Radiofrequency ablation (RFA)

Radiofrequency ablation (RFA) uses heat to destroy cancer cells. It is a type of treatment called thermal ablation. It is used to try to cure a cancer, reduce its size or relieve pain. It can be given alone, or with surgery, chemotherapy or radiotherapy.  

RFA is mainly used to treat liver, lung or kidney cancer. It may sometimes be used to treat other cancer types.

Depending on your situation, you will have the treatment under local or general anaesthetic. The doctor uses an ultrasound or CT scan to guide the procedure.

A probe called an electrode applies an electrical current (radiofrequency) to a tumour. The current heats the cancer cells to a high temperature, which destroys (ablates) them.

The risk of complications is low, but the procedure may cause bleeding or infection.

Side effects of treatment include:

  • pain or discomfort
  • slight fever
  • generally feeling unwell.

You will have a repeat scan after RFA. This shows how well the treatment has worked. RFA doesn't always destroy all cancer cells. You may need to be treated more than once.

Radiofrequency ablation (RFA)

Radiofrequency ablation (RFA) is a treatment that is used for some types of cancer. It is a type of thermal ablation. This means using heat to destroy (ablate) cancer cells.

RFA is the most widely used thermal ablation treatment. Other thermal ablation treatments include:

  • microwave ablation (MWA)
  • laser therapy
  • high-intensity focused ultrasound (HIFU)
  • cryotherapy or cryosurgery.

RFA uses a probe called an electrode to apply an electrical current (radiofrequency) to a tumour. The electrical current makes the cancer cells vibrate rapidly, causing friction. The heat created from the friction destroys the cancer cells. The area that has been treated gradually gets smaller and becomes scar tissue.

RFA doesn't always manage to destroy all the cancer cells. You may need to be treated more than once. RFA can be repeated if the tumour starts to grow again.


How radiofrequency ablation is given

RFA can be given in several ways:

  • Placing one or more needle-like electrodes through the skin (percutaneously) into the tumour, guided by an ultrasound or CT scan. This is the most common method.
  • 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 other tumours.

The way RFA is given will depend on the type of tumour and its position in the body. Your doctor or specialist nurse will explain how the RFA will be given.

What usually happens

You will be asked not to eat anything for several hours before your treatment. If you take any medicines, you will usually be asked to take them as normal. If you take medicines 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 are 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. A doctor or nurse will then place a fine tube (cannula) into a vein in your arm or on the back of your hand. They may also take blood samples to check your general health.

You usually have RFA in the operating theatre or hospital scanning department. Treatment takes around one to three hours, depending on the size and number of tumours being treated. It is possible to have treatment as an outpatient, but most people will stay overnight in hospital. If you are having the treatment as an outpatient you will need to arrange for someone to take you home, as you should not drive for 24 hours after your treatment.

Most hospitals will use a general anaesthetic for RFA. It can also be given with a local anaesthetic to numb the area and a sedative to make you drowsy.

Once you have had the anaesthetic, you will have an ultrasound or CT scan. These scans help the doctor guide the electrode into the right position. They also help the doctor monitor what is happening during your treatment.

Once the electrode is in the right position, an electrical current is passed through to the tip. How long treatment lasts for will depend on the size of the tumour, and whether you have more than one tumour.

An area of healthy tissue around the tumour is usually also treated, as it may contain cancer cells.

If you have a larger tumour or more than one tumour, the doctor may need to reposition the electrode before repeating the treatment. Or they may use a number of electrodes.


When radiofrequency ablation can be used

RFA can be used to try to cure a cancer, reduce its size or relieve pain (palliative treatment). It can be given alone, or with other cancer treatments.

RFA may be used instead of surgery when someone has other medical conditions, which means they are not fit enough to have a major operation.

RFA is mainly used to treat:


Radiofrequency ablation for liver cancer

RFA can be used as a treatment for both primary and secondary liver cancer.

Primary liver cancer

RFA works best for tumours smaller than 5cm (2in). Larger tumours can be treated but may need multiple RFA treatments at the same time, or repeated RFA treatments.

RFA is suitable for people who already have liver disease such as cirrhosis (scarring of the liver) and can't have surgery. However, if a person's liver is very damaged then treatment may not be possible.

Secondary liver cancer

RFA is most commonly used to treat cancers that have spread to the liver from the bowel or breast. It usually works best for tumours that are smaller than 5cm (2in). Neuroendocrine cancers (rare tumours that can release hormones into the bloodstream) that have spread to the liver can also be treated with RFA.

