Kidney Cancer Treatment

If you have kidney cancer, your doctor may suggest you treat it with surgery, medication, or other ways. The treatment you choose depends on things like your overall health, how old you are, the stage of your disease, and the kind of kidney cancer you have.

There are two main types. Renal cell carcinoma is the most common. It forms in the lining of the tiny tubes inside your kidneys. The second type, transitional cell carcinoma, is found in the center of the kidney.

Watchful Waiting

If your tumor is less than 1.5 inches, your doctor might suggest watchful waiting, sometimes called "active surveillance." This is more likely if your body is already weakened by age or illness.

While you do watchful waiting, you'll need to get regular checkups. Your doctor will ask you to get imaging tests, such as MRIs or CT scans, to see if the tumor has grown.

Treatment typically changes quickly to surgery or some other more active treatment once the tumor gets larger than 1.5 inches.

Surgery

It's the most common and effective treatment for most kidney cancer. Your surgeon will try to cut out as much of the tumor as possible while at the same time keeping as much of your kidney as they can.

The surgeon may also remove some or all of your lymph nodes -- small bean-shaped organs that are part of the immune system, your body's defense against germs.

Standard surgery starts with a 10-inch cut in your belly area. Laparoscopic surgery uses tube-like instruments that go in through small holes to cut into the same area.

There are several types of kidney cancer surgery:

Radical nephrectomy. The surgeon removes your whole kidney and surrounding fatty tissue, usually along with the attached adrenal gland and lymph nodes in the area. If you lose both kidneys, you'll need to go on a dialysis machine several times a week to clean your blood.

Partial nephrectomy. It's common surgery for people with early-stage kidney cancer. Your doctor may recommend it to remove tumors up to 2.75 inches.

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Long-term results seem to be about equal with radical nephrectomy, with the added benefit that you keep more of your kidney function.

A partial nephrectomy may not be the best choice if your tumor is very large or if it's growing in the center of your kidney. It also may not be useful if your cancer has already spread to the lymph nodes and other parts of your body.

Regional lymphadenectomy. Your doctor removes lymph nodes in this surgery. They may do this simply to check for cancer cells, or as part of a radical nephrectomy, especially if the tumor looks like the type that spreads easily or the lymph nodes look enlarged. Sometimes your doctor won't know if there's a problem with the lymph nodes until they can see and feel inside your body during surgery.

Targeted Therapy

In targeted therapy you take drugs that are specifically made to block the proteins and blood vessels that your kidney cancer needs to grow.

In some cases, these medications seem to shrink tumors or slow their growth. Your doctor will likely try one at a time to see which drug, or combination of drugs, work best.

Doctors typically use targeted therapy if the cancer has spread to other parts of your body.

Immunotherapy

Immunotherapy, sometimes called biologic therapy, boosts your immune system to fight your particular cancer type.

For kidney cancer, your doctor will likely use proteins called cytokines (interleukin-2 or interferon-alpha) to activate your immune system. Though it can shrink kidney tumors in some people, it so far only works in a small percentage of cases.

Chemotherapy

Chemotherapy puts powerful drugs into your bloodstream through pills or shots. The goal is to slow or stop cancer cell growth.

It's a less common treatment, since kidney cancer typically resists chemotherapy. If your doctor does recommend it, ask about possible side effects and how to manage them.

Radiation Therapy

A specialist called a radiation oncologist delivers high-energy radiation into your body from machines that send radioactive particles through the air, a shot, or an implant. The goal is to shrink tumors.

Radiation therapy isn't typically very effective on kidney cancers, though your medical team may suggest it if other treatments have failed. More often your team might suggest it to ease symptoms after the cancer has spread to bones or nearby organs where it can cause quite a bit of pain.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on December 23, 2019

Sources

SOURCES:

American Cancer Society: "Kidney Cancer."

American Society of Clinical Oncology: "Kidney Cancer Guide."

RadiologyInfo.org: "Professions in Diagnostic Radiology."

Urology Care Foundation: "Kidney Cancer." 

Christopher G. Wood, MD, professor of urology, MD Anderson Cancer Center. 

National Kidney Foundation: "Kidney Cancer: Treatment."

Mayo Clinic: "Kidney Cancer."

Johns Hopkins Medicine: "Active Surveillance for Kidney Cancer."

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