Treatment for kidney cancer
Surgery is the main treatment for kidney cancer that hasn't spread outside the kidney. If all of the cancer can’t be removed by surgery, other treatments may be used.
Surgery is the main treatment for kidney cancer that hasn’t spread outside the kidney (stages 1 and 2). If the tumour is small, the surgeon will usually only remove the part of the kidney containing the tumour. But in some cases, depending on the size of the cancer, the whole kidney may need to be removed (nephrectomy). This is sometimes done using keyhole surgery.
In some situations, treatments that destroy the cancer cells using heat (radiofrequency ablation) or extreme cold (cryotherapy) can be used to treat small kidney cancers instead of an operation.
There is currently no standard treatment given to reduce the risk of kidney cancer coming back after surgery (called adjuvant treatment). But clinical trials are trying to find out if targeted therapy or biological therapy treatments can help reduce the risk of some cancers coming back.
Even when the cancer has spread outside the kidney, your surgeon may still advise you to have an operation to remove the kidney. This can help to slow down and control the cancer. You’ll usually have treatment with a targeted therapy drug as well.
When kidney cancer has spread outside the kidney and to other parts of the body the main treatment is targeted therapy. Occasionally radiotherapy, chemotherapy or hormonal therapy treatment is used.
How treatment is planned
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In most hospitals, a team of specialists will meet to discuss and agree on the plan of treatment they feel is best for your situation. This multidisciplinary team (MDT) normally includes:
a urologist - a surgeon who specialises in treating kidney cancers
an oncologist - a specialist in cancer treatments such as chemotherapy, radiotherapy, targeted therapy drugs and biological therapy drugs
a urology nurse specialist, who gives information and support
a radiologist, who helps to analyse scans and x-rays
a pathologist, who advises on the type and extent of the cancer.
Other staff are also available to help you if necessary, such as:
psychologists and counsellors.
Your doctor or nurse specialist will discuss with you what the best treatment is for your particular situation, or they may offer you a choice of treatments. If you have to decide between treatments, make sure that you have enough information about each treatment option, so that you can decide which is right for you. You may find it helps to ask questions about what is involved with each treatment and the possible side effects they may cause.
If you have any questions about your treatment, don’t be afraid to ask your doctor or the nurse looking after you.
It often helps to make a list of the questions you want to ask and to take a relative or close friend with you to help you remember what is discussed.
Your multidisciplinary team (MDT) uses national treatment guidelines to decide the most suitable treatment for you. Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information.
If you do go for a second opinion, it may be a good idea to take a relative or friend with you, and have a list of questions ready, so that you can make sure your concerns are covered during the discussion.
Getting a second opinion
Watch our video to see Dr David Plume explaining the possible benefits or disadvantages of getting a second opinion.
Before you have any treatment, your doctor will explain its aims. They will usually ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should be given full information about:
the type and extent of the treatment
its advantages and disadvantages
any significant risks or side effects
any other treatments that may be available.
If you don’t understand what you’ve been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it’s not unusual to need explanations repeated.
It’s a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion. You may also find it useful to write a list of questions before your appointment.
People sometimes feel that hospital staff are too busy to answer their questions, but it’s important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions. You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.
You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.
The benefits and disadvantages of treatment
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Many people are frightened at the idea of having cancer treatments, particularly because of the side effects that can occur. However, these can usually be controlled with medicines. Treatment can be given for different reasons and the potential benefits will vary depending on your individual situation.
Early-stage kidney cancer
In people with early-stage kidney cancer, surgery is usually done with the aim of curing the cancer. Occasionally, drug treatments are also given in a clinical trial trying to find out if they reduce the risk of kidney cancer coming back.
Advanced-stage kidney cancer
If the cancer is at a more advanced stage, the treatment may only be able to control it, improving symptoms and quality of life. Sometimes treatment for advanced kidney cancer may help some people to live for longer.
However, for some people in this situation the treatment will have no effect on the cancer, and they will get the side effects without any of the benefits.
If you have early-stage cancer and have been offered treatment that aims to cure it, it may be easy to decide whether to accept the treatment.
However, if a cure is not possible and the treatment is being given to control the cancer for a period of time, it may be more difficult to decide whether to go ahead.
Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your doctor whether you wish to have treatment. If you choose not to, you can still be given supportive (palliative) care, with medicines to control any symptoms.
It’s important that you ask your doctors and nurses any questions you have about your treatment. The more you understand about your treatment, the easier it will be for you and them.
You may find our section on making treatment decisions helpful.