Tumour ablation for kidney cancer

Tumour ablation is a type of treatment that uses extreme temperatures to destroy small tumours. This treatment may be used if you have a small tumour, and are not fit enough to have surgery or choose not to have it.

Tumour ablation preserves more of the kidney than kidney‑sparing surgery. So it may be used for people who have only one kidney. It can also be an option for people who have an inherited form of kidney cancer that causes multiple tumours, or if cancer is affecting both kidneys.

Tumour ablation generally causes fewer side effects and has a quicker recovery time than surgery for kidney cancer. But there is a slightly higher risk of some cancer remaining in the kidney. The benefits of avoiding surgery and sparing more of the kidney need to be balanced against this risk. Your cancer doctor will talk to you about the risks and benefits if this treatment is an option for you.

There are different methods for destroying the tumour. The two most commonly used treatments are:

• cryotherapy, which uses liquid nitrogen to freeze the tumour
• radiofrequency ablation (RFA), which uses an electric current to produce high temperatures to destroy the tumour.

Other methods of tumour ablation may be used in clinical trials. These include:

• microwave ablation
• laser ablation
• high‑intensity focused ultrasound (HIFU).

Your cancer doctor or specialist nurse will talk to you about tumour ablation.

Usually, a specialist x-ray doctor (radiologist) will do tumour ablation. You will either be given a sedative to help relax you, or a general anaesthetic.

You may have a catheter put in to drain urine from your bladder. This is usually removed soon after the procedure.

The doctor uses a local anaesthetic to numb the area around the kidney. Then you have an ultrasound or CT scan. These scans guide the doctor to the right area of the kidney. The scans also help them monitor what is happening during your treatment.

When the doctor sees the tumour on the monitor, they place one or more fine probes through the skin (percutaneously) into the tumour.

The probes freeze or heat the tumour. The extreme temperature destroys the cancer cells. The doctor will also aim to destroy a small area (about 1cm) of healthy tissue around the tumour. This is to try to make sure no cancer cells are left behind to grow back again.

Sometimes a tumour ablation is done using keyhole surgery. You have a general anaesthetic for keyhole surgery. The surgeon makes a few small cuts in your tummy (abdomen) to do the tumour ablation.

They pass a laparoscope through one of the cuts to see the tumour. A laparoscope is a thin tube with a light and a camera on the end that sends video images to a monitor. The surgeon inflates your tummy with gas so that it is easier to see and work with the laparoscope.

The risk of complications after tumour ablation is low.

Possible complications include:

• Infection – you may be given antibiotics to reduce the risk of this happening.
• Bleeding – you will be monitored during the treatment and for a few hours afterwards.
• A narrowing of the ureter – this can affect how urine drains from the kidney.

You will have a scan after treatment to check for any complications. These can be treated straight away if needed.