Radiofrequency ablation (RFA) is a cancer treatment in which radiofrequency energy—derived from electric and magnetic energy—is sent by means of a narrow probe that is placed in the center of a lung tumor. Surgical incisions are not required, and the probes are placed into tumors using CT scan to guide the physician. RFA is a newer method of treating lung cancer, as well as cancers of the liver, kidney, and bone. RFA can target and kill cancerous cells sparing healthy tissues that are close to the cancer. Systemic treatments such as chemotherapy and certain types of radiation are absorbed into both healthy and diseased tissue, whereas RFA is delivered directly into a tumor.
RFA can provide a cure for small cancers limited to the lungs. It can also slow the progression of larger tumors or be used in combination with other treatments for lung cancer. RFA has a very low rate of complications and is generally well tolerated. Since it is a local treatment, treating only tumors that are visible, it is preferred for patients that are unable to tolerate more standard types of surgery.
How to Prepare for RFA
Before treatment with RFA, patients have a physical examination and medical history, and the physician may order one or more tests.
Patients should mention all medications they take, including prescription, over-the-counter, herbs, and supplements, and any allergies. They will most likely be asked to avoid food and drink after midnight on the night before their scheduled procedure. Water is usually allowed up to two hours beforehand.
What to Expect During RFA
RFA is performed under general anesthesia and patients stay overnight. Sometimes, a mild sedative and local anesthetic are sufficient—and patients can resume normal activities typically within one week, as opposed to open surgery, which requires longer hospital stays, longer recovery, and more risk of infection and complications.
The RFA probe is guided by an imaging tool such as ultrasound or CT into the tumor. Once the probe is placed in the tumor, the radiofrequency energy is delivered, causing heating of the cancer and a small area of lung immediately surrounding this. Temperatures in the tumor can rise to 90° C (194° F). Cancer cells will start to immediately die at 60° C (140° F).
After the abnormal cells are killed, they shrink and turn to scar tissue over time. Unlike surgery where the cancer is removed, there will usually be a scar remaining in the area of the treated tumor. It is important that patients continue to follow up with their physician with repeated CT scans to make sure that there is no further tumor growth.
Recovery from RFA
Immediately after the procedure, the physician takes CT images to make sure the treatment was successful in destroying abnormal tissue. The patient is usually discharged the next morning, and should be able to resume normal activities within the week. Minor complications may include low-grade fever, bruising, pain, and/or infection. Patients should call the Center if they notice any of these symptoms or anything else of concern, or if they have trouble breathing.