By Damian Dupuy, MD, director of ultrasound, department of diagnostic imaging, Rhode Island Hospital
Radiofrequency ablation (RFA) is a minimally invasive technique that uses heat to destroy tumors. Using CT scan or ultrasound guidance, a small needle electrode is placed directly into the tumor. The electrode's high frequency radiowaves create intense heat that can reach the boiling point of water, killing cancerous cells. Radiofrequency ablation using the current technology was approved by the FDA in October 1997. Since then, a number of hospitals around the country have adopted the technique, most often to destroy liver tumors.
At Rhode Island Hospital, we have taken RFA a step further by broadening its application. RFA has been used successfully to combat breast, kidney, liver, lung, adrenal and bone cancer. In the years following FDA approval, more than 700 patients have undergone radiofrequency ablation here. To date this is the largest use of RFA in treating malignancy in North America. Radiofrequency ablation takes between 45 and 90 minutes and can be performed with intravenous sedation. The procedure creates a small incision that only requires a band-aid and because heat cauterizes the area, no bleeding has been reported. It can be done safely on an outpatient basis.
RFA is less traumatic than surgery, so it is an alternative for older patients, those who are frail or patients who have medical conditions that exclude surgery as an option. It has also been used successfully when treatments such as radiation or chemotherapy fail. Age is no barrier to eligibility; my patients have ranged in age from 2 to 89. Unlike radiation, RFA does not adversely affect the immune system. Patients can receive more than one RFA treatment, if necessary. An ongoing study will help determine its effectiveness in treatment of painful metastatic bone disease. To enroll in the study or for more information about RFA, call Derek Tessier at 401-444-2453.
Webmaster's Note: At a meeting of the Radiological Society of North America, Dupuy's scientific exhibit, "RFA of Extra-Hepatic Malignancies," received a highly prestigious magna cum laude award.