Ablation for Kidney Cancer

What is ablation for kidney cancer?

Ablation is an alternative to surgery for kidney cancer. During ablation therapy, your healthcare provider inserts a probe (a thin, needle-shaped device) through your skin and into the kidney tumor (renal tumor). This probe sends extreme cold or high heat directly to the diseased tissue. The treatment destroys (ablates) abnormal cells, causing cell death. It spares the surrounding healthy kidney tissue.

Who needs ablation for kidney cancer?

Your healthcare provider may recommend ablation for kidney tumors if you:

• Can’t get (or don’t want) surgery (nephrectomy) to remove a cancerous kidney tumor. Options for surgery typically include removal of the kidney tumor and some surrounding normal kidney tissue (partial nephrectomy) or removal of your entire kidney (radical nephrectomy).
• Have kidney tumors smaller than 1.2 inches (3 centimeters).
• Have multiple small tumors in one kidney or small tumors in both kidneys.

What are the types of kidney cancer ablation?

There are different ablative procedures for kidney cancer:

• Cryoablation: Cryoablation for kidney cancer uses very cold gas to freeze and thaw diseased tissue. This process starves cells of the blood and oxygen they need to survive. Cryoablation is also called cryotherapy or cryosurgery.
• Radiofrequency ablation: Radiofrequency ablation (RFA) uses heat from radio waves (electrical energy) to destroy tumors. Other types of heat ablation for kidney cancer include microwave ablation (MWA) and laser ablation.

How common is ablation for kidney cancer?

Surgery (partial or radical nephrectomy) is still the primary treatment for kidney cancer. However, more providers are using ablative procedures to treat small tumors. Ablation therapy is also a good option for people with medical conditions that make surgery too risky.

How should I prepare for this procedure?

You should follow your healthcare provider’s instructions to prepare for kidney cancer ablation. Depending on the type of ablative procedure, you may need to:

• Not eat or drink before the procedure.
• Stop taking certain medications, vitamins or herbal supplements.

What happens during ablation for kidney cancer?

There are two ways that healthcare providers can perform ablation for kidney cancer:

• Laparoscopically: Urologists perform ablation with this approach. Your surgeon makes small incisions and uses a laparoscope (video camera device) to deliver the treatment. This is a minimally invasive surgical procedure. You’ll receive general anesthesia.
• Percutaneously: Interventional radiologists perform ablation with this approach. These medical doctors specialize in treating conditions with the aid of imaging equipment. Your provider inserts the ablation probe through a small puncture in your numbed skin and uses imaging to find the kidney tumor for ablation. You may receive local anesthesia and/or a sedative.

During ablation for kidney cancer, your provider:

1. Numbs your skin, or gives you a sedative or general anesthesia.
2. May place a ureteral stent, as there’s a small risk that the temperature changes from the ablation can cause a urine leak or blockage. This stent allows urine to flow from your kidney to your bladder and out through a Foley catheter during the procedure.
3. Uses a needle to remove a piece of the tumor for a biopsy. They send it to a pathology lab, and you’ll receive the information about five to seven days after your ablation. This tells your provider what type of kidney tumor you had, which can guide future management and monitoring strategies.
4. Inserts the ablation probe through a small incision or puncture. If you’re having this procedure with laparoscopy, you’ll have a few small incisions for the camera, probe and other instruments.
5. Activates the probe, generating extreme hot or cold temperatures at the tip of the device.
6. Looks at real-time images from an ultrasound, MRI (magnetic resonance imaging) or CT scan (computed tomography scan) to destroy the cancerous tissue.

How long does kidney cancer ablation take?

Kidney cancer ablation typically takes one to three hours, including preparation time. The amount of time required for an ablative procedure depends on your unique condition and treatment.

What happens after ablation therapy?

After ablation, you may:

• Recover at the outpatient clinic and have someone drive you home.
• Stay in the hospital for about 24 hours (for an inpatient procedure).
• Experience fatigue, pain, light bleeding and muscle soreness.

What are the benefits of ablation for kidney cancer?

Some benefits of ablation therapy compared to surgery include:

• Faster recovery with minimal pain and bleeding.
• Less invasive procedure compared to surgery.
• Minimal damage to healthy kidney tissue.
• No hospitalization (or short hospital stays).
• Smaller incisions and minimal scarring.

How successful is kidney tumor ablation?

When surgery isn’t an option, ablation can be an effective treatment for kidney cancer and tumors. Studies show that people who get kidney cancer ablation instead of surgery have similar five-year outcomes. They also have fewer treatment complications.

What are the risks or complications of ablation therapy?

Ablation for kidney cancer can be safer than surgery. Still, all procedures have risks. You may experience:

• Blood clots or hemorrhage (bleeding).
• Bruising.
• Damage to blood vessels, nerves or nearby organs.
• Infections.
• Scarring.
• Stroke or heart attack.
• Ureteral obstructions.

What is the recovery time after kidney cancer ablation?

Recovery time after ablation depends on your unique situation. You should follow your healthcare provider’s recovery instructions, which may include:

• Lowering infection risk by taking antibiotics.
• Not lifting anything heavy or engaging in strenuous physical activities for a specific time.
• Taking prescription or over-the-counter (OTC) pain relievers to ease pain and soreness.

When can I resume activities after ablation therapy?

You should resume activities when your provider gives the OK. Most people can resume normal activities like walking and driving 24 hours after undergoing kidney tumor ablation. Your provider will let you know when you can start doing strenuous activities or heavy lifting.

When should I call my healthcare provider?

You should call your healthcare provider if you experience:

• Excessive bleeding or pain.
• Nausea and vomiting.
• Problems urinating (peeing).
• Signs of infection, like fever.

Is kidney cancer ablation a major surgery?

No. Depending on the method, ablation is sometimes a minor surgical procedure. The procedure typically takes place in an outpatient clinic. In rare instances, ablation for kidney cancer requires a short hospitalization.

Can you get ablation treatment for kidney cancer more than once?

Yes. You may need more than one ablative procedure if:

• Tumors come back or don’t respond to the initial treatment.
• New tumors form.

A note from Cleveland Clinic

Compared to a surgical nephrectomy, ablation is an effective, less invasive kidney cancer treatment for many small renal tumors. Some people prefer ablation treatment because it offers a faster, less painful recovery. However, you may need more than one ablative procedure. Your healthcare provider can discuss the risks and benefits with you. That way, the two of you can make the best decision for your health.