Radiofrequency ablation (RFA) is a treatment that uses heat to destroy cancer cells or certain tissue. The heat is supplied by electrical currents (radiofrequency energy) passed through a special needle, or probe, called a needle electrode.
Why radiofrequency ablation is done
RFA may be used to treat some cancerous tumours. It is offered when the tumour is too difficult to remove with surgery or the person can’t have surgery because of other health problems. It is usually used for cancerous tumours that are smaller than 5 cm. RFA is most often used to treat:
- primary liver cancer
- liver metastases
- lung metastases
- stage 0 esophageal cancer
RFA may also be used to treat the following precancerous conditions and non-cancerous tumours:
- Barrett’s esophagus
- certain non-cancerous tumours of the kidney
- certain non-cancerous tumours of the bone
- benign prostatic hyperplasia (BPH)
RFA can also be used to treat an irregular heart beat (arrhythmia).
Preparing for radiofrequency ablation
Before RFA, your healthcare team may do blood tests to check your general health and how well certain organs are working.
You are usually told not to eat or drink anything several hours before the treatment. You may be asked to stop taking some medicines that you normally take.
How radiofrequency ablation is done
RFA is done at a hospital in the imaging department or operating room. Most people can go home the same day, but some people may need to stay in the hospital overnight.
Doctors use different methods to treat the area with RFA. They will choose the best method based on the size, number and location of the tumours. RFA can be done:
- through the skin (called percutaneous)
- with an endoscope (a thin, tube-like instrument with a light and lens) placed in or passed through an organ such as the esophagus
- with laparoscopy, which is when the surgeon makes small cuts, or incisions, in the abdomen to insert an endoscope and tools to do the RFA
- as open surgery, which is when the surgeon makes a large cut in the abdomen to reach the area to be treated
Depending on the method used and the area being treated, the doctor may use a local anesthetic to freeze, or numb, the area. In some cases, you will be given a general anesthetic to make you unconscious during RFA.
The doctor may use imaging tests, such as ultrasound, CT scan or MRI, to guide the needle electrode to a specific area. The doctor places the needle electrode into the tumour or tissue that will be treated. The needle electrode is connected to a generator, which makes electrical currents as radiofrequency energy waves. Once the generator is turned on, electrical currents flow through the needle electrode directly into the tumour or tissue. The electrical currents create heat, which destroys the cancer cells or tissue. The tumour or area destroyed by RFA will shrink and eventually turn into scar tissue.
Each treatment of RFA lasts about 10–30 minutes. For a large tumour, you may need to have more than one RFA treatment.
RFA may be used along with other treatments.
After radiofrequency ablation
If the surgeon used laparoscopy or open surgery to reach the treatment area, the surgeon will use stitches to close the incisions. Stitches are not usually needed for percutaneous RFA. A dressing is also applied to the area.
You may be given pain medicines, antinausea medicines or both after RFA treatment is complete. You may not feel well and have a fever for a few days after RFA. Tell your doctor if you have a fever that does not go away because you may have an infection.
You will usually have a CT scan or MRI a few weeks after RFA to see if the tumours are smaller or if you need more treatment. Some people have a CT scan or MRI every 3–4 months to check if cancer has come back.
Side effects can happen with any type of treatment, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.
The side effects of RFA depend mainly on how and where it was done. Side effects include:
- pain or discomfort
- collapsed lung (called pneumothorax)
- damage to organs such as the gallbladder, bile duct, intestine or ureter
Special considerations for children
Preparing children before a test or procedure can lower anxiety, increase cooperation and help them develop coping skills. Preparation includes explaining to children what will happen during the test, including what they will see, feel and hear.
The preparation for RFA depends on the age and experience of the child. Find out more age-specific information on coping with tests and treatment.
A condition in which cells that line the lower part of the esophagus (the tube through which food passes from the throat to the stomach) change into or are replaced by abnormal cells. It may be caused by stomach acid backing up into the esophagus over time (gastroesophageal reflux disease or GERD).
Barrett’s esophagus is associated with an increased risk of developing esophageal cancer.
A non-cancerous (benign) enlargement of the prostate.
Also called benign prostatic hypertrophy.