Radiofrequency Ablation (RFA)

What is Radiofrequency Ablation?

Radiofrequency ablation is a treatment that uses radio waves to create heat and directs the heat though a needle probe at cancer cells to destroy tumors.

Radiofrequency ablation (RFA) is minimally invasive, meaning it involves having to enter the body with a needle rather than an incision, as with major surgery. Because of this and its ability to create heat in a specific location, RFA is a good treatment choice for patients with many different types of cancer.

What Are Some Common Uses of the Procedure?

RFA is used to treat several types of cancer such as liver, kidney or lung tumors. RFA can be used as a primary treatment or in combination with surgery and chemotherapy. RFA can also be an effective treatment if the tumor is in a difficult to reach area, if you have other medical conditions that make surgery risky, have tumors that are not responding to chemotherapy or several small tumors that are too spread out to be removed surgically. RFA can also be used for tumors that have reoccurred.

Before Your Procedure

• RFA is safe for most patients and generally can be used in place of surgery for patients who cannot withstand longer surgical procedures, complications and recovery times.
• Your physician will discuss the benefits and risks of RFA, and alternatives to this procedure, with you before your procedure.
• The procedure usually will require some anesthesia and/or pain and sedation medication.
• A medical history and blood tests may need to be done before your procedure.
• Patients may have blood drawn for routine blood tests.
• The physician, nurse or scheduler will provide preparation instructions that will include concerns about eating or drinking before the procedure. These instructions will depend on the type of anesthesia planned.
• You may be told not to eat or drink 8 hours (or after midnight) before the RFA procedure.
• Certain medications may need to be changed or stopped before the procedure. For example, blood thinners and aspirin may interfere with the procedure and usually must be stopped.

During Your Procedure

• You will lie on a table in an examination or procedure suite.
• The radiologist may use computed tomography (CT) during the procedure to guide the needle placement into the tumor.
• Most interventional radiologists guide the small needle or probe that holds the current through the patient's skin and directly into the tumor.
• Once the physician has positioned the probe into the tumor, the electrode delivers heat to a larger area. The heat can be controlled by the physician. A small needle can accurately heat a precise area. The heat will destroy the tumor.

After Your Procedure

• A small bandage is placed over the probe insertion site.
• Each RFA treatment takes 30-60 minutes, but the entire procedure can take longer, depending on the number of tumors, tumor size and location. For instance, the radiologist may have to reposition the probe several times for one liver mass, then turn to a second smaller mass, increasing the procedure time.
• Since some pain can be associated with RFA, most physicians will insert an intravenous (IV) line in the patient through which they will give sedation or anesthesia.
• Some patients also have nausea and will receive medications and instructions for nausea and pain care before leaving the facility.
• Patients will have to remain in bed for the first few hours following the procedure and usually stay overnight after receiving RFA.
• Results vary depending on the location, type and size of tumor. Normally, scar tissue replaces the tumor cells destroyed by RFA and shrinks over a period of time.
• You may have a follow-up CT scan the day after the procedure and usually in 3 months.

When You Go Home

• You should drink plenty of fluid.
• Mild pain may continue and may require prescription medication for the first day or two.
• Patients should not drive a car or make important decisions for 24 hours after the procedure because of anesthesia effects.
• Excessive physical activity is also discouraged. However, most patients can resume normal diet, physical activity and sexual activity within a few days of RFA.
• You may be given an antibiotic to take by mouth for 5 days.

Risks

The risks associated with radiofrequency ablation are relatively minor compared to those associated with many other cancer treatments, particularly surgery. However, no procedure is risk-free.

Some risks include:

• Serious injury if the needle makes a hole (perforates) a nearby organ. If this happens, you may require surgery to repair the injury.
• There also is a minor risk of infection at the site where the probe is inserted.
• You may experience bruising or bleeding. Bleeding could require transfusion or catheter embolization or surgery.
• If the lesion is in the liver and next to the diaphragm, this may cause pain in the abdomen or the right shoulder.

Contact Your Physician:

• If pain continues for more than a few days.
• Flu-like symptoms can be normal, however contact your physician if your symptoms become severe.
• If you experience bleeding not controlled with a gauze dressing or band aid.

For any concerns, contact your physician.