What is RFA?

When I tell people I had RFA to treat a metastatic tumour in my liver they invariably ask... “What the H--- is RFA?” When I tell them that it is "Radio Frequency Ablation" they nod politely. When I try to explain by saying… “an alternating current is sent though electrodes inserted into the tumour resulting in coagulative necrosis of the malignant tissue” their eyes glaze over and they wish they could change the subject.

But RFA is just too cool not to talk about! It is one of those great new techniques that is changing how we approach small tumours in the liver and other locations. So here, in a nutshell, is a concise description of RFA. (with help from Medicinenet.com)

First let’s unpack the term.

Ablation: “Removal or excision. Ablation is usually carried out surgically. For example, surgical removal of the thyroid gland (a total thyroidectomy) is ablation of the thyroid. The word ablation comes from the Latin ablatum meaning to carry away.” Medicinenet.com

The geologists among us will of course recognize "ablation" as also referring to the erosional processes by which a glacier is reduced, thus yielding… “ablation till”. Fascinating as this is, I digress…

Radiofrequency ablation: “The use of electrodes to generate heat and destroy abnormal tissue. In radiofrequency ablation (RFA), heat is generated locally by a high frequency, alternating current that flows from the electrodes. A probe is inserted into the center of the tumor and the non-insulated electrodes, which are shaped like prongs, are projected into the tumor. The local heat that is generated melts the tissue (coagulative necrosis) that is adjacent to the probe. This results in a 3 cm to 5.5 cm sphere of dead tissue per treatment session. The probe is left in place for about 10 to 15 minutes.” Medicinenet.com

One of the really great things about RFA is that it can often be administered "percutaneously", or through the skin, making it a “minimally invasive” procedure. In my case, because of the tumour location, RFA was administered within open surgery. Several deployments of the probe were needed to create a "zone of ablation" large enough to encompass the whole tumour and allow for clear margins. A follow-up CT taken a couple of months later showed that the "zone of ablation", or "sphere of dead tissue", did completely encompass the pre-existent tumour (whew!!). I’m now taking Chemo to clean up any microscopic metastases that may be in the area. I'll be having regular CT scans down the road to keep an eye on things.

Now when people ask "What is RFA?". I just say... "We burnt that little sucker right out of there!!"

Enjoy the solstice... Rob; "The Cancer Geek"

"What is not cured by the knife may be cured by fire." Hippocrates