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Guidelines for sites linking to mayoclinic.orgMayo Clinic physicians and other members of your treatment team come together to assess your needs and the most appropriate approach to treating your specific disease. Each patient is different, and your treatment team will weigh many factors, including your physical condition and personal preferences, before recommending a course of treatment.
Most kidney tumors today are detected incidentally when physicians review magnetic resonance imaging (MRI) results, a CT scan, or abdominal ultrasound, which are typically ordered to investigate other conditions. Kidney masses discovered incidentally account for 70 percent of the kidney procedures performed at Mayo Clinic. Only 5 percent of kidney cancer patients exhibit one or more of the classic symptoms — pain, blood in the urine, or a lump or mass detected on the lower back or abdomen during a physical exam.
Generally, surgery is the most common initial treatment for most kidney cancer tumors. For some patients, alternatives to surgery may be considered, including minimally invasive procedures, radiation therapy and experimental drug therapies.
Mayo Clinic offers extensive experience in all forms of kidney cancer surgery, from removing part of the kidney (partial nephrectomy) to removing the entire kidney (radical nephrectomy).
Mayo Clinic urologists have long been leaders in performing surgery on both large and small kidney cancer tumors, and those that have spread to other organs or structures, including the veins that drain the kidney. Mayo surgeons' ability to perform such complex surgical procedures can help many patients whose cancer might otherwise be inoperable or untreatable.
Early kidney tumor detection, combined with advances in diagnostic techniques, prompted Mayo Clinic urologists to investigate the potential of a kidney-sparing procedure (partial nephrectomy) to treat small, solid masses confined to the organ. Mayo urologic surgeons have more than 30 years of experience using partial nephrectomies to treat kidney cancer, and have performed thousands of partial nephrectomies.
Partial nephrectomies — sometimes also referred to as nephron-sparing surgery — offer excellent protection against cancer recurrence for patients who have small, localized solid masses with no other suspicious features present. A partial nephrectomy can also improve the odds of good long-term kidney function, which is particularly important for patients with only one kidney, who would otherwise require regular dialysis treatment and/or a kidney transplant following a radical nephrectomy.
Further, a Mayo Clinic study indicates that partial nephrectomies performed in patients less than 65 years old may actually contribute to increased survival rates, compared to patients who undergo radical nephrectomies. Evidence suggests risks associated with heart-related complications increase as kidney function declines with age. Therefore, a patient who undergoes partial nephrectomy will keep the function of more than one kidney to help offset any eventual decreases in kidney performance.
The complete surgical removal of a diseased kidney and its neighboring adrenal gland, called radical nephrectomy, was once the most widely-performed surgery to treat kidney cancer. Now that kidney tumors are being detected much earlier, Mayo Clinic surgeons perform a radical nephrectomy only when absolutely necessary to treat advanced kidney cancer.
Mayo physicians have extensive experience with laparoscopic and robotic-assisted surgical approaches. Your surgeon will discuss what option is best for you. Read more about Mayo's extensive capabilities for robotic surgery.
Mayo Clinic urologists are also investigating novel surgical procedures that use minimally invasive techniques, require fewer incisions and use natural body openings when possible. Performing procedures through natural openings such as the mouth, belly button, vagina and urethra may diminish surgery's impact on patients and reduce scarring.
While surgery is the most common initial treatment for most kidney cancer tumors, alternatives to surgery may be considered for some patients. These approaches combine advanced imaging techniques with other technologies to deliver treatment.
In percutaneous cryoablation, one or more needles are inserted into the skin, including a small freezing probe (cryoprobe) that is delivered directly into the cancerous tissue. Placement is guided by simultaneous imaging from a CT scan and ultrasound. The probe projects high-intensity, freezing cold temperatures of -100 degrees Celsius into the tumor itself and into a margin of about 5 millimeters beyond the tumor's edge to ensure the whole tumor is destroyed.
After the procedure, a small adhesive bandage is placed on the skin, and patients typically stay overnight at the hospital before discharge. The U.S. Food and Drug Administration (FDA) recently approved this treatment for kidney cancer, but research studies still need to measure long-term outcomes to compare cryoablation to other treatments.
In radiofrequency ablation, ultrasound or CT imaging is used to guide a needlelike electrode through the skin into the tumor, similar to the cryoablation technique described above. Radiofrequency energy is then passed into the tip of the electrode, resulting in very high temperatures in the surrounding tumor which destroy it in five to 15 minutes, depending on the tumor's size and location. Following ablation, a small adhesive bandage is placed over any puncture sites. Most patients are observed overnight in the hospital and discharged the next morning.
Patients with metastatic kidney cancer can benefit from the extensive experience Mayo Clinic specialists have in treating cancer that has spread. Physician care teams develop a plan to treat each patient's cancer and maximize quality and quantity of life. Treatment options may include surgical treatment, radiation therapy, therapy targeting tumor growth, or therapy meant to enhance the patient's immune system. Other options may be available through clinical trials.
Radiation therapy is part of multi-faceted treatment approach for most kidney cancers, and may be considered one aspect of treatment, particularly when the cancer has spread to other organs (most commonly to bone or the brain). The goal of radiation therapy is to relieve or diminish symptoms of the disease. It is not considered an effective alternative to surgery.
Patients may be candidates for clinical trials that test experimental treatments. Several new drugs are being studied, and new studies may be available in the next year or two. Other drugs may become available for future studies, and Mayo Clinic physicians offer access to clinical trials to eligible patients, if trials are available and appropriate.
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