Ablation and Other Local Therapy for Kidney Cancer

Whenever possible, surgery is the main treatment for kidney cancer that can be removed. But ablation therapy or other local treatments to destroy tumors might be considered in some situations.

These treatments might be helpful for some people. However, there is much less data on how well they work in the long term compared to what we know about surgery.

What is ablation therapy?

Ablation is the use of extreme temperatures to destroy a tumor. Although surgery is often recommended for treating kidney cancer, ablation might be considered in certain cases.

Ablation can be done in 2 ways:

• Percutaneously with a needle or probe through the skin. This is usually done as an outpatient. You probably do not need to stay in the hospital after this procedure.
• Surgically with a laparoscope. You might need to stay in the hospital to recover.

It isn’t clear if one approach is better than the other. However, these are specialized procedures and should be done by an experienced cancer care team.

How the procedure is done

Before the procedure, medicine will be put into a vein (IV) to make you more comfortable or fall asleep. This will either be a sedative and pain medicine to help you relax or general anesthesia to put you into a deep sleep.

You will usually lie on your side or face down on your belly for the procedure.

After anesthesia, an ablation tool or laparoscope is placed through the skin into the tumor. To guide the tool to the right place, the doctor uses imaging tests or the camera on the laparoscope. Once the tool is in place, heat or cold is delivered to the tumor for a few minutes.

You might be able to go home a few hours after the procedure, or you might need to stay in the hospital overnight. This will depend on how the procedure was done and any complications.

When is ablation used for kidney cancer?

Ablation might be considered if:

• The tumor is small (less than 3 or 4 cm) and only located in the kidney.
• Surgery is not a good option for another reason, such as other health problems.
• Your kidney function is low, you are at risk of developing multiple kidney tumors, or you already have multiple kidney tumors, and your care team wants to minimize damage to any healthy kidney you have left.

Ablation is often not recommended if there is distant spread of your kidney cancer, the tumor is large or in the center of the kidney, or if your life expectancy is limited.

Ablation procedures might need to be done more than once to treat a kidney tumor.

Types of ablation

Several ablation techniques might be used to treat kidney tumors.

• Radiofrequency ablation (RFA) uses high-energy radio waves to heat and destroy cancer cells.
• Cryoablation (cryotherapy) uses extreme cold to kill cancer cells by freezing, thawing, and refreezing them during a treatment session.
• Microwave ablation uses electromagnetic microwaves to heat and destroy cancer cells.

Other local treatments for kidney cancer

Other, newer types of local treatment might also be used to destroy tumors in the kidney, or possibly in other parts of the body. These approaches haven’t been around as long as other treatments, so there is less long-term data on them at this point. Still, they might be an option for some people.

Irreversible electroporation

For this treatment, imaging tests are used to guide long needles, called electrodes, into place around the tumor. The needles are then used to create a strong electrical field within the tumor. This causes holes (pores) to form in the walls of the cancer cells, damaging them.

This treatment doesn’t use heat or cold to destroy the cells. It might be useful in areas where it is important to protect vital structures, like nearby blood vessels, but many doctors feel that more research is needed to show it is safe and effective.