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Kidney Cancer

  • Posted: 01/19/2011

Treatment

Surgery
Targeted Therapy
Biological Therapy
 

Common treatment options for people with kidney cancer are surgery, targeted therapy, and biological therapy. You may receive more than one type of treatment.

The treatment that’s right for you depends mainly on the following:

  • The size of the tumor
  • Whether the tumor has invaded tissues outside the kidney
  • Whether the tumor has spread to other parts of the body
  • Your age and general health

You may have a team of specialists to help plan your treatment. Your doctor may refer you to a specialist, or you may ask for a referral.

You may want to see a urologist, a surgeon who specializes in treating problems of the urinary tract. Other specialists who treat kidney cancer include urologic oncologists (surgeons who specialize in cancers of the urinary tract), medical oncologists, and radiation oncologists. Your health care team may also include an oncology nurse and a registered dietitian.

Your health care team can describe your treatment choices, the expected results of each, and the possible side effects. Because cancer therapy often damages healthy cells and tissues, side effects are common. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. You and your health care team can work together to develop a treatment plan that meets your needs.

At any stage of disease, supportive care is available to control pain and other symptoms, to relieve the side effects of treatment, and to ease emotional concerns. Information about such care is available on NCI’s Web site at http://www.cancer.gov/cancertopics/coping. For example, some people with kidney cancer may need to have radiation therapy to relieve pain or certain other problems. Radiation therapy uses high-energy rays to kill cancer cells.

Also, NCI’s Cancer Information Service can answer your questions about supportive care. Call 1–800–4–CANCER (1–800–422–6237). Or chat using LiveHelp, NCI’s instant messaging service, at https://livehelp.cancer.gov/.

You may want to talk with your doctor about taking part in a clinical trial. Clinical trials are research studies testing new treatments. They are an important option for people with all stages of kidney cancer. See the Taking Part in Cancer Research section.

You may want to ask your doctor these questions before you begin treatment:

  • How large is the tumor? What is the stage of the disease? Has the tumor grown outside the kidney or spread to other organs?
  • What are my treatment choices? Which do you suggest for me? Why?
  • What are the expected benefits of each kind of treatment?
  • What can I do to prepare for treatment?
  • Will I need to stay in the hospital? If so, for how long?
  • What are the risks and possible side effects of each treatment? How can side effects be managed?
  • What is the treatment likely to cost? Will my insurance cover it?
  • How will treatment affect my normal activities?
  • Would a research study (clinical trial) be a good choice for me?
  • Can you recommend a doctor who could give me a second opinion about my treatment options?
  • How often should I have checkups?

 Surgery

Surgery is the most common treatment for people with kidney cancer. The type of surgery depends on the size and stage of the cancer, whether you have two kidneys, and whether cancer was found in both kidneys.

You and your surgeon can talk about the types of surgery and which may be right for you:

  • Removing all of the kidney (radical nephrectomy): The surgeon removes the entire kidney along with the adrenal gland and some tissue around the kidney. Some lymph nodes in the area may also be removed.
  • Removing part of the kidney (partial nephrectomy): The surgeon removes only the part of the kidney that contains the tumor. People with a kidney tumor that is smaller than a tennis ball may choose this type of surgery.

There are two approaches for removing the kidney. The surgeon may remove the tumor by making a large incision into your body (open surgery). Or the surgeon may remove the tumor by making small incisions (laparoscopic surgery). The surgeon sees inside your abdomen with a thin, lighted tube (a laparoscope) placed inside a small incision. Sometimes a robot is used. The surgeon uses handles below a computer display to control the robot’s arms.

The surgeon may use other methods of destroying the cancer in the kidney. For people who have a tumor smaller than 4 centimeters and who can’t have surgery to remove part of the kidney because of other health problems, the surgeon may suggest:

  • Cryosurgery: The surgeon inserts a tool through a small incision or directly through the skin into the tumor. The tool freezes and kills the kidney tumor.
  • Radiofrequency ablation: The surgeon inserts a special probe directly through the skin or through a small incision into the tumor. The probe contains tiny electrodes that kill the kidney cancer cells with heat.

It takes time to heal after surgery, and the time needed to recover is different for each person. It’s common to feel weak or tired for a while.

Also, you may have pain or discomfort for the first few days. Medicine can help control your pain. Before surgery, you should discuss the plan for pain relief with your doctor or nurse. After surgery, your doctor can adjust the plan if you need more pain control.

Your health care team will watch you for signs of bleeding, infection, or other problems. They will keep track of how much fluid you take in and how much urine passes out of your body.

If one kidney is removed, the remaining kidney is usually able to do the work of both kidneys. However, if your remaining kidney isn’t doing a good job cleaning your blood, you may need dialysis. Some people may need a transplant with a healthy kidney from a donor.

You may want to ask your doctor these questions before having surgery:

  • What type of surgery do you suggest for me? Do you recommend surgery that is through a large incision? Or through small incisions with a laparoscope? Do you recommend surgery with a robot?
  • Will lymph nodes and other tissues be removed? Why?
  • How will I feel after surgery? If I have pain, how can it be controlled?
  • How long will I be in the hospital?
  • When will I be able to return to normal activities?
  • What are the long-term effects of the surgery? Will I need dialysis?

 Targeted Therapy

People with kidney cancer that has spread may receive a type of drug called targeted therapy. Many kinds of targeted therapy are used for kidney cancer. This treatment may shrink a kidney tumor or slow its growth.

Usually, the targeted therapy is taken by mouth. You may feel very tired while taking targeted therapy for kidney cancer. Other side effects may include diarrhea, nausea, vomiting, sores on the lips or in the mouth, and high blood pressure. You may want to read the NCI fact sheet Targeted Cancer Therapies.

 Biological Therapy

People with kidney cancer that has spread may receive biological therapy. Biological therapy for kidney cancer is a treatment that may improve the body’s natural defense (the immune system response) against cancer. The treatments used for kidney cancer can slow the growth of tumors or shrink them. The biological therapy is injected intravenously or under the skin. The treatment may be given at the hospital or a doctor’s office.

Other drugs may be given at the same time to prevent side effects. The side effects differ with the biological therapy used, and from person to person. Biological therapy commonly causes a rash or swelling. You may feel very tired during treatment. The treatment may also cause a headache, muscle aches, a fever, or weakness.

You may find it helpful to read the NCI fact sheet Biological Therapies for Cancer.

You may want to ask your doctor these questions about targeted therapy or biological therapy:

  • Why do I need this treatment?
  • Which drug or drugs will I receive?
  • How do the drugs work?
  • When will treatment start? When will it end?
  • How will I feel during treatment? What are the side effects? Are there any lasting side effects? What can I do about them?