What is Radiofrequency Ablation for Cancer? Purpose, Procedure & Results

Radiofrequency ablation (RFA) is a minimally invasive treatment that uses heat energy to destroy cancer cells. Think of it as a precise, targeted way to "cook" tumor tissue from the inside out, using electrical energy converted to heat through a thin needle-like probe.

This treatment offers hope for many people with cancer, especially when surgery isn't possible or when you want to avoid more extensive procedures. It's particularly effective for smaller tumors and can often be done as an outpatient procedure, meaning you can go home the same day.

What is radiofrequency ablation?

Radiofrequency ablation works by delivering controlled heat directly into cancer cells through a special probe. The heat reaches temperatures of about 212°F (100°C), which destroys the tumor tissue while minimizing damage to surrounding healthy areas.

The procedure uses the same type of energy that powers radio waves, but it's concentrated and controlled to create therapeutic heat. Your doctor guides a thin electrode through your skin directly into the tumor using imaging guidance like CT scans or ultrasound.

The destroyed cancer cells are gradually absorbed by your body over several weeks to months. This process is natural and safe, similar to how your body handles other damaged tissue.

Why is radiofrequency ablation done?

RFA is recommended when it can effectively treat your cancer while preserving your quality of life. It's often chosen for people who aren't good candidates for surgery due to age, other health conditions, or tumor location.

Your doctor might suggest RFA if you have tumors in organs like the liver, lungs, kidneys, or bones. It's especially valuable for treating liver cancer, both primary tumors and those that have spread from other parts of your body.

Sometimes RFA is used alongside other treatments like chemotherapy or radiation therapy. It can also help manage cancer symptoms, particularly bone pain from tumors that have spread to your skeleton.

The procedure works best for tumors smaller than 2 inches (5 cm) in diameter. Larger tumors may require multiple treatment sessions or combining RFA with other approaches.

What is the procedure for radiofrequency ablation?

The RFA procedure typically takes 1-3 hours and is performed by an interventional radiologist. You'll receive conscious sedation or general anesthesia to keep you comfortable throughout the treatment.

Your doctor will clean and numb the skin where the probe will be inserted. Using real-time imaging guidance, they'll carefully guide the electrode through your skin directly into the tumor tissue.

Here's what happens during the actual treatment:

1. The electrode is positioned precisely within the tumor
2. Radiofrequency energy is delivered for 10-30 minutes
3. The heat creates a zone of destroyed tissue around the probe
4. Multiple probe positions may be used for larger tumors
5. Imaging confirms complete treatment of the target area

After treatment, you'll be monitored in a recovery area for several hours. Most people experience only mild discomfort, which can be managed with over-the-counter pain medication.

How to prepare for your radiofrequency ablation?

Your preparation will depend on which organ is being treated, but some general guidelines apply to most RFA procedures. Your medical team will provide specific instructions tailored to your situation.

You'll typically need to stop eating and drinking for 6-8 hours before the procedure. This precaution helps prevent complications if you need general anesthesia or conscious sedation.

Your doctor will review your current medications and may ask you to temporarily stop certain ones, particularly blood thinners like warfarin or aspirin. Don't make these changes without medical guidance, as some medications need to be stopped days before the procedure.

Plan for someone to drive you home after the treatment, as the sedation medications will affect your ability to drive safely. You should also arrange for someone to stay with you for the first 24 hours after the procedure.

Wear comfortable, loose-fitting clothing and remove jewelry or metal objects that might interfere with the imaging equipment. Your medical team will provide a hospital gown for the procedure.

How to read your radiofrequency ablation results?

RFA results are typically evaluated through follow-up imaging studies done 1-3 months after your treatment. These scans show whether the cancer cells were successfully destroyed and help detect any remaining viable tumor tissue.

A successful treatment creates what doctors call a "zone of ablation" - an area where all cancer cells have been destroyed. On imaging, this appears as a clearly defined area that doesn't enhance with contrast material.

Your doctor will look for several key indicators of treatment success:

• Complete absence of active tumor tissue in the treated area
• Proper size and shape of the ablation zone
• No evidence of remaining cancer cells at the margins
• Stable or decreasing size of the treated area over time

If imaging shows incomplete treatment, your doctor may recommend additional RFA sessions or alternative treatments. This doesn't mean the procedure failed - sometimes tumors require multiple treatments to achieve complete destruction.

