RFA is not a new technology; the method has been used for decades to treat benign bone tumors and some heart conditions. RFA is currently approved by the FDA to treat liver tumors that are not eligible for surgery, painful bone tumors, and other soft-tissue tumors.
RFA has been most often used for liver tumors, because so many tumors of the liver are ineligible for surgery. The procedure has been approved by the FDA since 1996 and is covered by many insurance carriers. Some researchers even suggest that RFA could replace surgery altogether for the treatment of liver lesions.
In many cases, RFA is used to reduce or eliminate pain caused by tumors, not to cure the cancer itself. However, researchers in Italy, a major center or RFA expertise, have found that the survival rates for patients whose liver tumors were treated with RFA are similar to, if not better than, those for patients whose tumors were treated with surgery.
Cross sectional CT image of the liver following RFA treatment. Darkened area represents tissue area treated with RFA. (Provided by A Drooz)
RFA has been used for years to destroy painful benign bone tumors, and researchers are now applying the technique to malignant bone tumors.
RFA and other ablative techniques can be used to kill or reduce the tumor and deaden nerve endings affected by the tumor. This does not cure the cancer, but it can drastically reduce or even eliminate the pain these tumors cause. Because RFA does not carry the risk of surgery, doctors are more willing to use the technique for palliative purposes.
RFA can be used to treat tumors that originate in the kidneys and those that metastasized from other organs. The procedure is often used to treat tumors in the remaining kidney when one kidney has been removed.
As in other parts of the body, RFA is most effective on kidney tumors between 0.5 and 3 cm in size, and no more than three in number. The technique is promising, but long-term studies are needed to determine how effective the treatment is in the kidney.
RFA is showing impressive results in treating lung tumors. As with other cancers, it is most effective in tumors that are smaller than 4 cm in size.
A recent study in Italy showed that RFA of lung tumors can dramatically increase survivability rates without decreasing quality of life.
Surgery is still the gold standard for treatment of breast tumors, but researchers are seeing advantages to RFA treatments. RFA can be used both to eliminate small tumors in the breast and to reduce the size of larger tumors, making surgery easier and less disfiguring.
Where RFA Should Not Be Used
While RFA and other tumor ablation treatments show great promise, they should not be used in every situation.
• Near blood vessels
RFA and other heat ablation procedures can be ineffective when used on tumors near major blood vessels. This is due to the “heat sink” effect: The blood vessels can carry heat away from the treatment area, causing inconsistent ablation. In this case, all areas of the tumor may not receive the same amount of heat, so some areas may not be destroyed.
• Near nerve endings
RFA may not be used when a tumor is located near major nerve centers. Nerve endings are highly susceptible to heat, and the treatment may inadvertently destroy the nerves while it is killing the tumor.