Monitoring for kidney cancer

Monitoring means delaying treatment until it is needed. Sometimes, doctors suggest monitoring small, slow-growing kidney cancer.

What is monitoring (active surveillance)?

Monitoring a kidney cancer is a way of delaying treatment until it is needed. It is sometimes called active surveillance.

During monitoring, you have regular ultrasound, CT or MRI scans. The scans look for signs that the cancer is growing. Sometimes you have a guided biopsy to give your doctor more information about the cancer.

Your cancer doctor or specialist nurse may talk to you about starting treatment if:

  • the scans or biopsy show signs the cancer is growing
  • your symptoms change.

The main advantage of monitoring is that you can avoid the risks or side effects of treatment.

Who is monitoring suitable for?

Monitoring is an option for some people who have very small, slow-growing kidney cancers (under 4cm). We have more information about staging and grading of kidney cancer.

It is most likely to be offered to people who already have health problems that would increase the risks of surgery. Because the cancer is slow growing, it may not cause them any problems in their lifetime.

If you have kidney cancer that has spread to other parts of the body, but you do not have symptoms, you may also have monitoring to delay starting targeted therapy or immunotherapy treatment.

Before deciding whether monitoring is right for you, make sure you understand why it is recommended. If you have any concerns, talk to your cancer doctor.

Coping with monitoring

Monitoring can be difficult to adjust to at first. You may find it difficult to accept that the cancer is not being treated. But many people find it gets easier as time goes on.

Sharing your feelings can help. You could:

The Macmillan Online Community also has a kidney cancer group.

About our information

  • References

    Below is a sample of the sources used in our kidney cancer information. If you would like more information about the sources we use, please contact us at

    Escudier B, et al. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology 30: 706-720, 2019. doi:10.1093/annonc/mdz056 Published online 21 February 2019. Available from (accessed April 2021).

    European Association of Urology. Renal cell carcinoma guidelines. EAU Guidelines. Edn. presented at the EAU Annual Congress Milan 2021. ISBN 978-94-92671-13-4. Available from (accessed April 2021).

    National Institute for Health and Care Excellence (NICE): Nivolumab with ipilimumab for untreated advanced renal cell carcinoma. Technology appraisal guidance (TA581). Published 15 May 2019. Available from (accessed April 2021).

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Lisa Pickering, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Date reviewed

Reviewed: 01 November 2021
Next review: 01 November 2024
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.