How Radiofrequency Ablation (RFA) works
RFA uses heat to destroy cancer cells. It involves using a probe, called an electrode, to apply an electrical current (radiofrequency) to a tumour. The electrical current heats the cancer cells to high temperatures, which completely destroys (ablates) them. The cancer cells die and the area which has been treated gradually shrinks and eventually becomes scar tissue.
RFA does not always manage to destroy all the cancer cells. Some people may need to have it done more than once. RFA can be repeated if the tumour starts to grow again.
How RFA is given
RFA can be given:
- By placing one or more needle-like electrodes through the skin (percutaneous) into the tumour. This is the most common method.
- By making a small cut in the skin, and passing the electrodes through a mini-telescope (laparoscope) into the tummy area.
- At the same time as an operation to remove some of the tumour.
What usually happens
On the day of treatment you’ll have been asked not to eat anything for several hours beforehand. If you take any medicines you’ll usually be able to take them as normal. If you take drugs that can thin your blood such as aspirin or warfarin, your doctor will have given you instructions about when to stop taking these.
The treatment usually takes place in the operating theatre or hospital scanning department and takes from about 1–3 hours depending on the size and number of tumours being treated. It’s possible to have it done as an outpatient but most people will have an overnight stay 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.
Before the treatment you’ll see a doctor who will explain to you about the procedure. This is a good time to ask any questions about anything that you’re unsure about. You will then be asked to sign a form to say 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.
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 which give a 3-D picture of inside the body). This helps the doctor to guide the electrode into the right position and it’s also used to keep a close eye on what’s happening during your treatment.
Once it’s in the right position the electrical current is passed through the electrode 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 tumour, the doctor may need to use a number of electrodes.
When RFA can be used
RFA can be used to try to cure a cancer, to reduce its size, or to relieve symptoms (palliative treatment). It can be given alone, or along with other cancer treatments.
RFA may be used when surgery is not possible. This may be if:
- someone has other medical conditions, which mean they’re not fit enough to have a general anaesthetic
- the tumour is near an important body structure or major blood vessel
- there is more than one tumour.
RFA is mainly used to treat:
- Liver cancer that has started in the liver (primary), or a cancer that has spread to the liver from another part of the body (secondary).
- Lung cancer that has started in the lung (primary), or a cancer that has spread to the lung from another part of the body (secondary).
- Kidney cancer.