Ablation and Other Local Therapy for Kidney Cancer

Whenever possible, surgery is the main treatment for kidney cancer that can be removed. But for people who are too sick to have surgery or don't want to have surgery, other treatments can sometimes be used to destroy the kidney tumor. These approaches are usually considered for small (no larger than 4 cm or1½ inches) kidney cancers. There is much less data on how well these treatments work over time than there is for surgery, but they might be helpful for some people.

Cryotherapy (cryoablation)

Cryotherapy 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, CT or MRI scans) 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)

Radiofrequency ablation uses high-energy radio waves to heat the tumor. A thin, needle-like probe is placed through the skin and moved forward until the end is in the tumor. Placement of the probe is guided by ultrasound or CT scan. Once it is in place, an electric current is passed through the tip of the probe. This 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.

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Campbell S, Uzzo RG, Allaf ME, Bass EB, Cadeddu JA, Chang A, et al. Renal Mass and Localized Renal Cancer: AUA Guideline. J Urol. 2017; 198:520-529. doi: 10.1016/j.juro.2017.04.100. Epub 2017 May 4.

Correa AF, Lane BR, Rini BI, Uzzo RG. Ch 66 - Cancer of the kidney. In: DeVita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.

Hines A and Goldberg SN. UpToDate. Radiofrequency ablation and cryoablation for renal cell carcinoma. This topic last updated: Mar 09, 2018. Accessed at https://www.uptodate.com/contents/radiofrequency-ablation-and-cryoablation-for-renal-cell-carcinoma on November 12, 2010. 

McNamara MA, Zhang T, Harrison MR, George DJ. Ch 79 - Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier: 2020.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Kidney Cancer. V.2.2020. Accessed at: www.nccn.org on November 12, 2019.

References

Campbell S, Uzzo RG, Allaf ME, Bass EB, Cadeddu JA, Chang A, et al. Renal Mass and Localized Renal Cancer: AUA Guideline. J Urol. 2017; 198:520-529. doi: 10.1016/j.juro.2017.04.100. Epub 2017 May 4.

Correa AF, Lane BR, Rini BI, Uzzo RG. Ch 66 - Cancer of the kidney. In: DeVita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.

Hines A and Goldberg SN. UpToDate. Radiofrequency ablation and cryoablation for renal cell carcinoma. This topic last updated: Mar 09, 2018. Accessed at https://www.uptodate.com/contents/radiofrequency-ablation-and-cryoablation-for-renal-cell-carcinoma on November 12, 2010. 

McNamara MA, Zhang T, Harrison MR, George DJ. Ch 79 - Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier: 2020.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Kidney Cancer. V.2.2020. Accessed at: www.nccn.org on November 12, 2019.

Last Revised: February 1, 2020

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