Long-term follow-up continues with regular imaging studies to monitor for cancer recurrence. The frequency of these scans depends on your specific cancer type and overall treatment plan.

How effective is radiofrequency ablation for cancer?

RFA success rates vary depending on tumor size, location, and cancer type, but overall results are very encouraging. For small liver tumors (less than 2 inches), success rates often exceed 90% for complete tumor destruction.

The procedure is most effective for primary liver cancer and liver metastases from colorectal cancer. Success rates for lung tumors are also high, particularly for tumors smaller than 1.5 inches in diameter.

Several factors influence how well RFA works for your specific situation:

• Tumor size - smaller tumors have higher success rates
• Location - tumors away from major blood vessels respond better
• Cancer type - some cancers are more heat-sensitive than others
• Overall health - better general health supports healing and recovery

Even when RFA doesn't completely eliminate cancer, it often provides significant benefits. Many people experience reduced symptoms, slower tumor growth, and improved quality of life.

The procedure can be repeated if necessary, and it doesn't prevent you from receiving other cancer treatments in the future. This flexibility makes RFA a valuable option in comprehensive cancer care.

What are the risk factors for radiofrequency ablation complications?

While RFA is generally safe, certain factors can increase your risk of complications. Understanding these helps you and your medical team make informed decisions about your treatment.

Age and overall health status play important roles in determining your risk level. People over 70 or those with multiple medical conditions may face slightly higher risks, though RFA is still often safer than major surgery.

Tumor location significantly affects risk levels. Tumors near major blood vessels, the diaphragm, or other critical structures require extra caution and expertise during treatment.

Several specific risk factors deserve special attention:

• Previous abdominal surgery that may have created scar tissue
• Blood clotting disorders or use of blood-thinning medications
• Severe heart or lung disease
• Active infections or compromised immune system
• Pregnancy (RFA is not performed during pregnancy)

Your medical team will carefully evaluate these factors before recommending RFA. They may suggest additional precautions or alternative treatments if your risk level is too high.

What are the possible complications of radiofrequency ablation?

Most people tolerate RFA very well, but like any medical procedure, it carries some risks. The good news is that serious complications are rare, occurring in fewer than 5% of cases.

Minor complications are more common and usually resolve quickly with appropriate care. These typically don't require hospitalization and can be managed at home with guidance from your medical team.

Common minor complications include:

• Mild to moderate pain at the treatment site
• Temporary fever for 1-2 days after treatment
• Fatigue that may last several days
• Minor bleeding or bruising at the probe insertion site
• Temporary nausea, especially after liver treatments

These symptoms are part of your body's normal healing response and typically improve within a few days. Your doctor will provide specific instructions for managing any discomfort.

Serious complications are uncommon but require immediate medical attention. While rare, it's important to be aware of these possibilities so you can seek help promptly if needed.

Rare but serious complications may include:

• Infection at the treatment site or in the treated organ
• Damage to nearby organs or blood vessels
• Pneumothorax (collapsed lung) during lung treatments
• Bile duct injury during liver treatments
• Severe bleeding requiring transfusion

Your medical team takes extensive precautions to minimize these risks. They use advanced imaging guidance and have protocols in place to handle any complications that might arise.

When should I see a doctor after radiofrequency ablation?

Contact your doctor immediately if you experience severe pain that doesn't improve with prescribed medications, or if you develop signs of infection like fever above 101°F (38.3°C), chills, or increasing redness around the treatment site.

You should also seek immediate medical attention if you notice any of these warning signs:

• Difficulty breathing or chest pain
• Persistent vomiting or inability to keep fluids down
• Significant bleeding or large bruises at the treatment site
• Severe weakness or dizziness
• Yellowing of skin or eyes (especially after liver treatment)

For routine follow-up, you'll typically see your doctor within 1-2 weeks after the procedure. This visit allows them to check your healing progress and address any concerns you might have.

Your regular follow-up schedule will include periodic imaging studies to monitor treatment effectiveness. These appointments are crucial for tracking your progress and planning any additional treatments if needed.