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Radiofrequency Ablation Radiofrequency ablation (RFA) is a technique used to destroy unwanted tissue. RFA is frequently used to ablate (remove/destroy) tumors like cancer. The most common area in which RFA has been used is in the liver, although it has been used in other areas such as the breast, lung, kidney, and bone. Most often, radiofrequency ablation is used to kill cancer, but benign tumors of certain tissues, sleep apnea, certain heart arrhythmias, and other problems can also be treated in this way. Common aims of RFA treatment include:
RFA is a macroscopic technique. Doctors can only treat what they can see with the image guidance. The CT scanner cannot see on the cellular level, so even when the entire tumor appears to be ablated, there is always a risk of some residual tumor cells not killed with RFA. In this case, the patient is not cured because those remaining cells can grow and form the tumor again. Thus, RFA is best viewed as a palliative technique (to reduce symptoms, not to cure the disease completely). RFA does not replace chemotherapy. RFA is complementary to other techniques when treating cancer. People who have had surgery, chemo, or radiation therapy can have recurrence of their tumor or develop new tumors; RFA can be used then. In reality, most people who have cancer require a combination of all these techniques. A patient might have surgery to remove the primary tumor or as much as possible, then undergo either radiation or chemotherapy to kill off any cells that may have spread or to reduce the remaining tumor not surgically resected. Most of these techniques are complimentary and are frequently used in conjunction, not necessarily in the very same setting but at different times during the patient’s course of treatment. One advantage of RFA is that you can repeat it in most cases if necessary. Other cancer treatments, on the other hand, cannot always be repeated in the case of recurrent cancer. In surgery, there is a limit to how much you can safely cut out; you can’t cut out vital structures that you need to live, just as with RFA. Similarly, the body can only sustain so much radiation therapy because of damage to adjacent normal tissue. Chemotherapy cannot be continued indefinitely due to the harsh effects on the body. After so many doses of chemotherapy, the tumor cells become resistant so that they do not respond the chemo, while the normal cells are so damaged that they do not grow back well. For example, sometimes bone marrow (which makes new blood) will never recover from chemotherapy. On the other hand, there is no specific contraindication to performing RFA again to kill tumor regrowth, although there are some cases when it would not be feasible to do RFA again (such as if the tumor is in a location which cannot be reached).
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