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Radiofrequency ablation (RFA), explained step by step | CION Cancer Clinics
Radiofrequency ablation, or RFA, destroys a small tumour by heating it with an electrical current passed through a thin needle. The needle is guided through the skin using a CT or ultrasound scan, usually under sedation or anaesthesia. It is used for some small liver, kidney, lung, bone and thyroid tumours. It does not suit large tumours or those lying against major blood vessels. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- How does radiofrequency ablation kill a tumour?
- What happens during an RFA procedure?
- Which tumours is RFA used for?
- What do the words on an RFA report mean?
- What do people often misunderstand about RFA?
- Who is RFA not suitable for, and what can this page not tell you?
- Common questions about radiofrequency ablation
The short answer
How does radiofrequency ablation kill a tumour?
Radiofrequency ablation, or RFA, passes an electrical current through a thin needle placed inside the tumour. The current heats the tissue around the tip until the cells die, and the tumour is left in place to scar.
Where the heat comes from
The current is the same kind of energy used by a radio, but at a low power. Tissue resists the current, and that resistance turns into heat. The needle itself does not glow. It is the tumour around it that warms up, steadily, from the centre outwards.
Why a rim of normal tissue is treated too
Cancer cells can sit just beyond the edge you see on the scan. So the doctor aims to heat a thin rim of healthy tissue as well. This rim is the ablation margin. It plays the same part as the clear edge a surgeon tries to leave around a tumour.
Why blood vessels matter
Flowing blood carries heat away, a bit like water cooling a hot pan. A tumour lying against a large vessel may not get hot enough on that side. Doctors call this the heat-sink effect, and it is one reason RFA is not chosen for every tumour.
On the day
What happens during an RFA procedure?
Getting ready
You are asked not to eat for some hours beforehand. A cannula goes into a vein. Pads are stuck on your thighs or back, so the current has a safe path out of the body.
Sedation or anaesthesia
Most people have deep sedation or a general anaesthetic. The team chooses based on the organ, the position of the tumour and your health.
Placing the needle
Using CT or ultrasound pictures, the doctor guides the needle through a tiny nick in the skin into the tumour. Several pictures are taken to check the tip is exactly right.
Heating and checking
The current is switched on, sometimes more than once to cover the whole tumour. The needle track is heated as the needle comes out, and a final scan checks the treated area.
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Ask an oncologistWhere it is used
Which tumours is RFA used for?
RFA works best on small tumours that a needle can reach without passing through or touching a delicate organ.
Liver
Small primary liver cancers, and some small deposits that have spread to the liver from bowel cancer. People with scarred livers who cannot safely have part of the liver removed are often discussed for it.
Kidney
Small kidney tumours, especially in older people or those with only one working kidney. Keeping as much healthy kidney as possible is often the aim.
Lung
Small tumours in people whose breathing or heart would not cope with lung surgery. Air leaking around the lung is the main risk the team watches for.
Bone and thyroid
Painful cancer deposits in bone, where the aim is easing pain. Some thyroid nodules too, though those are often not cancer at all.
On your report
What do the words on an RFA report mean?
- Ablation zone
- The area of tissue that was destroyed. It should be larger than the tumour it contained.
- Technical success
- The tumour was fully covered on the scan taken at the time. It describes the procedure, not the long-term result.
- Residual disease
- Living tumour still seen at the edge of the treated area on a later scan. It may be treated again.
- Local recurrence
- Cancer growing back at the edge of the ablation zone after a clear check scan.
- Enhancement
- Parts of the scan that brighten after contrast dye. A thin even rim can be normal healing; a thick patchy area needs a closer look.
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Commonly believed
What do people often misunderstand about RFA?
"RFA is a kind of radiation."
It is not. Radiofrequency is an electrical current that makes heat. There are no rays, nothing stays in the body, and there is no risk to family members at home afterwards.
"A newer machine would always be a better choice."
Microwave and other methods have their uses, but RFA has been studied for longer. Which one suits you depends on the tumour's size and what lies next to it, and on what your team knows how to do well.
"If the scan is clear after RFA, no more scans are needed."
A clear first scan is good news, but tumours can come back at the edge or appear elsewhere in the same organ. Regular check scans are part of the treatment, not an optional extra.
