Surgery is typically the first step in treating kidney cancer. During a nephrectomy, surgeons may remove an entire diseased kidney or only the cancerous tumor. This is a highly successful treatment for early-stage kidney cancer that hasn’t spread outside of the kidney (metastatic kidney cancer). But not everyone who has kidney cancer can, or should, get surgery. If your doctor decides against a nephrectomy, they may recommend ablation. 

From the community: “I have had a tumor thats a few cm that they have been looking at for almost a year now. Wednesday morning I am having a cryoablation procedure to have it frozen. Its an outpatient procedure and takes about an hour. They put a CT guided probe through the back into the tumor and freeze and thaw it twice to kill it. It has a 95% success rate to kill it on first procedure. I have had multiple intestinal surgeries and had my large intestine removed... They feel this is the safest procedure for me to have.” – Inspire member 

What is kidney cancer ablation?

Ablation uses different types of energy sources to destroy cancer cells in kidney tumors. It is a minimally invasive procedure, which means the procedures take place through the skin (percutaneously) or through very small incisions. 

Minimally invasive ablative procedures are less likely to cause complications like bleeding, pain, and infections that can occur with open surgeries. A kidney ablation is typically an outpatient procedure, which means you go home the same day. Depending on the type of ablation, you may only need a sedative to help you relax. But some ablative procedures require general anesthesia. 

Who needs ablation for kidney cancer?

Your doctor will consider many factors like the cancer stage, tumor size, and your overall health when developing your treatment plan. Kidney ablation typically only takes place on tumors that are smaller than 1.5 inches (4 centimeters). Larger tumors are more difficult to treat with ablation. 

There are several reasons why your doctor may recommend ablation instead of a nephrectomy. For instance, you have:

• advanced age that may make postoperative recovery more difficult

• an aversion to undergoing a major surgery and recovery 

• health conditions like high blood pressure or obesity that make an open surgery too risky

• hereditary kidney disease that causes you to develop multiple kidney cysts 

• only one functioning kidney

• recurrent kidney cancer that came back after surgery

• tumors in both kidneys

From the community: “I was resently diagnosed with clear cell renal cancer with a tumor size of 1.7 cm (stage one). The doctor said I have a choice of active surveillance, cryoablation, partial nephrectomy?? I don't know what to do? Do you keep cancer in your body, and wait? Anyone gone through the same type thing? I don't know what a "normal" protocol is…” – Inspire member

What are the types of ablations for kidney cancer?

Types of kidney ablations:

• cryotherapy (cryoablation)

• radiofrequency ablation (RFA)

• microwave ablation (MWA)

Cryotherapy (cryoablation)

Cryotherapy, or cryoablation, uses a thin needle or probe to deliver extremely cold gas to the cancerous kidney tumor. Your doctor then quickly warms and thaws the tumor. This freeze-thaw process cuts off the tumor’s supply of blood, oxygen, and water, causing it to die.

There are two methods for performing cryotherapy:

• Percutaneous: During this procedure, your doctor inserts a needle through the numbed skin on your back and into the kidney tumor. Images from CT, MRI, or ultrasound technology help guide the needle placement and ensure the treatment doesn’t damage nearby healthy tissue. 

• Laparoscopic: Your doctor makes a couple of small incisions in your back and inserts a scope device (laparoscope) with a light and camera on the end through one of the incisions. They insert the needle into the other incision and use the scope’s camera to guide the needle placement and freeze the tumor. 

From the community: “I had cryoablation procedure on my left kidney a few days ago. My tumor was about 1.5 cm. They stated all went well with the procedure. Strange thing is , my hip is very sore and the area from my hip to 6 inches down on front outter area is numb? Feels like when your foot falls asleep without the pins and needles.. The probes and needles were half way up my back so its strange that im sore and numb so far down nowhere by the area they worked on. I asked the doctor this morning and he stated they may have brushed up against a nerve or there might be swelling pressing on the nerve. He said nerves take awhile to heal, so he said give it several weeks and it should be ok..I hope so.” – Inspire member

Radiofrequency ablation (RFA)

With radiofrequency ablation, your doctor inserts one or more thin needles through the numbed skin on your back and into the tumor. Ultrasound, MRI, or CT images help guide the needle. High-frequency radio waves (electric currents) travel into the tumor through electrodes in the needles. The currents emit extreme heat that destroys cancerous cells. 

Microwave ablation (MWA)

Microwave ablation is similar to radiofrequency ablation, except the probe emits electromagnetic waves. These waves heat up the tumor to destroy cancer cells. Like RFA, your doctor relies on imaging scans to perform this treatment. 

What are the risks or side effects of kidney ablation?

Ablative procedures are less invasive than major surgery. However, you’re still at risk for potential complications like:

• damage to the kidney or nearby organs

• infection

• temporary pain in your lower back or side 

• urine leak or blockage

How effective is ablation for kidney cancer?

Studies indicate that kidney ablation can be an effective treatment for small, cancerous kidney tumors. Some people need more than one treatment session to target all of the tumor. Because the tumor remains in your kidney, there’s a possibility that missed or lingering cancer cells can start to multiply again. Your doctor will order regular imaging scans to check for cancer recurrence.

Sources

• Ablation and other local therapy for kidney cancer. American Cancer Society. February 2020.

• Kidney cancer: Types of treatment. American Society of Clinical Oncology. October 2020.

• Ablation for kidney cancer. Cleveland Clinic. September 2021.

• Kidney cancer ablation. Johns Hopkins Medicine.

• Radiofrequency ablation (RFA)/microwave ablation (MWA) of kidney tumors. Radiological Society of North America. January 2019.

Disclaimer

Member comments are lightly edited for length and to remove identifying information but are otherwise reproduced as they appear in the community as part of public posts.

This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition.