Radiofrequency ablation

Radiofrequency ablation (RFA) uses heat to kill cancer cells. High-frequency electrical currents are passed through a special needle or probe called a needle electrode. The electrical current from the probe heats a small area containing cancer cells to high temperatures, killing the cancer cells. The area around the tumour is also usually treated because it may contain cancer cells.

RFA may be done to treat some tumours if the cancer is in a position that makes surgery difficult or if you can’t have surgery because of other health problems. It is usually used for tumours that are smaller than 5 cm across. RFA can be given alone or with other cancer treatments. It is most often used to treat:

• primary liver cancer
• liver metastases
• lung metastases
• kidney cancer

RFA can also be used to treat Barrett’s esophagus, which is a precancerous condition of the esophagus. It is also used to treat other medical conditions, including some non-cancerous conditions.

Blood tests may be done to check your general health and see how well certain organs are working before RFA. You will be asked not to eat or drink anything for several hours before treatment. If you take medicines, your doctor will give you instructions about whether or not to take them.

RFA can be given in different ways. The doctor will choose the best method based on the size, number and location of the tumours.

RFA can be done:

• through the skin (called percutaneous RFA)
• with an endoscope
• by laparoscopy
• at the same time as surgery to remove other tumours

RFA can be done under general anesthesia (you will be asleep). It can also be done using a local anesthetic to numb the area and sedation to make you drowsy. Then you will have a CT scan or an ultrasound to help the doctor or radiologist guide the probe or needle into the right position.

Once the probe is in place, an electrical current is sent through to the tip. More than one probe may be used if you have a large tumour or more than one tumour. The doctor can adjust the heat based on the size of the tumour. The treatment can take anywhere from 30 minutes to 3 hours.

Most people stay in the hospital overnight after RFA. Sometimes RFA can be done as an outpatient procedure and you can go home the same day. You will probably be instructed not to drive for 24 hours after RFA, so you’ll need someone to take you home. You should be able to return to your normal activities in a few days.

You will usually have a CT scan or an MRI a few weeks after RFA to see if the tumours have shrunk or if you need more treatment. Some people have a CT scan or an MRI every 3 to 4 months to check if the cancer has come back.

Side effects can happen with any type of treatment, but everyone’s experience is different. Side effects that you may have for a few days after RFA include:

• pain or discomfort
• feeling unwell with a fever
• blood in the urine (pee) after RFA to the kidney

In rare cases, an infection can happen after RFA.