Radiofrequency Ablation (RFA)
Radiofrequency ablation (RFA) offers a nonsurgical, localized treatment that kills the tumor cells with heat, while sparing the healthy tissue. This treatment is much easier on the patient than systemic therapy. Radiofrequency energy can be given without affecting the patient's overall health and most people can resume their usual activities in a few days. In this procedure, the Interventional Radiologist guides a small needle through the skin into the tumor. From the needle, radiofrequency energy (similar to microwaves) is transmitted through the tip of the needle, where it produces heat in the tissues. The dead tumor tissue shrinks and slowly forms a scar. The complication rates range from 2-3%. While the tumors themselves may not be painful, when they press against nerves or interfere with vital organs, they can cause pain. RFA is effective for small to medium sized tumors and emerging new technologies should allow the treatment of larger cancers in the future.
RFA is:
- Most effective when all the cancer is localized within the organ
- Can be used to treat primary cancer
- May not require general anesthesia
- Most patients can resume their normal routine the next day although they may feel tired for a few days
- Can be repeated if necessary
- May be combined with other treatment options
- Can relieve pain and suffering for many cancer patients
Risks of RFA
The risks of RFA are bleeding and pain. Bleeding that requires intervention is uncommon due to the fact that radiofrequency energy cauterizes the tissue and minimizes the risk of bleeding. Heating of the tumor may cause heating of an adjacent structure, which can lead to adjacent tissue damage. This can be avoided by carefully reviewing the size and location of the tumor before the procedure. Tumors adjacent to structures such as bowel may not be candidates for RFA or may require special procedures (injection of fluid) to create safe distances between the tumor being treated and the adjacent bowel.
Cryoablation
Cryoablation is similar to RFA in that the energy is delivered directly into the tumor by a probe that is inserted through the skin. But rather than killing the tumor with heat, cryoablation uses extremely cold gas to freeze the tumor. This technique has been used for many years by surgeons in the operating room. In the past few years, the needles have become small enough to be used by Interventional Radiologists through a small nick in the skin, without the need for open surgery. The ‘ice ball’ that is created around the needle grows in size and destroys the frozen tumor cells.
Microwave Tumor Ablation
Microwave tumor ablation is a minimally invasive procedure used to treat liver, lung, kidney, bone and spine tumors. During a microwave ablation, an Interventional Radiologist uses CT guidance or ultrasound guidance to precisely locate the tumor and guide a needle probe into the tumor. Microwaves are sent through this probe, heating and killing the tumor.
Some advantages of microwave tumor ablation include:
- CT or ultrasound-guided for increased accuracy
- Fast ablation times
- Ability to treat small and large tumors
- Fewer smaller probes, which leads to fewer complications
- Simultaneously targets up to three tumors with independent control of each probe
- Expanded treatment area allows microwaving of tumors close to major arteries and veins
- Lower recurrence rates
- Specially designed kidney and bone probes
- First lung probe approved by the U.S. Food and Drug Administration
- Minimal risk to patient
- Short hospital stay
- The procedure can be repeated if new cancer appears