Kidney Cancer: Ablation Therapy

What is ablation therapy?

Ablation therapy is a type of treatment that kills cancer cells. There are 2 main types of ablation therapy used to treat kidney cancer:

• Radiofrequency ablation(RFA). This uses energy waves to kill cancer cells.

• Cryoablation. This uses extreme cold to kill cancer cells.

Both types are done by putting a needle into an area of cancer cells. This treatment doesn't cause a lot of damage to nearby tissues. It also causes less bleeding. But sometimes more than 1 treatment is needed.

A newer treatment

Ablation therapy is a newer treatment for kidney cancer. It is not yet clear how well it compares with surgery. You may need preapproval from your insurance company to get this kind of treatment.

When might radiofrequency ablation (RFA) be used for kidney cancer?

Your healthcare provider may advise RFA if 1 or more of the below applies to you:

• You have 1 or more kidney tumors.

• You have only one kidney or your other kidney is not working well.

• Your other kidney is not working well.

• You have other health conditions that make you unable to have surgery.

• You are an older adult and surgery would be too difficult for you.

• Your tumor is small.

• The cancer is on the kidney's surface and not too close to other organs.

• The cancer has spread to other organs, such as your lungs or liver.

• You have a cancer that has come back, or you have more than 1 kidney tumor.

• You have a family history of multiple kidney tumors.

• You will have surgery, but need RFA to treat the tumor area to help prevent excess bleeding during surgery.

When might cryoablation (cryotherapy) be used for kidney cancer?

Your healthcare provider may advise cryoablation if 1 or more of the below applies to you:

• Your tumor is smaller.

• You are an older adult and surgery would be too difficult for you.

• You have only 1 kidney and you need to keep your kidney.

What are the possible risks of ablation therapy?

All procedures have risks. The risks of ablation therapy include:

• Pain after the procedure that requires pain medicine

• Infection at the site where the needle is put into the body

• Damage to the treated kidney

• Damage to other nearby parts of your body (depends on where the tumor is)

• Contact with radiation, depending on the type of imaging used during the procedure

Talk with your healthcare provider about which risks apply most to you.

Before the procedure

• Your healthcare provider will likely do blood tests to make sure that your blood clots normally and to see how well your liver and kidneys are working.

• Tell your healthcare provider about all the medicines, herbs, and supplements you are taking. He or she may ask that you stop using some of these for a time before the procedure. These kinds of medicines include blood thinners, aspirin, and other nonsteroidal anti-inflammatory medicines, such as ibuprofen.

• Tell your healthcare provider about any allergies that you may have. This includes allergies to anesthesia or contrast dye.

• Tell your healthcare provider if you are pregnant or think you might be pregnant.

• Your healthcare provider will tell you not to eat or drink anything starting the night before the treatment.

• Arrange for someone to drive you home after the procedure.

During the procedure

This procedure will be done by an interventional radiologist. He or she will work with your urologist during your treatment. The procedure may follow these basic steps:      

• You will be given a gown to wear. You will lie on an exam table.

• Your blood pressure, heart rate, and pulse might be tracked during the procedure.

• If anesthesia is needed, the nurse will put an IV (intravenous) line in your arm or hand in order to give you this medicine.

• Your healthcare provider will clean the skin over the area where the ablation will take place. You will be injected with a medicine that numbs the area (local anesthetic).

• A small cut will be made in your skin. The needle will be inserted here. In some cases, the healthcare provider may need to make more than 1 cut.

• The healthcare provider will use imaging to help guide the needle to the tumor. This may be done with a CT scan, MRI, or ultrasound.

• For RFA, a high-frequency electrical current will be sent through the needle to kill the cancer cells. Your healthcare provider may need to do this at more than 1 site. For cryoablation, the needle’s tip will release a very cold gas to freeze the tumor and kill the tumor cells. 

• At the end of the procedure, the needle is removed. The skin is covered with a bandage.

After the procedure

The procedure takes 1 to 3 hours. You will wake up in a recovery room and stay there until you're fully awake and ready to go home. You will likely be able to go home the same day. You may have mild pain or nausea. Your healthcare provider may treat these with medicines.

You can go back to normal activity after a few days.

Working with your healthcare provider

Talk with your healthcare providers about what signs to look for after treatment and when to call them. Make sure you know what number to call with questions. Is there a different number for evenings and weekends?