Ablation and Other Local Therapy for Kidney Cancer

Whenever possible, surgery is the main treatment for kidney cancers that can be removed. But for people who are too sick to have surgery, other approaches can sometimes be used to destroy kidney tumors. They might be helpful for some people, but there is much less data on how well they work over time than there is for surgery, so they are not yet considered a standard treatment.

Cryotherapy (cryoablation)

This approach uses extreme cold to destroy the tumor. A hollow probe (needle) is inserted into the tumor either through the skin (percutaneously) or during laparoscopy (see Surgery for Kidney Cancer). Very cold gases are passed through the probe, creating an ice ball at its tip that destroys the tumor. To be sure the tumor is destroyed without too much damage to nearby tissues, the doctor carefully watches images of the tumor during the procedure (with ultrasound) or measures tissue temperature.

The type of anesthesia used for cryotherapy depends on how the procedure is being done. Possible side effects include bleeding and damage to the kidneys or other nearby organs.

Radiofrequency ablation (RFA)

This technique uses high-energy radio waves to heat the tumor. A thin, needle-like probe is placed through the skin and advanced until the end is in the tumor. Placement of the probe is guided by ultrasound or CT scans. Once it is in place, an electric current is passed through the tip of the probe, which heats the tumor and destroys the cancer cells.

RFA is usually done as an outpatient procedure, using local anesthesia (numbing medicine) where the probe is inserted. You may be given medicine to help you relax as well.

Major complications are uncommon, but they can include bleeding and damage to the kidneys or other nearby organs.

Arterial embolization

This technique is used to block the artery that feeds the kidney that has the tumor. A small catheter (tube) is placed in an artery in the inner thigh and is moved up until it reaches the renal artery going from the aorta to the kidney. Material is then injected into the artery to block it, cutting off the kidney’s blood supply. This will cause the kidney (and the tumor in it) to die.

Although this procedure is not used very often, it is sometimes done before a radical nephrectomy to reduce bleeding during the operation or in patients who have persistent bleeding from the kidney tumor.

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Richie JP. UpToDate. Definitive surgical management of renal cell carcinoma. This topic last updated: March 14, 2017. Accessed at https://www.uptodate.com/contents/definitive-surgical-management-of-renal-cell-carcinoma on June 5, 2017.

Last Medical Review: August 1, 2017 Last Revised: August 1, 2017

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