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How is percutaneous cryoablation used to treat kidney cancer?

The freezing of tumors – a therapy which has been used to treat certain lung, liver, and prostate cancers – is also particularly well suited for certain kidney cancers called renal cell carcinomas. Relying on computed tomography, magnetic resonance imaging (MRI), or ultrasound guidance, a urologist and an interventional radiologist work together to insert several 1.5 mm "ablation" needles through the patient's skin into the kidney tumor. Once the needles are in place, the device called a "cryoablation machine" delivers temperatures of -140 degrees C or lower until the entire tumor and surrounding borders are frozen.

The surgeon and radiologist initiate several freeze/thaw cycles until they are confident that the tumor cells have been killed. "The CT scanner can be used to actively monitor the development of the ablative iceball to precisely control the destruction of the tumor," explained Jaime Landman, MD. The procedure typically takes just 45 minutes and can be done without general anesthesia.

Over time, the tumor tissue "scars down" and eventually disappears. "The truly revolutionary aspect of this treatment is the realization that we don't have to surgically cut out cancer tissue, which shatters a thousand years of medical and surgical tradition," Dr. Landman added.

Kidney cancer is a potentially lethal disease that can be treated in various ways.  The only available traditional cure was to remove the entire kidney with open surgery.

With medical advances, we can now remove just the kidney tumor using open, laparoscopic or robotic surgery or even single port surgery (LESS), thereby leaving the majority of the "good kidney" tissue behind, which has been shown to decrease cardiovascular problems.

Cryoablation and radiofrequency ablation (RFA) are needle based treatments that dont require open surgery at all.  In cryoablation, the tumor is localized using CT or MRI, the needle(s) are placed precisely into the tumor and the tumor is then frozen and thawed for 2 cycles to lethal temperatures (less than -20 celcius).  As can be seen in frostbitten toes and fingers, the tumor similarly dies and shrivels up over time.

The potential downsides are that cryoablation has been performed for <10 years, so we do not know whether the cancers will come back in 15, 20 years.  You also require multiple repeated CT and MRI's to make sure the tumor is dead, and some patients do not like the idea of leaving the tumor inside the body, instead being more reassured with it being removed from the body surgically.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.