What is RFA?
Radiofrequency ablation (RFA) is a time-proven and FDA-approved technique that has been used to destroy tumors in tissue in thousands of patients. Recently RFA has been used percutaneously (through the skin) to treat cancer in patients who are unable to undergo an open and more invasive traditional surgical procedure. Most commonly these tumors are cancer of the lung, liver and kidney. This specific technique is usually practiced by an interventional radiologist. These physicians specialize in using X-ray, MRI, CT and ultrasound to see inside the body to guide treatments of various organs. Another advantage of percutaneous RFA is patent recovery. These less invasive procedures compare favorable in success of treatment of tumors but can be done on an outpatient basis or requiring a brief overnight stay in the hospital.
How does it work? An electrode (a small needle) is inserted into the body through a small skin incision to the location of the tumor. Radiofrequency waves are then generated in the lines of the electrode at the tumor site which results in heat formation. This heat results in coagulation and cell death to the tumor which is called necrosis. The process of heat generation is similar to how a microwave oven is able to heat food. Single or multiple applications can be used to destroy the entire lesion. Once the lesion/cancer is destroyed, the body will form a scar around the debris of the dead tumor which will be slowly absorbed over time. Lastly, the needle/electrode is then removed during heating to cauterize the tract and prevent tumor cells from recurring along the path of the electrode.
What are the advantages? Since the procedure can be performed through the skin, it is less risky and has fewer complications than traditional open surgical techniques. Most of the RFA procedures are performed without general anesthesia, thus further reducing the risks. RFA is typically performed using IV conscious sedation similar to other outpatient interventional procedures such as colonoscopy. It can also be repeated multiple times to achieve a successful result and can be combined with other treatment modalities like chemotherapy and radiation.
What should I expect? Patients will arrive at the hospital on the morning of the procedure and receive an IV as well as antibiotics. Lab work will be drawn to ensure the safety of the procedure. The patient will then be taken to the room for the procedure, typically the CT scanner. This is the same scanner that most people commonly refer to as a "CAT scan." The patient is then given medications to relieve any discomfort and anxiety associated with the procedure. The procedure itself will usually take a few hours. Then the patient is taken to recovery with only a Band-Aid covering the small incision made to insert the probe into the tumor. After recovering from anesthesia, the patient will be allowed to go home. Most are able to resume normal activity the following day.
Is the tumor gone? Most of the time, the cancer is entirely eliminated on the first treatment. However, the patient will be monitored closely using a combination of CT, MRI and PET/CT scans to ensure there is no recurrence. Typically, the scans are performed frequently at first, once every three months, and then later once or twice a year. If there is evidence for tumor recurrence, percutaneous RFA can be repeated.
In summary...percutaneous RFA can be used as an alternative to traditional more invasive open surgical procedures with similar results. Most importantly, it can be used when no other treatment option can be tolerated by the patient to remove the cancer. Therefore, the procedure is able to provide hope to patients who are fighting cancer and hope is one of the keys to winning that battle.
James Busch, M.D., "What is RFA?" Woman's Way, August 2007, 23.