Microwave and radiofrequency ablation for kidney cancer

Microwave ablation and radiofrequency ablation use heat to kill cancer cells. They can treat small, early stage kidney cancers.

What is microwave and radiofrequency ablation?

A specialist doctor (radiologist) puts small probes through your skin into the area of the cancer. The probes use microwave energy or radiofrequency energy to heat up the tissue around the cancer. This causes the cancer cells to die.

Microwave ablation is more commonly used than radiofrequency ablation.

Who can have microwave and radiofrequency ablation?

The specialist urological cancer multidisciplinary team (MDT) assess you for this treatment.

You might have an ablation if you have:

• a small early stage kidney cancer but you can't have surgery
• more than one small tumour, or tumours in both kidneys

You may not be able to have ablation if your cancer is too close to other organs, such as the bowel.

If your kidney cancer comes back after an ablation you may be able to have the treatment again.

This treatment is only available in specialist cancer centres. So you may have to travel to another hospital to have it.

Before microwave or radiofrequency ablation

Your doctor or specialist nurse explains how they do the treatment and what the possible risks are. They ask you to sign a consent form saying that you agree to have the procedure. You can ask them any questions that you have. Tell them about any medicines you are taking and if you have any allergies.

You might need to stop any blood thinning medicines before your treatment. Your doctor or nurse will let you know. They will also say when you need to stop eating and drinking before the procedure.

Speak to your doctor, nurse specialist (CNS) or the department where you are having the procedure, if there are any changes to your health or medicines before your ablation. Or if you have any questions or concerns.

Ask your doctor or nurse how long it may take you to recover from the procedure. And if you need to take any time off work.

Having microwave or radiofrequency ablation

You have kidney cancer ablation through a small cut in your skin over the kidney. This is called percutaneous ablation.

You might have this treatment under a general anaesthetic. This means you are deeply asleep and you can’t feel anything. Or you may have a local anaesthetic to numb the area and some medicine to make you feel relaxed and drowsy (sedation).

Your doctor uses a CT or ultrasound scan to see the kidney. They put a small thin tube called a cannula into one of your veins and inject a special dye (contrast) into your bloodstream. This lets your doctor see the kidney better on the scan.

Your doctor puts one or more probes through your skin and into the kidney cancer. They use scans to check the probes are in the right place. An electrode in the probes then creates microwave or radiofrequency energy. This heats the probe which kills the cancer cells.

Your doctor removes the probes when they have finished the ablation. A dressing is then put over the small cut.

After microwave or radiofrequency ablation

When you are awake enough you go back to the ward. You usually have to stay in bed for about 4 hours after the procedure. Your doctors and nurses will let you know when you can get up. They will also tell you when you can start eating and drinking.

Tell your nurse if you have any pain and they will give you some painkillers.

You should be able to go home the next day if your doctor thinks you are well enough. You might need to take it easy for a week and avoid strenuous activity or driving. You can normally remove the dressing 48 hours after the procedure.

If you had to stop some of your normal medicines before the procedure, your doctor will talk to you about when to start taking them again.

Side effects of microwave and radiofrequency ablation

As with any medical procedure there are possible side effects or complications. Your doctor makes sure the benefit of the treatment outweighs these risks.

Everyone is different and side effects can vary from person to person. You may not have all the effects mentioned. Side effects can include:

• pain in the treatment area - you may need to take painkillers at home for a few days afterwards
• flu-like symptoms that start a few days after the procedure (called post ablation syndrome)
• infection – your nurse will tell you who to contact if you have a high temperature or any other problems
• bleeding – rarely you may need a blood transfusion
• narrowing of the tube from the kidney to the bladder (ureter) – this may cause problems peeing
• a small leak of urine around the kidney or injury to the bowel – this is very rare

Your healthcare team will monitor you closely during treatment. They will tell you what to look out for when you go home. They will also tell you who to contact if you have any problems.