Physician Information: Frequently Asked Questions

September 9, 2004

What Is Tumor Ablation?
Tumor ablation therapies are a method of targeting and destroying a tumor from the inside out. The most common type of tumor ablation is radiofrequency ablation (RFA).

What Is Radiofrequency Ablation?
Radiofrequency ablation uses radio waves to heat a tumor. The radio waves cause friction, which heats and kills the surrounding tissue.

How Does RFA Work?
RFA uses a needle electrode with an insulated shaft and an uninsulated or "live" tip to heat the tissue directly around the needle tip. Radio waves emitted from the tip of the needle electrode cause the molecules in the tissue directly surrounding it to move; the friction of this movement heats the area. When the heat exceeds at least 50 degrees C, cell death occurs. The dead tumor is not removed-it will gradually shrink and be absorbed into the body and will then be replaced by scar tissue.

Who Can Benefit From RFA?
Most patients can benefit from RFA, including:
• Patients who are too frail to withstand surgery
• Patients taking blood thinners or who otherwise face an increased risk of blood loss
• Patients with compromised immune systems
• Patients whose tumors are located in a place that makes surgery impossible or its removal would destroy too much healthy tissue

Is RFA Experimental?
No. RFA has been used to treat benign bone tumors and some heart problems for more than 20 years. It has been approved by the FDA for the treatment of liver tumors since 1996. The procedure has expanded to treat tumors of the kidney, lung, and breast with some success.

Is RFA a Cure for Cancer?
No. But RFA can reduce the size of some tumors or completely eliminate them, increasing survivability rates in many instances. In other cases, RFA is used primarily to eliminate painful tumors and improve a patient's quality of life.

What Types of Cancer Can Be Treated With RFA?
RFA can be used to treat tumors of the
• Liver
• Kidney
• Breast
• Lung
• Prostate
• Adrenal glands
• Bone

RFA has been most often used to treat liver tumors. Other treatments show promise but do not yet have studies providing long-term results.

What Are the Common Complications From RFA?
The risks associated with RFA include:
• Pain
• Bleeding
• Bruising
• Infection
• Fever

Depending on the site of the ablation, some patients are at increased risk of lung collapse.

In addition, some patients experience post-RFA syndrome, which may include a low-grade fever and flu-like symptoms. In most cases, the syndrome disappears within 10 days after the procedure.

Is RFA Covered by Insurance?
Many insurance providers do cover the use of RFA to treat liver and bone tumors. Coverage is expanding to include other types of tumors; for example, Cigna has made a determination to cover palliative RFA of nonresectable kidney tumors. Other procedures may be covered on a case-by-case basis.