Radiofrequency Ablation (RFA)

Radiofrequency Ablation is a cancer treatment which is highly successful, and yet relatively unknown. In its short history RFA has saved many lives.

RFA is a medical procedure in which a special needle is inserted into a tumor. The physician is guided in the placement of the needle by images from an imaging machine, such as a CT scanner. Once the needle is in place, tines are deployed from the hollow core of the needle. These tines penetrate the tumor. RFA energy is then sent through the needle and tines, destroying the tumor.

Since the patient's body is only penetrated with this special needle, RFA is minimally invasive. Some patients will be able to return home the day of the procedure. Others will be observed overnight before returning home. Because the procedure is minimally invasive the patient can begin, or continue with, chemotherapy. In addition, the needle can be placed in locations unavailable to surgery, so that many tumors can be destroyed which would otherwise be inoperable. And while RFA has previously been used to ablate small tumors, multiple placements of the needle can effectively ablate larger tumors as well. And, even if all of the large tumor cannot be ablated, there is much to be gained from the debulking of a large tumor.

Radiofrequency ablation is not the same as radiation therapy. Radiofrequency ablation uses low-frequency radio waves which generate localized heat, not the destructive radiation given off by radioactive elements. Radiofrequency ablation can be used to target some large tumors by repositioning of the needle. Because of its versatility, RFA has become a treatment option for a growing number of cancer patients.

The procedure can be performed on an outpatient basis. The cancer is located with radiological imaging (usually a CT scan). Using direct guidance from the CT scanner a special needle is placed within the tumor. Once the needle is in the proper position within the tumor, smaller needle tines are pushed out from the needle tip. These tines help conduct the RF energy over a larger area within the tumor. A radiofrequency is then transmitted to the needle tines. The RF energy vibrates the molecules within the tissue. This vibration generates frictional heat within the tissue. This heat (up to 100 degrees Celsius or 212 degrees Fahrenheit) results in the death of the treated cancer cells. RF energy is applied for about 30-45 minutes in each area where the needle is placed within the tumor. Larger tumors require multiple overlapping placements of the RF needle. Multiple tumors can be targeted during the same procedure.

Radiofrequency Ablation (RFA) of Liver Tumors

Radiofrequency ablation (RFA) is an exciting new approach to destroying inoperable primary or metastatic tumors in the liver. This is a new technique that destroys liver tumors by heating them to high temperatures (80 - 100 °C).Tumors up to 4 centimeters (approximately 2 inches) in diameter can be effectively destroyed with this technique.

A probe is inserted through the liver tissue with ultrasound or CT guidance into the tumor and delivers alternating current (radiofrequency energy). Heat is generated at the site of the lesion and produces destruction (necrosis) of the tumor with near pinpoint accuracy. The tumor is literally "burned out" by the heat. This technology has been used in thousands of patients in the United States and Europe.

The patient undergoing radiofrequency ablation receives IV sedation and grounding pads are placed on the legs. A thin needle is inserted into the tumor and electrical current is passed through the tip of the needle which becomes very hot and destroys the tumor. The procedure lasts 20 - 40 minutes and the patient goes home on the same day. The majority of patients do not experience side effects and resume normal activity the following day.

The RFA treatment of liver tumors is available at Wattanosoth Hospital. Caring physicians consist of interventional radiologists, medical oncologists and gastroenterologists.

Radiofrequency Ablation (RFA) of Lung Tumors

Patients with lung cancer who were deemed medically inoperable showed mid-to-long-term results when treated with radiofrequency ablation (RFA). By the time lung cancer is diagnosed, 85 percent of patients are inoperable, often due to serious coexisting health conditions or poor respiratory function. For these patients, Minimally Invasive Interventional Radiology procedures can provide effective treatment of the tumor with minimal discomfort and a maintained quality of life.

RFA treatment in carefully selected, inoperable, lung cancer patients provides excellent control in tumors less than three centimeters. Radiofrequency ablation (RFA) offers a nonsurgical, localized treatment that kills the tumor cells with heat, while sparing nearby healthy lung tissue. As a result, RFA is much easier on the patient than systemic therapy. Radiofrequency ablation can be performed in most patients without affecting their overall health, so that most people can resume their usual activities in a few days. RFA is a safe, minimally invasive tool for local lung cancer control with negligible mortality, little morbidity, and short hospital stay.

For the RFA procedure, the Interventional Radiologist uses CT scan imaging to guide a small needle through the skin directly into the tumor. From the tip of the needle, radiofrequency energy (similar to microwaves) is transmitted to the tip of the needle, where it produces heat, resulting in controlled tumor destruction. The dead tumor tissue shrinks and slowly forms a scar. RFA is ideal for nonsurgical candidates, especially those with smaller tumors. The FDA has approved RFA for the treatment of tumors in soft tissue that includes the lung.

Depending on the size of the tumor, RFA can shrink or wipe out the tumor. Because it is a local treatment that does not harm much healthy tissue, RFA can be repeated if necessary to keep cancer under control.

By decreasing the size of a large mass, or treating new tumors in the lung as they arise, the pain and other debilitating symptoms caused by the tumors are often relieved. While the tumors themselves may not be painful, when they press against nerves or interfere with vital organs, they can cause pain. RFA is effective for small to medium-sized tumors and emerging new technologies should allow the treatment of larger cancers in the future.