Radiofrequency Ablation (RFA) – Cancer Treatment
Radiofrequency ablation (RFA) is an FDA-approved, non-surgical procedure used to treat inoperable cancer. This promising new procedure uses an electrical current to heat and destroy liver, kidney, lung and bone tumors.
Is Radiofrequency Ablation Safe? Will it Help?
Reasons for Having Radiofrequency Ablation (RFA)
Risks Involved in Radiofrequency Ablation
Prior to Scheduling Radiofrequency Ablation
Conditions to Let Your Doctor Know About
What To Expect During RFA
Follow-Up After Radiofrequency Ablation
Scheduling the RFA Procedure
With radiofrequency ablation, a needle in inserted into the tumor using ultrasound or CT guidance. When the needle is properly placed within the tumor, multiple electrodes are extended from the needle tip. When fully extended, the electrodes form an umbrella shape to create more contact points within the tumor. A radiofrequency current is then run through the electrodes (the needle is insulated) to essentially cook the tumor tissue. At the same time, blood vessels feeding the tumor are cauterized, preventing any significant amount of blood loss. The body eventually replaces the dead tumor cells with scar tissue, which eventually shrinks.
Radiofrequency ablation is a safe procedure with complications occurring in less than 3% of cases. It can be used to treat tumors that are visible with imaging techniques and are approximately 5 cm in diameter or less. Since it has few side effects and damages very little healthy tissue, this procedure can be performed repeatedly to help control both primary and secondary cancers.
In some instances radiofrequency ablation can be curative for example with small kidney tumors, lung tumors and primary liver tumors. However, in most cases radiofrequency ablation won’t cure the cancer, but rather destroys local tumors, improves quality of life, and often extends life for people with inoperable cancer.
Radiofrequency ablation is used to treat cancer in patients in whom tumors cannot be surgically removed. It may be used to treat tumors that have returned after surgery or haven’t responded to chemotherapy. Radiofrequency ablation may also be used to reduce the number of tumors prior to surgery or to control primary cancer prior to an organ transplant.
Not everyone with inoperable cancer is a candidate for this procedure. If you are a candidate, your doctor may recommend this procedure over other non-surgical treatments for the following reasons:
- Tumors are less than 2 inches in diameter and fewer than four in number
- Treatment is regional (e.g. only affects the liver)
- Milder side effects
- No or very short recovery
- Relatively inexpensive
- Can be repeated
- Preliminary survival rates are encouraging
Since a needle is inserted into the body, there is a small risk of bleeding and infection. Bleeding usually stops on its own. However, if it’s severe, an additional procedure or surgery may be required to control it.
If CT imaging guidance is used, you could have an allergic reaction to the contrast material. With CT imaging guidance, there is also the risk of radiation exposure; however, it is well below the level that generally causes adverse affects.
Approximately 25% of patients develop flu-like symptoms three to five days after the RFA procedure. These symptoms usually last about five days, but may extend for two to three weeks. Acetaminophen can be taken to control fever.
Injury to nearby structures, such as the intestines, gallbladder, bile ducts or lungs, may occur. An injury to the diaphragm may also occur, which may cause right shoulder pain. These injuries are uncommon when ultrasound or CT imaging guidance is used.
Radiofrequency ablation is usually covered by insurance. Please check with your insurance carrier to be sure.
Consultations for radiofrequency ablation are done at our offices at 8200 E Belleview Ave, Suite 600, Englewood, CO 80111.
The RFA procedure is performed at numerous partner hospitals in healthcare systems in the Denver,Colorado area.
Before scheduling the procedure, your interventional radiologist must determine if you are a good candidate for radiofrequency ablation. You will need to supply —or we will obtain —medical records and test results from your oncologist or surgeon so your eligibility can be determined.
If you appear to be a candidate, you will undergo additional exams including a blood test and a CT scan. These exams will help the radiologist confirm your eligibility for radiofrequency ablation and plan your treatment.
In advance of your exam, let your interventional radiologist or technologist know if any of the following circumstances apply to you:
- Previous reaction to iodine – CT or X-ray contrast
- Coagulation disorder or taking blood thinning medication
- Currently pregnant or nursing
Following are the general preparation guidelines for radiofrequency ablation. You may receive additional or differing guidelines based on your specific situation. Please contact us at 720.493.3406 if you have any questions.
- Stop taking blood-thinning medications 3-5 days before the procedure (contact your doctor first to ensure it’s safe).
- Do not eat anything for 8 hours before the procedure. You may have clear liquids up until 4 hours before the procedure.
- Take routine medications with sips of water.
- Prepare for an overnight stay in the hospital.
- Arrange for someone to drive you home from the hospital.
When you come in for the procedure, you will be asked to change into a gown. After answering any questions you have, a nurse will start an intravenous (IV) line in your arm. You will be put to sleep or may be given conscious sedation through the IV to help you relax and alleviate any pain.
The radiologist will use ultrasound or a CT scanner to precisely locate the tumor. Electromagnetic guidance is available at some of the hospitals and is a technology that exists at few other practices. If ultrasound is used, a warm gel will be applied to your skin. If a CT scanner is used, contrast material will be injected through your IV.
Local anesthetic will be applied to the skin where an incision will be made for the needle to pass through. Grounding pads for the electrical current will be placed on your abdomen or legs. Using the ultrasound or CT images as guidance, the radiologist will make the incision and then carefully insert the needle into the tumor. When the needle is properly positioned, electrodes will be placed in the tumor.
Once the electrodes are fully extended, an electric current will be passed through the needle into the electrodes by a radiofrequency generator. The radiofrequency current will be applied long enough to destroy the cancer cells and a small rim of surrounding healthy tissue. The electrodes will then be withdrawn and the needle removed. Larger tumors may require more then one needle insertion to kill the entire tumor.
It takes 15-30 minutes for each needle insertion. It takes 20-30 minutes for the electrical current application. The entire procedure will take 1-3 hours, depending on the number of tumors and their sizes. Each incision will be cleaned and sterilely dressed. There is very little pain after the procedure. Let your doctor known immediately if you feel any pain.>
Once the tumors have been treated, you will spend several hours in a recovery area. You may be given medication to control pain and nausea as the sedation wears off. You will then spend the night in the hospital. Most patients return to their normal activities the day after the treatment. Patients may experience pain after the procedure, but it usually subsides within a week and is manageable with prescription medication.
Within a week after the procedure, you may have a CT scan to ensure all the tumor tissue has been destroyed. You will have a CT scan every three months to check for new tumors or tumor recurrence.>
To schedule a consultation to discuss radiofrequency ablation, call 720.493.3406.