Ablation therapy for kidney cancer

Ablation therapy uses heat or cold to destroy the kidney tumour. It destroys cancer cells while keeping as much of the surrounding tissue as possible. It isn’t used very often to treat kidney cancer. It works best on smaller tumours (less than 3 cm, or 1 to 2 inches, in diameter).

For kidney cancer, ablation therapy may be used to:

• treat people who aren’t healthy enough to have surgery to remove a tumour
• control pain or bleeding from a tumour that can’t be removed with surgery
• treat people who only have one working kidney

Ablation therapy may also be offered to people with certain inherited genetic conditions that increase the risk of developing different types of kidney cancer. People with these genetic conditions often have several tumours in both kidneys. Ablation therapy allows doctors to keep as much kidney function as possible.

Ablation therapy for kidney cancer is done in one of the following ways:

Percutaneous ablation therapy uses an ultrasound or a CT scan to guide a tool though the skin and muscle of the abdominal wall, directly into tumours in the kidney.

Laparoscopic ablation therapy is done through narrow incisions (cuts) in the abdominal wall. The doctor uses special tools to reach the tumours. Tumours close to nearby organs can be more easily treated using the laparoscopic method.

Open (surgical) ablation therapy is done through a cut in the abdominal wall to reach the kidney. The doctor then puts tools into the tumours in the kidney. This method is best for treating larger or multiple tumours.

You may need to have several treatment sessions. After an ablation treatment is complete, a CT scan is used to see if the tumours have shrunk or if more treatment is needed.

The following ablation therapies are used for kidney cancer.

Radiofrequency ablation (RFA) is the most common type of ablation therapy used for kidney cancer. During RFA, a high-frequency electrical current creates heat that is used to destroy cancer cells. The electrical current is delivered directly into the tumour by a thin needle, which is guided by an ultrasound or a CT scan. A local or general anesthetic may be used during RFA.

The heat from the needle used in RFA may damage healthy tissue around the tumour. RFA is not used for tumours that are deep inside the kidney because it may damage the renal pelvis and collecting ducts.

Cryoablation is a procedure that destroys cancer cells by freezing them. It is also called cryosurgery, cryosurgical ablation or cryotherapy.

Cryoablation delivers an extremely cold liquid or gas to the tissues of the kidney through a metal tube called a cryoprobe. The doctor uses an ultrasound to guide the cryoprobe to the tumour. The area is left to thaw and then is frozen again. The freeze-thaw cycle may need to be repeated a few times.

Cryosurgery works best for small kidney tumours. It is used more often than RFA on kidney tumours deep inside the kidney because it causes less damage to the renal pelvis.

Side effects can happen with any type of treatment for kidney cancer, but everyone’s experience is different. Some people have many side effects. Other people have only a few side effects.

If you develop side effects, they can develop any time during, immediately after or a few days or weeks after ablation therapy. Most side effects will go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of ablation therapy will depend mainly on the type of ablation therapy, how the ablation therapy is done and your overall health. Some common side effects of ablation therapy for kidney cancer are:

• pain
• bleeding
• fever
• nausea and vomiting
• infection
• kidney problems or kidney failure

Tell your healthcare team if you have these side effects or others you think might be from ablation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.