People with secondary liver cancer that has spread from a different type of cancer may also be able to have treatment with RFA. However, the doctors need to be sure that the cancer is contained within the liver or is well controlled.


Radiofrequency ablation for lung cancer

RFA can be used as a treatment for both primary and secondary lung cancer.

Primary lung cancer

RFA can be given to people with early lung cancer who cannot have surgery or choose not to have it. It can be performed on tumours that are smaller than 3.5cm (1¼in) and located almost anywhere within the lung. It may not be possible to treat tumours involving the larger blood vessels and central airways. RFA is usually used alone but may be given in combination with radiotherapy treatment.

Secondary lung cancer

RFA can be used for tumours that are smaller than 3.5cm (1¼in) and in most parts of the lung. Multiple tumours may be treated at the same time, usually up to five in each lung. The most common side effect is a collapsed lung (see below), so only one lung is treated at a time. This is because it could be serious if both lungs collapse at the same time.

Tumours close to a large blood vessel, or larger than 3.5cm (1¼in), may also be treated. However, there is a greater risk of these tumours coming back after treatment.


Radiofrequency ablation for kidney cancer

Surgery is the main treatment for kidney cancer. But if someone is not fit enough for an operation to remove the kidney, RFA may be used. It may also be used for people who have only one kidney, or when it is important to keep both kidneys for other reasons.

It can be used to treat tumours of up to 5cm (2in), but it works best for tumours that are smaller than 3cm (1in) and close to the outside of the kidney.


Possible complications of radiofrequency ablation

The risk of complications is low. These are the main complications that can occur:

Bleeding from the site

There is usually very little bleeding during the treatment. Sometimes people have more serious bleeding during or straight after the procedure. You will be closely monitored for bleeding during the treatment and for a few hours afterwards, so that if it occurs it can be dealt with straight away.

Infection

Some people develop an infection at the treatment site. You may be given antibiotics to reduce the risk of this happening. Symptoms of an infection include:

  • redness or discharge
  • pain at the treatment site that doesn't go away after a few days
  • feeling generally unwell.

Contact your doctor for advice if you think you have an infection.

Collapsed lung (pneumothorax)

A part of the lung, or the whole lung, may collapse. This is most likely to happen when a tumour in the lung is treated with RFA. The lung can collapse when treating liver or upper kidney cancer, but this is very rare.

A collapsed lung can cause breathlessness. This may sound frightening but it is not usually serious. The lung will get better on its own over a few days. Most people don't need any treatment for a collapsed lung other than painkillers. Some people may need to have a tube placed into their lung for a short time to help it expand back to full size.

Damage to the organs close to the area being treated

This is rare because the doctor will use scans to guide the electrodes into place during RFA treatment. But some people are at a greater risk because of the size or location of their tumours. 

RFA treatment to the liver may sometimes damage the bile ducts, causing yellowing of the skin (jaundice). Rarely, it may also cause damage to the bowel.

RFA to the kidney can sometimes damage the tube that carries urine from the kidney to the bladder (ureter). Further treatment may be needed to repair any damage.


Side effects

These are some of the side effects you may have for a few days after RFA:


Pain or discomfort

You will probably have some pain or discomfort at the treatment site. Your doctor will prescribe painkillers for you to take regularly for a few days. Sometimes people have pain in their shoulder after treatment to the liver or lung. Others may have pain in their hip after treatment to the kidney. For most people, any pain or discomfort lasts for less than a week. If you feel pain for longer than a week, or the pain is not controlled with painkillers, contact your doctor for advice.

We have more information about managing pain, which you might find helpful.

Feeling unwell with a raised temperature

You may feel a little unwell for the first few days and have a slightly raised temperature. You will probably be tired as well. People who have treatment for larger tumours, or for a number of tumours, are most likely to be affected. This is a normal reaction and is caused by your body clearing away the cells that have been destroyed by the treatment.

Drinking plenty of fluids will help. It is a good idea to get plenty of rest for a few days, but you should be able to get back to your usual activities after around a week. If your temperature doesn't return to normal, or if it goes above 38°C (100.4°F), contact your doctor as this may be due to infection.

Blood in the urine

This may occur after RFA to the kidney. It should disappear after a few days.


Follow-up

You will usually be given an appointment to have a repeat scan after your RFA. This will show how well the treatment has worked.

Back to Other treatments

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