) treatment if you have a small non-cystic kidney tumour (less than 4 cm) and surgery is not an option for you. It is also an option for kidney cancer patients whose cancer has spread to other tissue (metastatic). The goal is to remove as many cancer cells as possible.

RFA is an effective and safe treatment, but there is a risk that tumour cells might be left in the kidney after RFA. This means that the chance of recurrence is higher than after surgery.

How is RFA performed?

RFA will usually be done using medicine that numbs the area to be treated (local anaesthesia). In some cases, the patient must be asleep (general anaesthesia). RFA can also be performed during surgery.

RFA kills cancer cells by heating them with radio waves. The radio waves reach the tumour through a needle. Usually RFA is performed through the skin, and the doctor uses imaging (ultrasound or a CT scan) to guide the needle (Fig. 1). A small piece of kidney tissue is usually taken and studied (biopsy) to learn the tumour subtype before starting the treatment.

Fig. 1: Ablation therapy kills tumour cells by either heating or freezing.
Fig. 1: Ablation therapy kills tumour cells by either heating or freezing.

Risks of complications

While the procedure is safe, there are risks of complications. The most common complications include:

  • Pain around the treated area
  • Prickling of your skin or a tingling sensation (paraesthesia)
  • Bleeding
  • Rare need for blood transfusion
  • Leaking and collection of urine around the kidney
  • Ureter, spleen, liver, or bowel injury

After RFA, follow-up visits are scheduled every 3 months. At these visits, imaging (CT or MRI scans) is used to monitor your kidney and to catch new abnormal cell growth (tumour recurrence) on time.

RFA can be performed more than once if a new tumour grows or if the first treatment was unsuccessful.