What Is Radiofrequency Ablation

Introduction to radiofrequency ablation (RFA) 

Radiofrequency Ablation (FRA) is a technique that utilises radio waves to destroy tumours and growths with heat.¹ It can also be used in treatment for chronic pain. It can be used alone or in combination with other forms of treatment depending on symptoms and individual treatment plans.

Principle of radiofrequency ablation 

Radiofrequency ablation uses heat from the radio waves to destroy the tumour cells via a needle-like probe. It can also be used to seal enlarged veins or to target specific nerves that result in nerve pain. This procedure can be carried out in an outpatient setting under local anaesthetic or with a sedative. However, an ultrasound or CT scan is required to guide the needle.²  

Medical applications of RFA 

Radiofrequency Ablation (RFA) can be used to treat a number of different conditions such as cancer. The heat produced from the radio waves can be used to destroy the tumours. This is not normally the first line of treatment, and it can also be used in combination with other methods such as chemotherapy or surgery.  

Another condition that may be treated with RFA is thyroid nodules. Thyroid nodules tend to be benign (non-cancerous) but can still cause significant health problems if left untreated. The usual treatment for thyroid nodules is surgical removal, but there has been significant progress made with the use of RFA as it is a less invasive treatment method. It also has a shorter recovery time compared to open surgery. Open surgery is not always suitable for all candidates due to other medical conditions an individual may have or due to the treatment location being inaccessible via surgery (such as with some cancers).³ Speak to your healthcare provider about whether you are suitable for RFA, and they can review your individual case and discuss what the best treatment options are for you.  

Additionally, RFA can be used to treat chronic or nerve pain. This may be a suggested course of treatment if other methods such as physical therapy or medication have not proven to be effective and if surgery is not an option. Though, RFA cannot be used in every case and your healthcare provider may have to refer you to a specialist before treatment can begin.  

Varicose veins are a common condition in many Western countries, which causes a swollen and enlarged appearance of veins in the lower legs and feet. The severity of the condition differs per individual, with some people experiencing no symptoms while others face serious pain and discomfort that may disrupt their day-to-day activities. RFA can be used to seal off the affected enlarged veins, redirect the flow of blood to healthy blood vessels, and relieve such symptoms. 

Candidates for radiofrequency ablation 

Before deciding if radiofrequency ablation is the right course of treatment, your healthcare provider should review your medical history to determine if you are suitable. A few different factors can make RFA an unsuitable course of treatment, such as pregnancy- it may not be safe for the baby. Additionally, if you are taking any blood thinning medication or anti-coagulants (drugs such as warfarin that prevent the blood from clotting), your healthcare provider may ask you to stop taking the medication for a few days leading to the procedure. This depends on your individual medical history and treatment plan, and RFA may be unsuitable, but there could be other methods that prove to be more effective in treating your symptoms.  

Preparation and pre-procedural steps 

Before the procedure, you will be required to have an initial assessment on whether this is a suitable method of treatment for you. Your doctor will review your symptoms and pain including what medication you currently take. It is important to disclose if you are on any medication, particularly any medication that affects your blood flow (such as anticoagulants).  

If the RFA is being used to treat nerve or chronic pain, then the doctor may also perform a diagnostic test to confirm that the treatment site is indeed where the pain originates from and if it would benefit from the treatment. This involves an injection of local anaesthetic near the site of the pain. If there is a difference in symptoms (such as a reduction in pain), then the doctor will recommend you for radiofrequency ablation. If there is no change in pain levels, then this may not be the best course of treatment for you. Your healthcare provider can suggest an alternative and more suitable course of treatment.  

The RFA process 

The procedure does not require the use of general anaesthetic, so you will be awake but under local anaesthetic or a sedative, so you will not experience any pain during the procedure. Depending on the site of the procedure (such as a cancer tumour that may not easily be reached through the skin), RFA can also be performed during surgery, but normally, a hollow needle is inserted through the skin (percutaneous) to reach the target site. Local anaesthetic is delivered first before the probe is inserted. The target site may be confirmed using an ultrasound or CT scan before the start of the treatment. This prevents any unnecessary damage to the surrounding cells and tissue. The radio waves are emitted from the probe at the end of the needle, and the treatment can take anywhere from 15 minutes to a few hours (depending on the size of the treatment area).   

