The most common type of kidney cancer is called renal cell carcinoma. Several treatment options are available, including surgery or medical treatment.
The choice of treatment depends upon the stage of the cancer. The “stage” describes the size and aggressiveness of the cancer, including whether it has spread to other parts of the body (such as the lungs, liver, or bones). Lower stage cancers are generally not as advanced and are less likely to come back after treatment.
Treatment Options for Localized Renal Cell Carcinoma
Localized kidney cancer includes stages I through III. It is called localized because the cancer has not yet spread beyond the kidney (except for nearby lymph nodes, which are part of the body’s immune system).
Surgery to remove part or all of the affected kidney is the preferred treatment for most people with localized kidney cancer. How much tissue is removed depends upon:
- size and location of the cancer in the kidney
- number of tumors present
- how well the kidneys work.
If the tumor is large or in the center of the kidney, your doctor may remove the entire kidney, as well as nearby areas that are affected (radical nephrectomy). This is more likely to be done if the other kidney works well. Fortunately, most people are able to live well with just one kidney.
If the other kidney is not functioning properly, the surgeon may remove only part of the kidney in order to allow the kidney to keep working, at least somewhat. This can be done either surgically, or by freezing or burning the kidney tumors.
Advanced Renal Cell Carcinoma
Advanced (or metastatic) renal cell carcinoma consists of stage IV kidney cancer. This type of advanced cancer is difficult to cure.
Medicine (also known as medical treatment) is used instead of, or in addition to, kidney surgery.
Three of the main types of medical treatment are:
- Interleukin-2 (IL-2). This therapy turns on the immune system so that it attacks the cancer cells. It is usually only used when you are healthy enough to withstand the severe side effects, such as fever, kidney failure, low blood pressure, and irregular heart beat.
- Anti-angiogenic therapies. This medical treatment keeps new blood vessels from forming and supplying the tumor with the blood that it needs to grow and survive. This will not cure the kidney cancer, but can stop the tumor from growing for a long time. Side effects include tiredness, high blood pressure, and rashes.
- Targeted therapies. These medicines slow the growth of the cancer by interfering with the cancer cells directly. This treatment also won’t cure the kidney cancer, but can help you live longer with fewer symptoms. Side effects include tiredness, high blood pressure, and rashes.
Surgery for advanced renal cell carcinoma is sometimes used before medical treatment, although medical treatment may be done on its own.
Surgery can be done robotically where the surgeon uses a high tech machine, called the da Vinci robot. The arms of the robot are controlled by the physician and it mimics the doctor’s hand movements precisely. This allows the surgeon to reach areas within the body without having to make large incisions and without seriously damaging skin and tissue.
As with localized kidney cancer, all or part of the kidney is removed. Treatment for advanced kidney cancer, though, also involves removing areas outside of the kidney where the cancer has spread (metastases).
Surgery does not usually cure the cancer in cases of advanced renal cell carcinoma, but may reduce the symptoms and allow you to delay medical treatment.
Radiation or Chemotherapy
Radiation or chemotherapy may be used after surgery in both localized and advanced kidney cancer. These are used to kill left-over cancer cells, even if all of the visible cancer was removed. This lowers the risk that the kidney cancer will return.
With radiation therapy, X-rays or another type of radiation is used to kill the cancer cells. The radiation source is either outside the body (as with the X-rays) or placed inside the body (using a radioactive substance).
Chemotherapy drugs—taken by mouth or injected—kill the cancer cells or stop them from growing.
Regular check-ups after treatment are advised in order to make sure that the cancer does not return. This may include an exam, lab tests, and X-ray tests, and are done every 6 to 12 months for at least five years.