Treatment for kidney cancer
When deciding on treatment, your doctors will consider the stage of the cancer, your age and your general health. The main treatment for kidney cancer is surgery. If you have other medical problems and surgery is not suitable, there are other ways to treat the cancer. Treatments for kidney cancer can include:
- Biological therapy or Radiotherapy or Chemotherapy
- Arterial embolisation
- Radiofrequency ablation
Surgery is the main treatment for kidney cancer that has not spread. Early stage kidney cancer is often cured with surgery. The aim of the surgery is to remove the tumour and nearby tissues.
There are different types of surgery:
- Radical nephrectomy
- Partial nephrectomy
- Keyhole surgery
Radical Nephrectomy: This can be done either as laparoscopic (keyhole) operation or through an open operation. In both open and keyhole surgery the surgeon removes all of the affected kidney and some surrounding tissue. The surgeon may also remove some, or all, of the lymph nodes close to the kidney to check if they contain cancer.
The open operation usually involves a cut (incision) made between the lower ribs on the side of the tumour. In keyhole surgery your surgeon uses a long flexible tube called a laparoscope. It looks like a telescope and has a camera at one end so your surgeon can see inside your body. Your surgeon first makes a few small cuts in your tummy so the tube and other instruments can go in. He or she can then remove your entire kidney or just part of it.
After keyhole surgery you are likely to need fewer painkillers and will recover quickly, so you will spend less time in hospital. Not everyone is suitable for keyhole surgery and it depends on the skill of the surgeon as well. If you wan to have a keyhole operation you have the right to ask to be referred to a different surgeon who performs keyhole kidney surgery.
Partial nephrectomy: A partial nephrectomy can be either an operation or a keyhole operation in some circumstances. Your surgeon might decide to remove the tumour and just part of the kidney around it. This is called a partial nephrectomy or nephron-sparing surgery. It is usually done if the tumour is small. For example, less than 4cm in size.
Keyhole surgery: This is also known as laparoscopic surgery. For this, your surgeon uses a long flexible tube called a laparoscope. It looks like a telescope and has a camera at one end so your surgeon can see inside your body. Your surgeon first makes a few small cuts in your tummy so the tube and other instruments can go in. He or she can then remove your entire kidney or just part of it.
After keyhole surgery you are likely to need fewer painkillers and will recover quickly, so you will spend less time in hospital. Not everyone is suitable for keyhole surgery and it depends on the skill of the surgeon as well.
Biological therapies use your body ´s immune system to fight cancer. They can interfere with how the cancer cells grow and divide. There are different types of these drugs and they have different actions. One type is called immunotherapy. It boosts your immune system to attack the cancer cells and stop them growing. For example, interferon and interleukin 2 .
Some types of drugs can cut off the blood supply to the cancer cells and prevent them growing.
For example, sunitinib (Sutent® ). Other types used to control the cancer are bevacizumab (Avastin®), sorafenib (Nexavar®) and temsirolimus (Torisel®). You might receive these as part of a clinical trial.
Radiotherapy uses high-energy X-rays to cure or control cancer. These rays are aimed directly at the cancer cells to destroy them while doing as little damage as possible to normal cells. Radiotherapy is not often used to treat kidney cancer. It can be used to control symptoms such as pain or bleeding. For more information, please see our Understanding Radiotherapy booklet, which you can download from our "Important cancer information booklets" list on the right hand side of this page.
This is the use of drugs to kill or control cancer. It is not used very often to treat kidney cancer. It can be given along with other treatments, such as surgery, radiotherapy and biological therapies. You may be offered chemotherapy as part of a clinical trial of new drugs. Please see our Understanding Chemotherapy booklet, which you can download from our "Important cancer information booklets" list on the right hand side of this page, for more about chemotherapy.
Arterial embolisation is a treatment that shrinks the tumour rather than curing it. It does this by blocking the blood vessels and cutting off the tumour’s main blood supply. To do this, your surgeon puts a narrow tube into a blood vessel in your leg. The tube is passed up to the main blood vessel that supplies blood to your kidney. Your surgeon next injects pieces of gelatine sponge or plastic beads into the blood vessel to block the flow of blood into your kidney. The blockage prevents the tumour from getting oxygen and other substances needed for it to grow.
Radiofrequency ablation is a treatment that kills cancer cells by heat. You may be suitable for it if you cannot have surgery and your tumour is small and can be easily reached by a needle. For the treatment, your surgeon puts a special needle in through your skin and into your kidney tumour using X-ray to guide him or her. An electrical current is then run through the needle and into the cancer cells. This causes the cells to heat up or burn.
Cryotherapy kills cancer cells by freezing them directly. For this treatment, your surgeon puts a metal probe into your kidney near where the tumour is. The probe contains liquid nitrogen, which can freeze and destroy the cancer. The treatment does not hurt but you will be given a local anaesthetic to numb the kidney and nearby area. The therapy is also known as cryosurgery. It is not available in Ireland at present.
Advanced kidney cancer means the cancer has spread beyond the kidney. Local spread means it has spread to tissues nearby. If it has spread to another part of your body, it is called a secondary cancer or metastasis.
If you have advanced kidney cancer, your doctor will aim to slow down the growth of the cancer and reduce or relieve any symptoms you have. For example, pain, bleeding, problems with eating, and fatigue.
The treatment will depend on how much the cancer has spread and where, the treatment you have already had, and how fit and well you are. Surgery, chemotherapy, radiotherapy, biological therapy or arterial embolisation may be used to relieve your symptoms and slow down the growth of the cancer.
When treatment is given to improve your symptoms and quality of life, it is called palliative treatment. The palliative team will visit you and help with your symptoms and support you and your family through your treatment.
The type of side-effects you get will depend on the type of treatment, the dose, the duration and your own general health. Your doctor or nurse will discuss any possible side-effects with you before your treatment. Some treatments may cause nausea, vomiting, diarrhoea, constipation, and sore mouth, loss of appetite and hair loss. A lot of treatments cause fatigue. Treatment with biological therapies can lead to numbness or tingling in your hands and feet (peripheral neuropathy) and flu-like symptoms.
For more about side-effects, see the booklets Understanding Chemotherapy, Understanding Radiotherapy, Coping with Fatigue, Diet and Cancer and Understanding Cancer and Complementary Therapies, all available to download under the "Important cancer information booklets" list on the right hand side of this page.
If a treatment looks like it might be helpful, it is given to patients in research studies called clinical trials. Trials may be taking place at the hospital you are attending. If you are interested in taking part, talk to your doctor. He or she can tell you if the trial would suit you or not.