Radiofrequency Ablation Patient Education

Radiofrequency Ablation Patient Education

Radio frequency ablation (RFA) is performed by an interventional radiologist using image guidance, such as ultrasound (US) or computed tomography (CT) to guide a needle through the skin and into the tumor. Metal prongs attached to the probe extend out inside the tumor. Radiofrequency energy causes the atoms in the cells to vibrate and create friction. This can generate heat up to 100 degrees Celsius and leads to the death of these cells. The area being treated can be seen by the interventional radiologist on imaging during the procedure. This allows the radiologist to reliably destroy a small, targeted area of tissue without affecting healthy structures beyond the treatment site.

After the cells are destroyed with heat, the dead tissue shrinks or disappears altogether as it is gradually absorbed and excreted like other waste products in the body. Multiple tumors can be treated in one session, and the procedure can be repeated as often as needed to treat new tumors that may arise.

Before the procedure

Once your oncologist or primary physician has decided you’re a candidate for radiofrequency ablation, an interventional radiologist and nurse from the Interventional Oncology group will be contacted. The interventional radiologist will review your MRI or CT images and labs that have been drawn.

The interventional radiologist and nurse will meet with you in their clinic and explain the procedure, its benefits and risks, and answer any questions you may have. They’ll also assist you in scheduling the procedure.

RFA is usually done in a CT scan machine or in an interventional radiology suite using ultrasound. Your physician will decide which method is right for you based on the location and size of the tumor(s) to be treated.

For the procedure, you’ll be given conscious sedation (twilight sleep) or be placed under general anesthesia (completely asleep) by an anesthesiologist. The decision for this will be made by you and your physicians.

Don't have anything to eat or drink after midnight on the day of your procedure unless you have pills that need to be taken that morning. Discuss with your physician your medications and if you’re to take any of them that morning. If so, do so with small sips of water.

You should arrive one hour before your procedure time or at the time told to you when your procedure was scheduled. You’ll be asked to complete some forms about your medical history and the medications you’re currently taking, so bring your list of medications.

A staff member from Interventional Radiology will get you and bring you to the prep and recovery area. You’ll be allowed to bring one family member with you at this time. A nurse will prepare you for your procedure by having you change into a gown, taking your vital signs, starting an IV and giving you any needed fluids or medications.

A physician will speak with you and get your consent for the procedure and answer any questions you may have. If you’ll have general anesthesia for the procedure, you’ll meet the anesthesiologist, who will get your consent and answer your questions about anesthesia.

Next, a team member will take you to the procedure room, where a radiology technologist and the interventional radiologist will be with you for the entire procedure.

During the procedure

In the procedure room, a nurse will help you lie on the exam table. You will be connected to heart and blood pressure monitors. IV medicine or anesthesia will be given to you to help you relax, depending on what type of sedation you and your physician have chosen. The area to be treated will be cleaned with a special soap and covered with sterile sheets.

Pictures will be taken with the CT or ultrasound machine to locate the tumor to be treated. Once the interventional radiologist locates the tumor, a needle or RFA probe will be inserted through your skin to the tumor, which will be burned or ablated for approximately 10-15 minutes. The physician will be able to see the area being treated on the CT or ultrasound machine.

After the treatment the physician will again take pictures with the CT or US to evaluate the area treated.

After the procedure

Once your procedure is over, you’ll go to a recovery room. If you received conscious sedation during your procedure, you’ll return to the prep and recovery area. Here a nurse will monitor your heart rate, blood pressure and the site where your procedure was performed. Let the nurse know if you’re experiencing any pain or discomfort at this time. After one or two hours of recovery, you’ll be discharged to go home.

If you received general anesthesia, you’ll go to the post-anesthesia recovery unit (PACU) for one to two hours. A nurse will monitor your vital signs and the site where your procedure was performed. Let the nurse know if you’re experiencing any pain or discomfort at this time. After one to two hours of recovery, you’ll be taken back to the Interventional Radiology prep and recovery area for discharge.

In rare instances, an overnight hospital stay may be required if a patient needs additional monitoring, as in the case of some lung cancer patients who may develop a pneumothorax (collapsed lung).

You may go home with prescriptions for antibiotics and pain medications as needed.

Follow-up care

Discuss your follow-up care with your physician. For most patients, the following is recommended.

• At-home diet: You may resume your regular diet after discharge. You should drink at least six eight-ounce glasses of water over the next 24 hours. Water helps to clear the dye used during the procedure from your body.
• Activity: On the day you leave the hospital, limit your activities. No physical exercise or heavy lifting (greater than 10 lbs.) is allowed for the next three days. Don’t drive for 24 hours after the procedure. You may resume all other daily activities 24 hours after the test.

Call your physician immediately if you notice any of the following:

• Swelling or bleeding at the puncture site
• Fever higher than 101 degrees Fahrenheit
• Redness or increasing tenderness or discharge at the puncture site

Follow-up appointment

Six weeks after the procedure, computed tomography (CT), magnetic resonance (MR) or other images are taken to be certain the treatment was effective. You’ll be asked to give a blood sample and schedule an appointment to review your blood work and images with a radiologist.