Kidney cancer: Treatments

Kidney Cancer - Treatments

Kidney cancer treatment usually begins with surgery to remove the cancer. For early-stage cancers confined to the kidney, this may be the only treatment needed. If the cancer has spread beyond the kidney (advanced stage), additional treatments may be recommended.

An individual with cancer should be assessed by a specialist to determine which modality of treatment is best suited for them.

Treatment options for early-stage kidney cancer

Surgery

Surgery is the standard treatment option for those with kidney tumours who are fit for surgery. Depending on the kidney tumour characteristics and patient suitability, kidney surgery may be performed using conventional open surgery, laparoscopic (keyhole surgery) or robot-assisted techniques.

The extent of surgery is categorised into two types:

Partial nephrectomy - the tumour is removed with a margin of normal tissue, preserving the rest of the unaffected kidney. Partial nephrectomy is performed either when the tumour is small or if the patient has impaired kidney function or a single kidney left.
Radical nephrectomy - the whole kidney including the tumour is removed. Radical nephrectomy is performed when the tumour is large and very close to the blood vessels or ureter.

It is possible to lead a normal, active life with only one good kidney. Most people with one kidney removed do not end up with kidney failure requiring dialysis. Your treating doctor will advise you on the risks of impaired kidney function after surgery, which depends on the presence of other factors such as diabetes, high blood pressure and advanced age.

Targeted ablation

This is a minimally invasive ablative procedure that uses thermal energy or ice (cryotherapy) to destroy tumour cells.

Active surveillance

Selected patients with a very small kidney tumour may be monitored closely with regular kidney scans to assess the growth rate or changes in the tumour appearance.

Radiofrequency ablation and active surveillance are more suited for elderly patients with multiple medical problems, who are not fit for surgery.

Treatment options for advanced kidney cancer

Radiotherapy

Radiotherapy uses powerful energy beams to kill cancer cells. It is sometimes used to relieve pain when the cancer is advanced and cannot be removed surgically. Another use for radiotherapy is to stop the cancer from bleeding.

Systemic therapy

For some patients who present late with kidney cancer that has spread to other parts of the body, surgery to remove the kidney in combination with systemic therapy has shown to be effective.

Systemic treatment for this group of patients includes:

Targeted therapy - drugs that target specific tumour growth pathways in the cancer cell
Immunotherapy - drugs that incite the body’s immune response towards the cancer

If a patient is not fit for surgery, immunotherapy or targeted therapy may be given to control the disease (with or without surgery), depending on the patient’s response to treatment.