Radiofrequency Ablation

What is Radiofrequency Ablation?

Radiofrequency ablation (RFA) is a treatment for some tumors, most often those found in the liver, lung, and kidney. RFA can also be used in some breast and bone tumors. In some cases, tumors cannot be destroyed by chemotherapy, radiation, or surgery. RFA uses heat to attack these tumors. There are few side effects with RFA, and often a hospital stay is not needed afterward.

RFA is done 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. The needle then heats the tumor cells and kills 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.

How is RFA done?

RFA is done in the interventional radiology (IR) 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 be cared for by 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 (to relax you), 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 IR department, you will have an IV placed and will be given a sedative medication. A medication called an anesthetic will be used to numb the skin where the needle will be placed in the skin. The IR team will use ultrasound, CT scan, or x-ray to find the tumor and guide where the needle goes. 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. Several tumors can be treated during the same procedure.

Once the RFA is complete, you will stay in the IR department to be monitored for several hours. Most patients can go back to their normal activities the next day.

What are the side effects of RFA?

You may feel tired or have 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. Call your provider if you have a fever that will not go away with acetaminophen, if you have chills, or if you have redness, warmth, or drainage where the needle was inserted. 

Is RFA right 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 along 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 RFA is the right treatment for your tumor. In some cases, the tumor may be too large or there may be too many tumors, so RFA would not work well. In the case of liver RFA, your liver function will need to be checked with blood tests before the procedure.

How will RFA help me?

In most cases, RFA is a palliative treatment. Palliative means that it is used to help with pain or to relieve other symptoms, to improve your quality of life, and not to cure your cancer. For example, it can be used to shrink a tumor blocking the flow of bile that is causing jaundice (yellowing of the skin and eyes). RFA can be used to lessen pain from bone metastases. For some types of cancer, RFA is a treatment that can improve survival.

This diagram shows a liver tumor being treated with RFA.

Resources and Further Reading

Society for Interventional Radiology