What is radiofrequency ablation (RFA) of lung tumors?

Radiofrequency ablation (RFA) is a way to destroy tissue in the body. It can be used as a cancer treatment.

In RFA, electricity is sent into a tumor using a needle electrode. The electricity creates heat that kills the cancer cells. The heat also seals nearby blood vessels to limit bleeding. As you heal, scar tissue replaces the tumor.

Your healthcare provider uses an imaging scan to see where to put the needle in your lungs. A CT scan or MRI is often used.

RFA lets your healthcare provider treat the cancer through small cuts in your skin. You may recover more quickly and have less pain after this procedure than with surgery.

Why might I need RFA of lung tumors?

RFA may be part of your overall cancer treatment. It can be done along with chemotherapy, radiation therapy, or both. It can also be combined with surgery.

Your healthcare provider may suggest this treatment to:

• Treat lung cancer that's small and hasn't spread (some early-stage lung cancers) instead of surgery or radiation therapy

• Treat cancer that has spread to the lungs from another place in the body (metastatic cancer)

• Manage or ease pain, bleeding, or breathing problems caused by lung tumors

• Treat tumors that come back in the same place

Using RFA to reduce the tumor size may help some people live longer. It might be a treatment choice for some people who can't have or don't want surgery. It can be done more than once if needed. It can also be used to treat multiple tumors.

RFA may not be a choice if the tumor is too close to key organs or tissues (such as major blood vessels or the heart) because they may be damaged by treatment.

What are the risks of RFA of lung tumors? 

All procedures have some risks. The risks of RFA of lung tumors include:

• Air can collect in the chest cavity and cause part of the lung to collapse (pneumothorax)

• Excess bleeding

• Rarely, bleeding into the lung

• Fluid can build up in the space between the lung and the membrane around it (pleural effusion)

• Infection

• Pain for a few days

• Lung disease symptoms that get worse

Your risks depend on your age, your overall health, and the reason RFA is done. Talk with your healthcare provider to find out more about your risks.

How do I get ready for RFA of lung tumors?

Talk with your healthcare provider how to prepare for RFA. Tell them about all the medicines you take. This includes over-the-counter medicines, prescription medicines, vitamins, herbs, and other supplements. It also includes marijuana or illegal drugs. You may need to stop taking some medicines, such as blood thinners and aspirin, before the procedure. If you smoke, you may need to stop before the procedure. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.

Blood tests might be needed before RFA. These may be done to see how your kidneys and liver are working and make sure your blood clots well.

Tell your healthcare provider if you:

• Have had any recent changes in your health, such as an infection or fever

• Are sensitive or allergic to any medicines, latex, tape, and anesthesia medicines (local and general)

• Have a history of bleeding disorders

• Are taking any blood-thinning (anticoagulant) medicines, aspirin, ibuprofen, or other medicines that affect blood clotting

• Are pregnant or think you may be pregnant

Also be sure to:

• Have a family member or friend ready to take you home from the hospital. You can’t drive yourself if you're given sedation for the procedure.

• Follow all instructions for not eating or drinking before the procedure.

• Follow all other instructions from your healthcare provider.

You'll be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully. Ask questions if anything isn't clear.

What happens during RFA of lung tumors?

RFA of lung tumors may take a few hours. The procedure will likely follow these basic steps:

• You’ll lie on an exam table. An IV (intravenous) line will be put in your hand or arm. Your healthcare team will give you medicine through this tube.

• Your healthcare team will track your blood pressure, heart rate, and pulse.

• RFA may be done while you’re awake or under general anesthesia. If you’re awake, your healthcare provider will numb the place on your body where the skin will be cut to put in the needle electrode.

• Pads to ground electricity will be put on your back or thighs.

• Your skin will be cleaned and covered with a sterile drape.

• Your healthcare provider will make a small cut in your skin. This where the needle electrode will go into the tumor. An imaging scan, such as a CT scan or ultrasound, will be used to guide the needle electrode to the lung tumor.

• An electrical current will pass through the electrode to destroy the tumor. The electrode may need to be moved around to other parts of the tumor to reach all of it.

• Once the procedure is done, your healthcare provider will take out the electrode and a bandage will be put over the site. Stitches aren't needed.

What happens after RFA of lung tumors?

You may have pain and nausea after RFA. These side effects are often mild and can be controlled with medicines. You should be able to go home a few hours after the procedure.

An X-ray will be taken about 2 hours after RFA. This is to make sure that no part of your lung has collapsed or been harmed. Sometimes part of the lung collapses because of trapped air. If this happens, you may need a small tube put in the lung to remove the air so the lung can expand. You can go home with this tube, and it's taken out after a day or so. Make sure to go to all of your follow-up appointments.

Call your healthcare provider right away if any of the following occur:

• Redness or fluid leaking at the incision

• Fever or chills

• Shortness of breath

Follow instructions from your provider for limiting activity and caring for the incision after the procedure. In about a week, you should feel back to normal and be able to return your daily activities. Call your healthcare provider if you have any problems after the procedure. They will tell you about tests needed after the procedure to see how well it worked.

Next steps

Before you agree to the test or procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how will you get the results

• Who to call after the test or procedure if you have questions or problems

• How much will you have to pay for the test or procedure