RFA can be given:
- by placing one or more needle-like electrodes through the skin (percutaneously) into the tumour - this is the most common method
- by passing the electrodes through the skin, guided by a mini-telescope (laparoscope) that is placed into the tummy area
- at the same time as an operation to remove some of the tumour.
What usually happens
You'll be asked not to eat anything for several hours before your treatment. If you take any medicines, you'll usually be asked to take them as normal. If you take drugs that can thin your blood, such as aspirin or warfarin, your doctor will give you instructions about when to stop taking these.
Before the treatment, you'll see a doctor who will explain the procedure. This is a good time to ask questions if you're unsure about anything. You will then be asked to sign a form to say that you agree (consent) to the treatment.
A nurse will give you a hospital gown to change into, and a doctor or nurse will place a fine tube (cannula) into a vein in your arm or on the back of your hand. You may also have blood samples taken to check your general health and blood clotting.
You usually have RFA in the operating theatre or hospital scanning department. Treatment takes about 1-3 hours, depending on the size and number of tumours being treated. It's possible to have treatment as an outpatient, but most people will stay overnight in hospital. If you're having the treatment as an outpatient, you'll need to arrange for someone to take you home, as you won't be able to drive for 24 hours afterwards.
RFA can be given with a local anaesthetic to numb the area and a sedative to make you drowsy. If you need to have a larger area treated, RFA is usually done under a general anaesthetic.
Once you're in position on the treatment couch and have had the anaesthetic, you'll have an ultrasound scan (uses sound waves to look inside the body) or a CT scan (takes x-rays that give a 3D picture of the inside of the body). These scans help the doctor guide the probe (electrode) into the right position, and to pay careful attention to what's happening during your treatment.
Once the probe is in the right position, the electrical current is passed through to the tip. How long the current is applied for will depend on the size of the tumours.
An area of healthy tissue around the tumour is usually also treated, as there may be cancer cells around the tumour that can't be seen. The treated tissue is not removed, but it slowly shrinks and heals over time.
If you have a larger tumour or more than one, the doctor may need to use a number of electrodes.