Ablation and Other Local Therapy for Kidney Cancer

Whenever possible, surgery is the main treatment for kidney cancer that can be removed. But for some people, such as those who aren’t healthy enough for surgery, other treatments can sometimes be used to destroy (ablate) the kidney tumor.

These methods are usually only considered for small kidney tumors (typically no larger than 4 cm or about 1½ inches across). 

These treatments might be helpful for some people, although there is much less data on how well they work over time than there is for surgery.

Cryotherapy (cryoablation)

Cryotherapy uses extreme cold to destroy a tumor.

For this treatment, a hollow probe (needle) is inserted into the tumor, either through the skin (percutaneously) or during laparoscopy (in which a long, thin tube with a tiny video camera on the end is inserted into the abdomen through a small incision). Very cold gases are then passed through the probe, creating an ice ball at its tip that destroys the tumor.

To be sure the tumor is destroyed without too much damage to nearby tissues, the doctor carefully watches images of the tumor during the procedure (with ultrasound, CT, or MRI scans) or measures the temperature of the nearby tissues.

The type of anesthesia used for cryotherapy depends on how the procedure is being done.

Possible side effects include bleeding and damage to the kidneys or other nearby organs.

Radiofrequency ablation (RFA)

Radiofrequency ablation (RFA) uses high-energy radio waves to heat and destroy the tumor. A thin, needle-like probe is placed through the skin and moved forward until the end is in the tumor. Placement of the probe is guided by ultrasound or CT scan. Once it is in place, an electric current is passed through the tip of the probe. This heats the tumor and destroys the cancer cells.

RFA is usually done as an outpatient procedure, using local anesthesia (numbing medicine) where the probe is inserted. You may be given medicine to help you relax as well.

Major complications are uncommon, but they can include bleeding and damage to the kidneys or other nearby organs.

Other local treatments

Other, newer types of local treatments might also be used to destroy tumors in the kidney (or possibly in other parts of the body). These approaches haven’t been around as long as cryotherapy or RFA, so there’s less long-term data on them at this point. Still, they might be options for some people.

Microwave ablation

For this treatment, imaging tests are used to guide a needle-like probe (antenna) into the tumor. Electromagnetic microwaves are then created at the tip of the probe to heat to destroy the tumor.

Stereotactic ablative body radiotherapy (SABR)

Also known as stereotactic body radiation therapy (SBRT), this is a type of advanced radiation therapy. Imaging tests are used to guide thin beams of radiation at the tumor from many different angles. SABR can usually be given over the course of a few treatments.

To learn more, see Radiation Therapy for Kidney Cancer.

Irreversible electroporation

For this treatment, imaging tests are used to guide long needles (electrodes) into place around the tumor. The needles are then used to create a strong electrical field within the tumor. This causes holes (pores) to form in the walls of the cancer cells, leading to their death.

This approach doesn’t use heat or cold to destroy the cells, and it might prove to be useful in areas where it’s important to protect vital structures like nearby blood vessels. But many doctors feel that more research is needed to show it is safe and effective.