Radiofrequency ablation (RFA) is the use of high-energy electrical waves to heat and destroy cancerous (malignant) cells. The electrical currents are delivered by the use of a needle electrode that is placed through the skin into the tumor in the chest. Imaging techniques, such as CT (computed tomography) scans, MRI (magnetic resonance imaging) or ultrasound, are used to guide the needle placement.1,2
When is radiofrequency ablation used?
Radiofrequency ablation may be used to treat lung cancer in patients who cannot tolerate surgery, such as patients who have other health conditions or limited lung function. Radiofrequency ablation may also be used in cases where the lung cancer has spread and surgery is not an option.
Radiofrequency ablation may be used for palliative care, a specialized field that aims to alleviate symptoms and maximize the patient’s quality of life. In palliative care, radiofrequency ablation can reduce the size of a tumor to reduce pain. Many patients receive a combination of treatment approaches to treat their lung cancer, and radiofrequency ablation may be used in combination with surgery, radiation therapy, and/or chemotherapy.1
What to expect with radiofrequency ablation
Radiofrequency ablation is often performed on an outpatient basis, meaning patients may be allowed to go home the same day of the procedure. An interventional radiologist, a specialist trained in using minimally invasive procedures to diagnose and treat diseases, most frequently performs the procedure.1,2
Patients are often given sedation and a local anesthetic (to numb the procedure area) where the needle will be placed. A CT scan is used to precisely locate the tumor, and the skin is marked at the planned site for entry of the needle. Using imaging guidance, the physician then guides the needle electrode to the site of the tumor and applies the radiofrequency energy. Large tumors may require multiple ablations, and the needle electrode will be repositioned into different parts of the tumor as needed. Each ablation takes 10-30 minutes, and the entire procedure generally takes 1-3 hours. Following the procedure, the patient is given an x-ray to check for the possibility of a collapsed lung. Pain from the procedure is generally mild.1,2
Benefits of radiofrequency ablation
Radiofrequency ablation is a minimally invasive procedure, reducing the recovery time and potential for side effects or complications compared to open surgery. It may be used on patients who have multiple tumors who cannot be treated with surgery. The procedure can be repeated several times if a tumor recurs in the same region, and even if radiofrequency ablation does not kill all the cancer cells, a reduction in the size of the tumor can potentially extend survival time and reduce the pain and symptoms from the cancer.1
Risks of radiofrequency ablation
One of the risks of radiofrequency ablation is the potential for a pneumothorax, where air or gas enters the chest cavity and collapses part of the lung. If pneumothorax does occur, some patients may require a chest tube placed in the chest to drain the air. Significant bleeding and severe pain from the procedure are rare. Some patients experience fluid build-up in the space between the lung and the pleural membrane, requiring removal with a needle or chest tube. There is a small risk of infection with the procedure; however, it appears the risk is less than one in 1,000 procedures require antibiotic treatment for an infection.1