Tumour ablation for kidney cancer
Tumour ablation means destroying the tumour (cancer). It is sometimes used to treat kidney cancers smaller than 3 to 4cm.
- This treatment may be used if you have a small tumour and are not well enough to have surgery, or choose not to have it.
- It may be done if it is important to try to keep the affected kidney, or if you have only one kidney.
- It can also be an option if you have an inherited form of kidney cancer that causes multiple tumours, or if cancer is affecting both kidneys.
Tumour ablation generally causes fewer side effects and has a quicker recovery time than surgery for kidney cancer. But there is a higher risk of some cancer remaining in the kidney.
The benefits of avoiding surgery and sparing more of the kidney need to be balanced against this risk. Your cancer doctor will talk to you about the risks and benefits if tumour ablation is an option for you.
There are different methods for destroying the tumour. The 2 most commonly used treatments are:
- cryotherapy – this uses liquid nitrogen to freeze the tumour
- radiofrequency ablation (RFA) – this uses an electric current to produce high temperatures to destroy the tumour.
Other methods of tumour ablation may be used in clinical trials. These include:
- microwave ablation
- laser ablation
- high-intensity focused ultrasound (HIFU).
Your cancer doctor or specialist nurse will talk to you about tumour ablation methods.
Before tumour ablation, you should have a guided biopsy to collect a tissue sample. This is to give your doctor more information about the cancer. Or your doctor may decide to take a sample during the treatment.
Usually, a specialist x-ray doctor (radiologist) will do tumour ablation. You will either be given a sedative to help relax you, or a general anaesthetic.
You may have a catheter put in to drain urine from your bladder. This is usually removed soon after the procedure.
The doctor uses a local anaesthetic to numb the area around the kidney. Then you have an ultrasound or CT scan. These scans guide the doctor to the right area of the kidney. The scans also help them monitor what is happening during your treatment.
When the doctor sees the tumour on the monitor, they place one or more fine probes through the skin (percutaneously) into the tumour.
The probes freeze or heat the tumour. The extreme temperature destroys the cancer cells. The doctor will also aim to destroy a small area (about 1cm) of healthy tissue around the tumour. This is to try to make sure no cancer cells are left behind to grow back again.
Sometimes a tumour ablation is done using keyhole surgery. You have a general anaesthetic for keyhole surgery. The surgeon makes a few small cuts in your tummy (abdomen) to do the tumour ablation.
They pass a laparoscope through one of the cuts to see the tumour. A laparoscope is a thin tube with a light and a camera on the end that sends video images to a monitor. The surgeon inflates your tummy with gas so that it is easier to see and work with the laparoscope.
If you had gas in your tummy for the laparoscope, you may feel bloated and have some discomfort in your shoulders. This improves over a few days as your body absorbs the gas.
You may feel a little unwell for the first few days and have a slightly raised temperature. You will probably also feel tired. Drinking plenty of fluids will help. If your temperature does not return to normal, or if it goes above 38°C (100.4°F), contact your doctor. This may be caused by an infection.
Blood in your urine
You may notice some blood in your urine (pee). This should disappear after a few days..
You usually need to stay in a hospital bed for 4 to 6 hours after the treatment.
The risk of complications after tumour ablation is low.
Possible complications include:
- Infection – you may be given antibiotics to reduce the risk of this happening.
- Bleeding – you will be monitored during the treatment and for a few hours afterwards.
- A narrowing of the ureter – this can affect how urine drains from the kidney.
You will have a scan after treatment to check for any complications. These can be treated straight away if needed.
After tumour ablation, you may go home on the same day or on the day after treatment. This depends on how quickly you recover.
Your surgeon or nurse can tell you when you can start doing everyday activities again.
Before you leave hospital, you will be given an appointment for a check-up. This will be at an outpatient clinic. Your doctor or nurse may arrange for you to have a CT scan to see the result of the treatment.
You will have regular follow-up scans to check the kidney for any signs of the cancer growing back.
Below is a sample of the sources used in our kidney cancer information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
Escudier B, et al. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology 30: 706-720, 2019. doi:10.1093/annonc/mdz056 Published online 21 February 2019. Available from www.annalsofoncology.org/action/showPdf?pii=S0923-7534%2819%2931157-3 (accessed April 2021).
European Association of Urology. Renal cell carcinoma guidelines. EAU Guidelines. Edn. presented at the EAU Annual Congress Milan 2021. ISBN 978-94-92671-13-4. Available from www.uroweb.org/guideline/renal-cell-carcinoma (accessed April 2021).
National Institute for Health and Care Excellence (NICE): Nivolumab with ipilimumab for untreated advanced renal cell carcinoma. Technology appraisal guidance (TA581). Published 15 May 2019. Available from www.nice.org.uk/guidance/ta581 (accessed April 2021).
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Lisa Pickering, Consultant Medical Oncologist.
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