"Being told RFA instead of surgery means the team has given up."
For some small tumours RFA is a standard choice. For people who cannot safely have an operation it may be the most sensible way to treat the tumour directly. Ask the team to explain the reasoning.
Did you know
RFA is usually done by an interventional radiologist, a doctor who treats disease through needles and scans, working with your surgeon and oncologist. Asking who will actually place the needle is a fair question.
Being straight with you
Who is RFA not suitable for, and what can this page not tell you?
RFA does not suit large tumours, many tumours, or cancer that has spread widely. It may not suit a tumour lying against the bowel, a main bile duct or a large blood vessel, because of heat damage or the heat-sink effect.
Other reasons it may be ruled out
Blood that does not clot well, or a pacemaker, may change the plan. So can a tumour the needle cannot reach safely. Tell the team about any blood thinners you take, such as aspirin or clopidogrel. The team decides whether and when to pause them. Never stop a medicine on your own.
What this page cannot tell you
It cannot tell you whether RFA is right for your tumour, or how you will do after it. Those answers depend on your scans, your biopsy and your overall health. Your treating team weighs all of it, and they can explain what else was considered.
What the first days usually look like
Expect an ache at the needle site, some tiredness and perhaps a mild fever for a few days. Rest at home, eat light meals and keep walking gently. Ask your team when you can go back to work, lift heavy things or travel a long way. Keep the date of your first check scan, because that scan is how the team knows the tumour was fully treated.
Questions we are asked
Common questions about radiofrequency ablation
Is RFA done under general anaesthesia?
Often it is, or under deep sedation. The choice depends on where the tumour is and how long the procedure is likely to take. A lung or liver tumour near the diaphragm may need you completely still. The anaesthetist will meet you beforehand and explain which they plan and why.
How long does the procedure take?
The heating itself is fairly short, but the whole visit to the scanner room takes longer. Setting up, placing the needle and checking scans all add time. Waking up and early monitoring follow. Ask the centre what to expect for your case so the family can plan the day.
Will I have pain afterwards?
Most people have some ache at the needle site and in the treated organ. Liver ablation can cause pain felt in the right shoulder, because the nerves are shared. Simple pain relief usually settles it within days. Pain that keeps getting worse should be reported straight away.
What is the fever I got after RFA?
A mild fever, tiredness and body aches in the first days are common and are called post-ablation syndrome. It is the body reacting to the dead tissue. A high fever with shivering, or one that begins after you felt better, can mean infection and needs a call to the team that day.
Can RFA be done again if the tumour returns?
Often, yes, if the new or remaining tumour is small and reachable. The team may also consider microwave ablation, surgery or radiotherapy instead. What they choose depends on the size and position of what the scan shows, and on how you coped the first time.
Is RFA better than surgery?
Neither is better for everyone. Surgery removes the tumour and gives a full laboratory report. RFA avoids a wound and a long stay but suits only small tumours. For some small liver and kidney tumours both are reasonable. Your team weighs your tumour and your health before advising.
Can I travel home to my district afterwards?
Many people travel home within a day or two, but ask your team before booking. Long bumpy journeys can be uncomfortable in the first days. Carry your discharge summary and the team's contact number, and know which hospital near home you would go to if something worried you.
Do Aarogyasri or insurance cover RFA?
Cover varies with the scheme, the package and the centre. Aarogyasri, CGHS, ECHS, EHS and cashless insurance can each treat RFA differently, and the needle itself is often a separate cost. Ask the centre to check your card or policy against the planned procedure before a date is fixed.
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Dr. Owais Mohammed
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Dr. Vinay Mamidala
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Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- American Cancer Society — Tumor Ablation for Liver Cancer
- National Cancer Institute — Definition of radiofrequency ablation
- Cancer.Net — Liver Cancer: Types of Treatment
- NHS — Kidney cancer: treatment
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Tumour Ablation: Destroying a Tumour Without CuttingHow all four kinds of ablation compareMicrowave Ablation ExplainedThe faster heat method and how it differs from RFAScans After Ablation: Reading the ReportWhat the check scan is looking forPain and Recovery After AblationWhat the first days at home are like
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