Kidney Cancer Treatment

If you have kidney cancer, your healthcare provider will review your treatment options so you can make the right decision for you. Here's what you should know.

You will have several options to treat your kidney cancer. What will work best for you depends on several factors.

They include the type, size, location, and stage of your cancer. Your age and overall health make a difference, too, as do side effects of your treatment.

Kidney cancers, like many cancers, have ways to overcome attacks from your body’s immune system.

But many approaches to kidney cancer have emerged in recent years that have doubled life expectancies. The first big discovery was that kidney tumors are rich in blood vessels. That makes them vulnerable to drugs called angiogenesis inhibitors that aim to cut off their blood supply.

Drugs called immune checkpoint inhibitors, which disarm your body’s defenses, are another advancement. The Food and Drug Administration has approved a drug called pembrolizumab for patients who have a high risk of relapse after kidney removal surgery.

Combining two checkpoint inhibitors may give a patient the best chance for long-term survival.

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Kidney cancer treatment options

You will want to know how you’ll feel and function after treatment. You’ll also have to change your normal activities.

Your medical team is the best source of answers to your questions. You should understand your treatment choices, their likelihood of success, and the risks and side effects. Your healthcare provider may advise a specific treatment or give you options to choose. It is important to take the time you need to make the best decision.

Ask your medical team how long you can take to explore your options. You may want to get another opinion before deciding on your treatment plan. In fact, some insurance companies may require a second opinion.

In addition, you may want to involve your family and friends in your decision. 

The goals of kidney cancer treatment

Treatment may control or cure the cancer. Certain treatments can minimize your symptoms, improving your quality of life.

Treatment aims to do one or more of the following:

• Remove the primary kidney cancer tumor or other tumors
• Kill or stop the growth or spread of kidney cancer cells
• Prevent or delay the cancer's return
• Ease symptoms of the cancer, such as pain or pressure on organs.

Types of treatment for kidney cancer

Surgery

Surgery to remove cancerous kidney tissue is called a nephrectomy. In partial nephrectomy, only some kidney tissue is removed. In radical nephrectomy, surgeons remove your entire kidney with the tumor and any nearby lymph nodes that contain cancer. You may also have surgery to ease pressure or pain.

Your remaining kidney is often able to do the work of both kidneys.

In most patients who have surgery for kidney cancer that has not metastasized, it never goes any further. The five-year survival rate for localized cancer is 93 percent. Even if the cancer has spread nearby, the five-year survival rate is more than 70 percent.  Those numbers are improving as new therapies are perfected.

Biologic therapy

Also called immunotherapy, biologic therapy uses medicines that overcome a tumor’s defenses to attacks from your immune system or otherwise bolster your immune system. Immune checkpoint inhibitors fall into this group.

Radiation therapy

This treatment kills cancer cells with high-energy x-rays. Radiation is most often used when the kidney cancer has spread to certain bones or your brain. It may be used to treat symptoms such as cough or pain.

Chemotherapy

This treatment uses one or more medicines to kill cancer cells or shrink tumors. Chemotherapy attacks rapidly growing cells. These medicines are not often very effective against kidney cancer, however.

Targeted therapy

These medicines target specific parts of kidney cancer cells to kill them or slow their growth. They work differently than chemotherapy and are often used to treat advanced kidney cancer. Angiogenesis inhibitors fall into this category.

Ablation therapy

Ablation therapy involves putting a needle into an area of cancer cells.

Radiofrequency ablation (or RFA) uses energy waves to kill cancer cells. Cryoablation uses extreme cold to kill cancer cells.

In both treatments, side effects are likely to arise only in that area and bleeding is minimized.

Supportive care

If the available remedies are likely to do more harm than good, your team will still offer you help to ease your symptoms. Your healthcare team may suggest that you have more than one treatment (combination therapy) or that you join a clinical research trial offering treatments that are not yet fully understood but probably safe for you.

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