Other surgical treatments for kidney cancer
Sometimes other treatments can be used to treat small (up to 3cm) kidney cancers instead of removing them with the standard operations.
These treatments are carried out through the skin (percutaneous) and tend to cause fewer side effects than a kidney operation. They also have quicker recovery times.
They may be suitable for people with smaller kidney tumours (stage T1a) who aren’t fit enough to have standard surgery. Some people may choose to have these treatments instead of having surgery.
They may also be used in people who have a rare inherited form of kidney cancer with multiple tumours or cancer affecting both kidneys.
Radiofrequency ablation (RFA)
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This uses heat to destroy the cancer cells and may need to be done more than once. You’ll be given a sedative drug before the treatment to make you feel drowsy and a local anaesthetic to numb the area over the kidney. Pictures produced by an ultrasound scan or CT scan help the surgeon to see the area of the kidney that needs treatment.
RFA may be done in the x-ray department or using keyhole surgery.
The doctor places one or more needle-like electrodes through the skin into the centre of the tumour. An electric current is then passed through the electrodes into the tumour. This heats the cancer cells and destroys them.
Side effects of RFA may include pain in the kidney area, bleeding and infection. In a small number of people, RFA may cause a blockage in the tube connecting the kidney to the bladder (ureter). It may also cause damage to the bowel.
Cryotherapy uses very cold temperatures to destroy cancer cells. It’s usually carried out under general anaesthetic. The surgeon places one or more probes into the centre of the tumour. A coolant is passed through the probes. This freezes and destroys the cancer cells and a small area (about 1cm) of healthy tissue around them.
Side effects may include pain in the kidney area, bleeding and infection. In a small number of people, the treatment may cause a blockage in the tube connecting the kidney to the bladder (ureter). It may also cause damage to the bowel.
High-intensity focused ultrasound (HIFU)
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This is a more recent treatment. It uses high-energy, high-frequency focused sound waves to produce high temperatures inside the tumour cells and destroy them. HIFU is used less often for kidney cancer than cryotherapy or RFA, so doctors know less about how effective it is.
It may be carried out under a local or general anaesthetic. Side effects may include pain in the kidney area, bleeding and infection. The treatment may need to be done more than once.
If surgery to remove the kidney isn’t possible because of your general health or because the tumour is too large, it may be possible to block off the blood supply to the tumour. This is called embolisation. It’s rarely used but can help control symptoms such as bleeding.
A thin, plastic tube (catheter) is put into a blood vessel in your groin. Then, using x-ray pictures as a guide, the surgeon threads the catheter upwards until the tip is in the artery that carries blood to the kidney. A substance is then injected through the catheter into the kidney. This blocks the blood supply to the kidney and so cuts off the supply of oxygen and nutrients to the tumour.
This treatment can sometimes cause pain in the back and a high temperature, so you may need to stay in hospital for a few days after you have it.