If you’re diagnosed with kidney cancer (also known as renal cancer), your doctor may recommend ablation therapy.

Ablation is a procedure that can treat small tumors without surgery. It’s less invasive than surgery and keeps healthy kidney tissue intact. For some people who can’t have surgery, ablation may be an alternative.

Here are some key facts about the different types of ablation used to treat kidney cancer.

What Is Ablation for Kidney Cancer?

Ablation destroys a tumor in place instead of surgically removing it. Rather than making a large cut, or incision, doctors insert a thin probe directly into the tumor. Then, they apply extreme heat or cold to destroy the cancer cells.

The specialist who does an ablation is known as an interventional radiologist. Usually, the ablation probe is inserted through a small hole in the skin. This technique is known as a percutaneous procedure. Imaging scans, such as CT scans and MRIs, are used to guide the probe to the right spot.

For this procedure, you may need only local anesthesia (around the area where the procedure is performed) or a sedative.

A urologist may also perform ablations. Instead of relying on imaging scans alone, they may do the procedure laparoscopically, which means they’ll use a small incision and a tiny video camera. This approach requires general anesthesia.

Ablation can be useful for people who need or want to avoid surgery, but it’s not for everyone. Small kidney tumors, especially those found early, are the best candidates to treat with ablation. In more advanced cases, surgery may be more effective.

Here are the main types of ablation and how each is performed.

1. Cryoablation

Cryoablation for kidney cancer uses extreme cold to destroy the tumor.

For cryoablation, a probe is inserted into the tumor and releases very cold gases, such as liquid nitrogen. The extreme cold forms ice crystals inside and around cancer cells, causing cell destruction through physical damage and vascular disruption. This means the ice directly harms the cells and blocks the tiny blood vessels that supply them.

One risk of cryoablation is that it can damage important structures near the kidneys. It’s generally recommended for tumors located near the center of the kidney.

Cryoablation is also known as cryosurgery or cryotherapy. There’s some evidence that cryoablation may have positive indirect effects on distant cancer cells. Cryoablation may trigger an immune response that targets cancer cells not directly treated by the probe.

2. Radiofrequency Ablation

Radiofrequency ablation (RFA) is a similar procedure. Instead of using cold, RFA destroys cancer cells with heat. This heat is generated by electrical energy from radio waves.

RFA has been studied for decades, with good success rates. It may be used in new cases of renal cancer or recurring cancer.

3. Microwave Ablation

Microwave ablation (MWA) is another heat-based method. Heat is made through microwaves rather than radio waves.

Some studies suggest that MWA can be just as effective for centrally located renal tumors as cryoablation, even though that’s not its traditional use. Thermoprotective gels may be used to help prevent heat damage to nearby organs and vessels during MWA.

4. Laser Ablation

Laser ablation is another type of heat ablation. Very small preliminary studies suggest laser ablation may have a role in treating certain recurrent renal tumors, but more research is needed. It uses a very small probe, which may make it useful for very small or hard-to-reach tumors.

This option may or may not be available, since it’s not as common as other forms of ablation. Although it’s helpful to know about different types of ablation therapy, you’ll need to choose a method that’s accessible to you and that your provider has experience using.

5. Histotripsy

Histotripsy is another form of ablation that’s still being studied for kidney cancer. It’s a new technology that uses ultrasound waves to destroy cancer cells. Although more research is needed, it may help deliver the benefits of ablation with even fewer complication risks.

Histotripsy is investigational for kidney tumors and isn’t approved by the U.S. Food and Drug Administration (FDA) for this use. Because it’s still under development, it’s not widely available yet.

Kidney Cancer Ablation vs. Surgery

Whether your doctor recommends kidney cancer ablation or surgery depends on several factors. Your kidney cancer specialist will need to consider your overall health, the specifics of your cancer type, and your personal preferences.

They’re more likely to recommend ablation if:

• Your tumor is smaller than 3 centimeters or 1.2 inches.
• You have multiple small tumors in one or both kidneys.
• You don’t want surgery.
• Surgery isn’t safe for you because of your age or health issues.

Although ablation is less invasive, it’s not as effective in every case. If your tumor is too large or if cancer has spread, you may need other forms of cancer treatment.

Tumor size plays a major role in decision-making. Smaller tumors are easier to treat completely with ablation. As tumors grow larger, it’s harder to ensure all cancer cells are destroyed through ablation. Studies show that ablation is 90 percent to 95 percent effective in renal tumors that are under 4 centimeters in size.

Location also matters. Tumors located on the outer part of the kidney are generally easier to reach and treat with ablation. Tumors deep within the kidney or close to important structures like the ureter or major blood vessels can be more challenging and require special considerations.

Ablation Pros and Cons

Ablation for kidney cancer offers several advantages. However, it’s not always recommended. Your healthcare team can help you weigh the pros and cons of different treatment options.

Potential Benefits

One of the biggest benefits of ablation is that it’s minimally invasive. From start to finish, the procedure may take just one to three hours. Local anesthesia or a sedative may be used instead of general anesthesia (being put fully under).

In many cases, a person undergoing ablation can also go home the same day. You can expect minimal scarring, little or no damage to the kidneys, and a faster recovery than surgery.

Potential Risks

If you have an ablation laparoscopically, you’ll need general anesthesia. This can come with some additional risks and may require an overnight hospital stay.

After any type of ablation, it’s essential to have regular follow-up appointments. Your doctor can monitor the treated area with imaging scans for signs of cancer. If the cancer comes back or wasn’t fully destroyed, you may need a repeat ablation.

Other potential ablation risks include:

• Bleeding at the treatment site
• Infection
• Damage to nearby structures in the urinary or bowel system
• Pain or discomfort
• Injury to nearby structures, including the ureter or collecting system, and pneumothorax (collapsed lung) with percutaneous approaches

The risk of complications is generally low. You can reduce your risk by following your doctor’s instructions before and after the procedure. These may include taking antibiotics and avoiding heavy lifting until you’re fully healed.

How To Choose the Best Treatment Option

Shared decision-making with your oncology team is crucial when deciding how to treat kidney cancer. There are many factors to consider before choosing ablation over surgery or other treatments.

Don’t hesitate to ask questions such as:

• Is my tumor a good candidate for cryoablation for kidney cancer or another type of ablation?
• What are the chances the tumor will come back after treatment?
• How often will I need follow-up scans?
• What are the risks in my specific situation?

You’ll also need to consider factors such as insurance coverage for your procedure. Having this conversation with your healthcare providers, insurance carrier, and loved ones can help you decide whether ablation is right for you.

Join the Conversation

On MyKidneyCancerTeam, people share their experiences with kidney cancer, get advice, and find support from others who understand.

Have you had ablation for kidney cancer? What was your experience like? Let others know in the comments below.