Kidney cancer FAQs
Urologic oncologist Bradley Leibovich, M.D., answers the most frequently asked questions about kidney cancer.
I'm Dr. Brad Leibovich, a urologic oncologist at Mayo Clinic, and I'm here to answer some questions patients may have about kidney cancer.
Patients diagnosed with kidney cancer often want to know what could they have done differently to prevent this from happening in the first place. In most cases, kidney cancer is completely unrelated to how you've lived your life. And there's really nothing you could have done differently to have prevented this.
Prognosis for kidney cancer depends upon the stage at which the kidney cancer is discovered. For patients with early stage disease, the prognosis is excellent and the expectation is typically that somebody will be cured of their kidney cancer. For later stage disease, thankfully, we have many new treatments. And even if it's not possible to cure a patient, the expectation is we will significantly extend their life.
Patients that have been diagnosed with kidney cancer often want to know if it's necessary to remove the entire kidney. In some cases, the kidney can be preserved and only the tumor needs to be removed. In other cases, it's necessary to remove the entire kidney. Thankfully, most patients have a second kidney and have good enough kidney function with just one kidney, that this is not a problem.
Since most patients have relatively normal kidney function after having a kidney removed, in the majority of circumstances, you do not have to change your lifestyle. Most important is that you have a healthy lifestyle overall. Get good sleep, regular exercise, and have a healthy balanced diet. If you do need to change something about your lifestyle, your doctor will tell you.
Many patients want to know if they need to alter their diet after treatment for kidney cancer. In the majority of circumstances, people have normal enough kidney function that no special diet is required, and people can eat and drink however they did previously.
In my opinion, being the best partner to your medical team means learning as much as you can about your diagnosis and about your options. This will empower you to make the best decisions that are right for you. Never hesitate to ask your medical team any questions or inform them of any concerns you may have. Being informed makes all the difference. Thank you for your time. We wish you well.
Stage I kidney tumor
The tumor can be up to 2 3/4 inches (7 centimeters) in diameter. The cancer is only in one kidney and completely contained within it.
Stage II kidney tumor
The tumor is larger than 2 3/4 inches (7 centimeters) in diameter, but it's still confined to the kidney.
Stage III kidney tumor
The tumor extends beyond the kidney to the surrounding tissue and may also have spread to nearby lymph nodes.
Stage IV kidney tumor
Cancer spreads outside the kidney, to multiple lymph nodes or to distant parts of the body, such as the bones, liver or lungs.
Tests and procedures used to diagnose kidney cancer include:
- Blood and urine tests. Tests of your blood and your urine may give your doctor clues about what's causing your signs and symptoms.
- Imaging tests. Imaging tests allow your doctor to visualize a kidney tumor or abnormality. Imaging tests might include ultrasound, X-ray, CT or MRI.
- Removing a sample of kidney tissue (biopsy). In some situations, your doctor may recommend a procedure to remove a small sample of cells (biopsy) from a suspicious area of your kidney. The sample is tested in a lab to look for signs of cancer. This procedure isn't always needed.
Kidney cancer staging
Once your doctor identifies a kidney lesion that might be kidney cancer, the next step is to determine the extent (stage) of the cancer. Staging tests for kidney cancer may include additional CT scans or other imaging tests your doctor feels are appropriate.
The stages of kidney cancer are indicated by Roman numerals that range from I to IV, with the lowest stages indicating cancer that is confined to the kidney. By stage IV, the cancer is considered advanced and may have spread to the lymph nodes or to other areas of the body.
Kidney cancer treatment usually begins with surgery to remove the cancer. For cancers confined to the kidney, this may be the only treatment needed. If the cancer has spread beyond the kidney, additional treatments may be recommended.
Together, you and your treatment team can discuss your kidney cancer treatment options. The best approach for you may depend on a number of factors, including your general health, the kind of kidney cancer you have, whether the cancer has spread and your preferences for treatment.
During a partial nephrectomy, only the cancerous tumor or diseased tissue is removed (center), leaving in place as much healthy kidney tissue as possible. Partial nephrectomy is also called kidney-sparing surgery.
For most kidney cancers, surgery is the initial treatment. The goal of surgery is to remove the cancer while preserving normal kidney function, when possible. Operations used to treat kidney cancer include:
Removing the affected kidney (nephrectomy). A complete (radical) nephrectomy involves removing the entire kidney, a border of healthy tissue and occasionally additional nearby tissues such as the lymph nodes, adrenal gland or other structures.
The surgeon may perform a nephrectomy through a single incision in the abdomen or side (open nephrectomy) or through a series of small incisions in the abdomen (laparoscopic or robotic-assisted laparoscopic nephrectomy).
Removing the tumor from the kidney (partial nephrectomy). Also called kidney-sparing or nephron-sparing surgery, the surgeon removes the cancer and a small margin of healthy tissue that surrounds it rather than the entire kidney. It can be done as an open procedure, or laparoscopically or with robotic assistance.
Kidney-sparing surgery is a common treatment for small kidney cancers and it may be an option if you have only one kidney. When possible, kidney-sparing surgery is generally preferred over a complete nephrectomy to preserve kidney function and reduce the risk of later complications, such as kidney disease and the need for dialysis.
The type of surgery your doctor recommends will be based on your cancer and its stage, as well as your overall health.
