Kidney Cancer: Chemotherapy

What is chemotherapy?

Chemotherapy uses anticancer medicines to kill cancer cells. The medicines are made to attack and kill cancer cells that grow quickly. Some normal cells also grow quickly. Because of this, chemotherapy can also harm those cells. This can cause side effects.

When might chemotherapy be used for kidney cancer?

Chemotherapy is used much less often than biologic therapy, which is another kind of treatment done with medicine. Chemotherapy may be used in rare cases where biologic therapy has not worked.

How is chemotherapy given for kidney cancer?

The oncologist will determine how often and how long the treatments will be. Sometimes more than one medicine is used. The medicines may be given in a hospital outpatient facility, a doctor's office or clinic, or a hospital. The medicines may be given in any of these ways:

• IV (intravenous) drip. A bag filled with medicine drips through a tube into a small catheter that's put into a vein.

• Oral. You swallow these medicines as pills.

• Injection. You get these medicines through a needle into a vein, muscle, or under the skin.  

You get chemotherapy in cycles over a period of time. That means you may take the medicine for a set amount of time and then you have a rest period. Each period of treatment and rest is 1 cycle. This schedule may continue for 4 to 8 cycles. Having treatment in cycles helps by:

• Killing more cancer cells. The medicine can kill more cancer cells over time, because the cells aren't all dividing at the same time. Cycles allow the medicine to fight more cells.

• Giving your body a rest. Treatment is hard on other cells of the body that divide quickly. This includes cells in the lining of the mouth and stomach. This causes side effects, such as sores and nausea. Between cycles, your body can get a rest from the chemotherapy.

• Giving your mind a rest. Having chemotherapy can be stressful. Taking breaks between cycles can let you get an emotional break between treatments.

What types of chemotherapy medicines are used to treat kidney cancer?

Some of the chemotherapy medicines that might be used include:

• Gemcitabine

• 5-fluorouracil (5-FU)

• Capecitabine

• Vinblastine

• Floxuridine

You may take more than 1 medicine. This is called combination therapy. Which medicines you get and how often you get them depend on many factors. If you have chemotherapy, you may have it along with biologic therapy.

Chemotherapy in cycles

You get chemotherapy in cycles over a period of time. That means you may take the medicine for a set amount of time and then you have a rest period. Each period of treatment and rest is 1 cycle. You may have several cycles. Having treatment in cycles helps by:

• Killing more cancer cells. The medicine can kill more cancer cells over time, because cells aren't all dividing at the same time. Cycles allow the medicine to fight more cells.

• Giving your body a rest. Treatment is hard on other cells of the body that divide quickly. This includes cells in the lining of the mouth and stomach. This causes side effects, such as sores and nausea. Between cycles, your body can get a rest from the chemotherapy.

• Giving your mind a rest. Having chemotherapy can be stressful. Taking breaks between cycles can let you get an emotional break between treatments.

What are common side effects of chemotherapy?

Side effects are common with chemotherapy, but it's important to know that they can often be prevented or controlled. Side effects of chemotherapy depend on the type and amount of medicines you’re taking. They vary from person to person.

Some common short-term (temporary) side effects from chemotherapy include:

• Nausea and vomiting

• Mouth sores

• Constipation or diarrhea

• Hair loss

• Infections from low white blood cell counts

• Easy bruising or bleeding from low blood platelets

• Tiredness from low red blood cell counts

• Loss of appetite

• Dizziness

• Dry or darkening skin

• Tingling, numbness, or swelling in hands or feet

Most of side effects will go away or get better between treatments and a few weeks after treatment ends. There are often ways to prevent or lessen them. You may also be able to help control some of these side effects. Tell your healthcare providers about any side effects you have. They can help you cope with the side effects.

Working with your healthcare provider

You will have blood tests done regularly while you're getting chemotherapy to make sure you aren't having harmful reactions. Make sure you ask which problems, if any, require calling your healthcare provider or nurse right away. For instance, chemotherapy can make you more likely to get infections. Your healthcare provider or nurse may advise you to call them if you have any of these symptoms:

• Fever

• Sore throat

• Shaking chills

• Redness, swelling, and warmth at the site of an injury or IV catheter

• New cough or shortness of breath

• Nasal congestion

• Burning during urination

Make sure you know what number to call with questions, even on evenings and weekends.

It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your medical team to make a plan to manage your side effects.