Treating renal cell carcinoma

Surgery may be the only treatment you need. But other options exist if your cancer is advanced or has returned.

Renal cell carcinoma treatment usually begins with surgery to remove the cancer. If the cancer is localized — stages I, II or III — this may be the only treatment you need. If the cancer is advanced — stage IV — your care team may recommend more treatments.

Treatment depends on your general health, what stage of cancer you have and your personal preferences.

Treating localized cancer

For localized renal cell carcinoma, surgery is the main treatment, although sometimes nonsurgical procedures, like heat and cold, are used.

Surgery

The goal of surgery is to remove the cancer while preserving normal kidney function, when possible.

Procedures used include:

  • Removal of the affected kidney (nephrectomy). A complete (radical) nephrectomy removes the entire kidney as well as a small portion of healthy tissue that surrounds the kidney. Additional nearby tissues like lymph nodes, adrenal glands or other structures may also be removed.

    This procedure is done through a single cut or incision in the abdomen or side (open nephrectomy) or through a series of small incisions in the abdomen (laparoscopic or robot-assisted laparoscopic nephrectomy).

  • Removal of the tumor (partial nephrectomy). The tumor and a small margin of healthy tissue that surrounds the cancer are removed during surgery. This is done as an open procedure, laparoscopically or with robotic assistance.

    Partial nephrectomy is a common treatment for small kidney cancers, and it may be an option if you have only one kidney. When possible, this approach is preferred over a complete nephrectomy to preserve kidney function and reduce the risk of later complications, like kidney disease and the need for dialysis.

Nonsurgical treatments

Small kidney cancers are sometimes treated without surgery. These procedures may be an option in certain situations, for example if you have other health problems that make surgery risky.

Options may include:

  • Treatment to freeze cancer cells (cryoablation). During cryoablation, a hollow needle is inserted through your skin and into the kidney tumor. Cold gas in the needle is used to freeze the cancer cells.
  • Treatment to heat cancer cells (radiofrequency ablation). During radiofrequency ablation, a probe is inserted through your skin and into the kidney tumor. An electrical current is run through the needle and into the cancer cells, causing the cells to heat up or burn.

Additional treatments usually aren't needed, although if your cancer is at high risk of returning, your doctor may suggest treatment with medication.

Treating advanced or recurring cancer

Advanced — stage IV — renal cell carcinoma that has spread to other parts of the body or has come back after treatment may not be curable. But treatments may help control the cancer and keep you comfortable. These treatments, which may be used in different combinations depending on your situation, may include:

  • Surgery. If the renal cell carcinoma can't be removed completely, surgeons may still remove as much of it as possible. Additional surgery may be necessary to remove cancer that's spread to another area of the body.
  • Targeted therapy. Targeted drug treatments focus on specific abnormalities in cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. For example, some drugs can damage the blood vessels that feed the tumor. Your doctor may recommend testing your cancer cells to see which targeted drugs may be most effective. Some targeted therapies are taken as a pill, while others are given through a small tube inserted into a vein (intravenously).
  • 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. Immunotherapy works by interfering with that process. You may take one drug or a combination of drugs given through a small tube inserted into a vein (intravenously).
  • Radiation therapy. Radiation therapy uses high-powered energy beams from sources like X-rays and protons to kill cancer cells. Radiation therapy is sometimes used to control or reduce symptoms of cancer that's spread to other areas of the body, like the brain.
  • Clinical trials. Clinical trials are research studies that give you a chance to try the latest innovations in renal cell carcinoma 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.
Oct. 13, 2020