Small kidney cancers are sometimes destroyed using nonsurgical treatments, such as heat and cold. These procedures may be an option in certain situations, such as in people with other health problems that make surgery risky.
Options may include:
- Treatment to freeze cancer cells (cryoablation). During cryoablation, a special hollow needle is inserted through your skin and into the kidney tumor using ultrasound or other image guidance. Cold gas in the needle is used to freeze the cancer cells.
- Treatment to heat cancer cells (radiofrequency ablation). During radiofrequency ablation, a special probe is inserted through your skin and into the kidney tumor using ultrasound or other imaging to guide placement of the probe. An electrical current is run through the needle and into the cancer cells, causing the cells to heat up or burn.
Treatments for advanced and recurrent kidney cancer
Kidney cancer that comes back after treatment and kidney cancer that spreads to other parts of the body may not be curable. Treatments may help control the cancer and keep you comfortable. In these situations, treatments may include:
- Surgery to remove as much of the kidney cancer as possible. If the cancer can't be removed completely during an operation, surgeons may work to remove as much of the cancer as possible. Surgery may also be used to remove cancer that has spread to another area of the body.
- Targeted therapy. Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. Your doctor may recommend testing your cancer cells to see which targeted drugs may be most likely to be effective.
- Immunotherapy. Immunotherapy uses your immune system to fight cancer. Your body's disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that help them hide from the immune system cells. Immunotherapy works by interfering with that process.
- Radiation therapy. Radiation therapy uses high-powered energy beams from sources such as X-rays and protons to kill cancer cells. Radiation therapy is sometimes used to control or reduce symptoms of kidney cancer that has spread to other areas of the body, such as the bones and brain.
- Clinical trials. Clinical trials are research studies that give you a chance to try the latest innovations in kidney cancer treatment. Some clinical trials assess the safety and effectiveness of potential treatments. Other clinical trials try to find new ways to prevent or detect disease. If you're interested in trying a clinical trial, discuss the benefits and risks with your doctor.
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
No alternative medicine therapies have been proved to cure kidney cancer. But some integrative treatments can be combined with standard medical therapies to help you cope with side effects of cancer and its treatment, such as distress.
People with cancer often experience distress. If you're distressed, you may have difficulty sleeping and find yourself constantly thinking about your cancer. You may feel angry or sad.
Discuss your feelings with your doctor. Specialists can help you sort through your feelings and help you devise strategies for coping. In some cases, medications may help.
Integrative medicine treatments may also help you feel better, including:
- Art therapy
- Massage therapy
- Music therapy
- Relaxation exercises
Talk with your doctor if you're interested in these treatment options.
Coping and support
Each person copes with a cancer diagnosis in his or her own way. Once the fear that comes with a diagnosis begins to lessen, you can find ways to help you cope with the daily challenges of cancer treatment and recovery. These coping strategies may help:
- Learn enough about kidney cancer to feel comfortable making treatment decisions. Ask your doctor for details of your diagnosis, such as what type of cancer you have and the stage. This information can help you learn about the treatment options. Good sources of information include the National Cancer Institute and the American Cancer Society.
- Take care of yourself. Take care of yourself during cancer treatment. Eat a healthy diet full of fruits and vegetables, be physically active when you feel up to it, and get enough sleep so that you wake feeling rested each day.
- Take time for yourself. Set aside time for yourself each day. Time spent reading, relaxing or listening to music can help you relieve stress. Write your feelings down in a journal.
- Gather a support network. Your friends and family are concerned about your health, so let them help you when they offer. Let them take care of everyday tasks — running errands, preparing meals and providing transportation — so that you can focus on your recovery. Talking about your feelings with close friends and family also can help you relieve stress and tension.
- Get mental health counseling if needed. If you feel overwhelmed, depressed or so anxious that it's difficult to function, consider getting mental health counseling. Talk with your doctor or someone else from your health care team about getting a referral to a mental health professional, such as a certified social worker, psychologist or psychiatrist.
Preparing for your appointment
Start by making an appointment with your primary care doctor if you have signs or symptoms that worry you. If your doctor suspects you may have kidney cancer, you may be referred to a doctor who specializes in urinary tract diseases and conditions (urologist) or to a doctor who treats cancer (oncologist).
Consider taking a family member or friend along. Sometimes it can be hard to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
What you can do
At the time you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet. Then make a list of:
- Symptoms you're experiencing, including any that may seem unrelated to the reason for your appointment
- Key personal information, including any major stresses or recent life changes
- All medications (prescription and over-the-counter), vitamins, herbs or other supplements that you're taking
- Questions to ask your doctor
List your questions from most to least important in case time runs out. Some basic questions to ask your doctor include:
- Do I have kidney cancer?
- If so, has my cancer spread beyond my kidney?
- Will I need more tests?
- What are my treatment options?
- What are the potential side effects of each treatment?
- Can my kidney cancer be cured?
- How will cancer treatment affect my daily life?
- Is there one treatment option you feel is best for me?
- I have these other health conditions. How can I best manage them together?
- Should I see a specialist?
- Are there brochures or other printed material that I can have? What websites do you recommend?
Don't hesitate to ask additional questions that may occur to you during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Be ready to answer them so that you'll have time to cover any points you want to focus on. Your doctor may ask:
- When did you first begin experiencing symptoms?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?