Benefits and efficacy 

Radiofrequency ablation is a relatively non-invasive method compared to open surgery so this can be preferable in terms of a quicker recovery- you can return to your normal activities within 24 hours after the procedure. It can also be used in combination with other treatment methods where necessary. The frequency of the radio waves can also be changed depending on the size and location of the treatment area.⁴

Risks and potential complications 

Common side effects after treatment include some numbness at the site where the needle was inserted. This is not uncommon and will go away on its own. Alternatively, you may experience some pain at the site where the needle was inserted, but this will also go away within a week or two after the procedure. Your doctor will advise you on how to handle this pain (such as painkillers or ice packs).  

Some people report experiencing flu-like symptoms called ‘post ablation syndrome’. This can include a mild fever, body aches and a general feeling of being unwell. This can begin 3-5 days after the procedure and last for around a week. Your healthcare provider will provide guidance after your procedure on what to do for such symptoms.  

Uncommon complications include bleeding at the site of the procedure or an infection. However, these are not common side effects, and should they occur, you should seek medical attention.  

Recovery and post-procedural care 

As the procedure does not require general anaesthetic, you may go home on the same day as your appointment. After the procedure, you may need some time while the procedure site is monitored by the health care team, but you will be fine with going home after that. You will need somebody else to drive you home, and you will need to avoid anything strenuous for at least 24 hours. After 24 hours, you may return to your normal activities, including showering, but wait at least 48 hours before taking a bath. You may experience some pain at the site of the procedure, and you may wish to ice the area for 20 minutes at a time throughout the day. For pain relief, do not use any heat packs on the site of the procedure.

Treatment outcome 

The outcome of RFA depends on the individual case, and a follow-up CT scan may be required to monitor the progress. Some people report that the pain relief lasts anywhere from 3 to 12 months, while other people do not experience a significant difference. This is because the nerve causing the pain may grow back after treatment.

In cases of cancer treatment, the tumour may be completely destroyed in a single treatment or may require further treatment. The tumour may also grow back.³ The RFA procedure can be repeated after some weeks.  

Comparison with other treatment modalities 

Radiofrequency ablation is a much-preferred option to surgery as it is a lot less invasive and has a significantly shorter recovery period. However, it can also be used in combination with other methods, such as surgery, chemotherapy, and pain medication. The use of radio waves also allows more precise targeting of a specific treatment area and prevents damage to the surrounding tissue that can result in unpleasant side effects.¹

Advancements and ongoing research 

RFA is currently used in the treatment of different types of pain relief and for the treatments of various cancers. Further research is required to establish how effective RFA is in the treatments of different cancers and when used in combination with targeted drugs.  

Conclusion 

Radiofrequency ablation is a minimally invasive procedure that treats a number of conditions and may be a good alternative to treatments such as surgery. Speak to your healthcare provider if you believe that you may be suitable for the procedure- they will be able to refer you to a specialist to decide if this is the best course of treatment for you. Ultimately, even if RFA is not the best case of treatment, then the specialist may be able to recommend an alternative treatment plan which is a better fit for your specific case after reviewing your medical history and examining your symptoms.

Summary 

Radiofrequency ablation (RFA) uses heat from radio waves to treat a number of conditions. It can be used to destroy cancer cells and tumours; it can be used to provide relief from nerve pain, and it can also be used in the treatment of varicose veins by sealing the affected veins and redirecting blood to healthy blood vessels. RFA uses a needle-like probe that is inserted through the skin to reach the target site and emit the radio waves directly to the affected cells and tissue. This is a minimally invasive procedure that does not cause any damage to the surrounding cells and tissue and has a relatively short recovery time, making it a preferable option when compared to treatments such as open surgery.