Treatment overview for kidney cancer

Your doctors will plan your treatment taking into account the size of the cancer and whether it has spread, as well as your preferences and general health.

Early kidney cancer

Early kidney cancer that hasn’t spread outside the kidney (T1 N0 M0 or T2 N0 M0) is usually treated with surgery. If the cancer is small, the surgeon will usually only remove the part of the kidney containing the cancer. But if the cancer is larger, the whole kidney may need to be removed. This is sometimes done using keyhole surgery.

In some situations, treatments that destroy the cancer cells with very high or low temperatures are used to treat small kidney cancers. This is called tumour ablation. It may be used instead of an operation.

Some kidney cancers are slow growing and very unlikely to spread outside the kidney. In certain situations, people who have small kidney cancers (less than 3cm across) may not need treatment. Instead they have regular scans of their kidneys to monitor the cancer. If the cancer shows signs of growing, they can have treatment. This approach is called monitoring, watch and wait or active surveillance.

Locally advanced cancer

If the cancer is larger, or has spread to lymph nodes but not to other parts of the body, surgery is often the main treatment. Clinical trials are trying to find out if targeted therapy drugs or immunotherapy can reduce the risk of the cancer coming back after surgery.

Advanced cancer (metastatic or secondary cancer)

If the cancer has spread outside the kidney to other parts of the body, your surgeon may still advise you to have an operation to remove the kidney. But, surgery will usually be combined with other treatments, such as targeted therapy.

Sometimes surgery is used to remove a secondary cancer, for example in the lung. This isn’t common. But, it may be done if there is only one area of secondary cancer and no sign of cancer elsewhere.

Targeted therapy drugs are the main treatment for advanced kidney cancer. They are used to try to shrink the cancer and control symptoms. Some advanced kidney cancers that are low-grade may grow very slowly. In this situation and if the cancer isn’t causing symptoms, your specialist may suggest monitoring with scans for a time before starting treatment.

Occasionally radiotherapy is used to relieve symptoms caused by advanced kidney cancer. Our section on advanced cancer has more information about symptom control and who can help.

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