Ablation for kidney cancer

Overview

Kidney cancer, also known as renal cancer, is typically addressed through surgical interventions aimed at removing either the entire kidney or a portion of it. Nevertheless, alternative approaches may be considered in specific cases, especially when individuals have underlying medical conditions that contraindicate surgery. One emerging treatment method involves ablation techniques, which utilize either extreme cold or heat to target and destroy tumors. Cryotherapy, utilizing cold, or cryoablation, and radiofrequency ablation, involving heat, are two such methods employed in select cases.

Types

The following are types of ablation procedure.

• Cryoablation: Cryoablation is employed to treat small tumors, typically measuring up to four centimeters (approximately 1½ inches) in size. It involves the use of cold gas to freeze and rapidly thaw the tumor, depriving cancer cells of essential nutrients. A thin needle is inserted into the tumor, usually through a minimally invasive laparoscopic procedure, which utilizes small incisions and a camera-equipped laparoscope. Alternatively, it can be performed percutaneously, where a radiologist guides a needle, aided by a computed tomography (CT) scan, to freeze the tumor through the skin, representing an even less invasive approach.
• Radiofrequency ablation: Multiple needles are inserted into the tumor, and these needles are utilized to apply heat through electric currents or radio waves to destroy the tumor. Typically conducted under local anesthesia, this procedure allows patients to remain awake, although they may be administered medication to aid in relaxation.

Risk

Ablation is a safer option than surgery for some individuals due to age or health concerns. It aims to destroy the tumor while preserving the kidney, leading to shorter hospital stays and quicker recovery. However, ablation may require multiple treatments, and there’s a risk of heat-related issues, such as urine leakage or blockage, although surgeons often use temporary stents for protection. Additional complications may involve infections or kidney damage.

Procedure

Cryoablation

Before the procedure, your doctor may request that you discontinue specific medications or supplements up to a week in advance. You’ll also need to fast for eight hours prior to the procedure.

Typically, you’ll spend just one day in the hospital, but complete recovery might extend up to three weeks. During this recovery period, it’s advisable to avoid strenuous activities, so having some assistance at home is recommended. You’ll also have several follow-up appointments for scanning procedures within the next six months.

Radiofrequency ablation

Your doctor will provide specific guidelines on discontinuing medications and supplements as well as fasting duration before the procedure, similar to cryoablation. After the procedure, you may often be able to return home shortly and resume regular activities within a few days, but it’s possible that multiple sessions might be necessary.

Outcome

These procedures are relatively recent innovations, with cryoablation being introduced for this purpose in 1995, and radiofrequency ablation for kidney cancer being an even more recent advancement. Although they have shown promising success rates, it is crucial to closely monitor patients who have undergone these procedures over the years to assess their long-term effectiveness.