About surgery for kidney cancer

Surgery may be the only treatment you need to treat kidney cancer. The type of surgery (operation) you have will depend on the stage of the cancer and on your general health.

It is important to talk to your surgeon and specialist nurse about the operation before you have it.

Removing part of the kidney (partial nephrectomy)

This is the most common operation for kidney cancers smaller than 4cm. But you may have it if you have a larger kidney cancer. Your doctor will explain if it is suitable for you.

During the operation, the surgeon removes the part of the kidney with the cancer. The aim is to remove the cancer but to leave as much normal tissue as possible. This is so the kidney can continue to work.

You may have this operation if it is important to try to keep the affected kidney. This may be because:

  • your other kidney does not work well
  • you have kidney disease
  • you have other conditions that might affect how well your kidneys work in the future.

If you have an inherited type of kidney cancer, you may be offered this operation. This is because there is a risk you may develop a cancer in the other kidney.

You are likely to be referred to a specialist hospital for this type of surgery. This may mean you have to travel for treatment.

Removing the whole kidney (radical nephrectomy)

You may have this operation if the cancer is bigger. Or you may have it if the cancer is in the middle of the kidney and a partial nephrectomy is not suitable.

During the operation, the surgeon removes the whole kidney and some surrounding tissue. They also remove lymph nodes close to the kidney to check them for cancer cells.

You can usually live a normal life with one kidney. It will be able to do the work of both kidneys. The surgeon can talk to you about this before you make a decision about having surgery. We have more information about making treatment decisions.

Removing a kidney is a big operation and is not suitable for everyone. Your doctors may need to do tests to check you are well enough to cope with the surgery.

If there is cancer in one of the large blood vessels leaving the kidney, it may be possible to have surgery. But this is a more complicated operation. You will need to go to a specialist hospital for this surgery.

Removing the kidney when the cancer has spread

Your doctors may talk to you about an operation to remove the kidney even if the cancer has spread. It will not cure the cancer, but in some people, it can mean that they are likely to live longer. Your treatment plan will usually include other treatments such as immunotherapy and targeted therapy.

You may need to consider the possible advantages of having the kidney removed, as well as the effects of having a big operation. Your doctors will talk to you about the possible benefits and disadvantages.

Surgery to remove a secondary cancer

Rarely, you may have an operation to remove a secondary cancer in another part of the body. This is a very specialised operation.

It is usually only possible if the cancer has spread to a limited area – usually just to one place in the body, such as the lung or the brain. It is also important that you are fit enough to cope with the operation.

Removing a secondary cancer may help control the cancer for longer. Or it may help reduce any symptoms it might be causing. Occasionally, it may be used to try to cure the cancer.

Types of surgery for kidney cancer

There are different ways a surgeon can operate on the kidney. Your surgeon will explain how they will do your operation and answer any questions you have. For kidney cancer surgery, you usually have a general anaesthetic.

Kidney cancer surgery is commonly done as keyhole surgery, but open surgery is sometimes needed.

Keyhole (laparoscopic) surgery

During keyhole surgery, the surgeon uses a laparoscope to see and work inside the tummy (abdomen). A laparoscope is a thin tube with a light and camera on the end. It sends video images to a monitor.

The surgeon starts by making 3 or 4 small cuts in the tummy. They then put the laparoscope through one of the small cuts in the skin. Your tummy will be inflated with gas to help the surgeon operate more easily.

During the operation, the surgeon puts the kidney they want to remove into a bag inside your body. At the end of the operation, they either make one of the cuts bigger, or they make an extra cut. This is so they can remove the bag with the kidney inside.

The position of the cuts depends on who is having the surgery and how the surgeon does the operation. Your surgeon can talk to you about what to expect. Recovery from keyhole surgery is usually quicker than from open surgery. This is because the wounds are smaller.

Keyhole surgery scars
Image: Keyhole kidney surgery scars

Robot-assisted surgery

The surgeon may use a specialised machine to help with keyhole surgery. There are instruments attached to the machine, which the surgeon controls. This is called robot-assisted surgery. The robot makes it possible for the surgeon to move in a very precise way to do complicated keyhole surgery.

Open surgery

During open surgery, the surgeon makes one large cut (incision) just under the bottom rib or between the 2 bottom ribs. This cut can be up to 30cm long. After the operation, the surgeon stitches or staples the wound closed.

Open surgery scar

Image: Open surgery scar

Before your operation for kidney cancer

Before your operation, you will visit a pre-assessment clinic. You will be asked about your medical conditions and any medication you take.

You may have tests to check your general health. These can include:

We have more information about what might happen before surgery

Recovery after kidney cancer surgery

Your recovery after surgery will depend on the type of operation you have.

Possible complications of surgery for kidney cancer

The most common complications after surgery are:

  • a wound infection
  • bleeding
  • a chest infection
  • a blood clot.

The nurses will monitor you for these. Tell them straight away if you:

  • feel unwell
  • have any bleeding
  • notice swelling and redness in a limb (arm or leg).

You should also tell them if you have symptoms of an infection, such as a cough or a leaking wound.

You will be given a telephone number to call if you need advice when you get home.

After open surgery to the kidney, some people develop a bulge (swelling) along their scar. Doctors call this an incisional hernia. It can happen because of weakness in the muscles around the scar. Tell your doctor or nurse if you develop a bulge around the scar.

We have more information about general complications after surgery.

Going home after surgery

How long you stay in hospital depends on the type of operation you have and how quickly you recover:

  • After keyhole surgery, most people go home after 2 to 5 days.
  • After open surgery, most people go home after 5 to 7 days.

Your body uses a lot of energy to heal. It is common to feel more tired than usual for about 6 weeks after the operation. Most people feel fully recovered after about 12 weeks.

Your surgeon or nurse can tell you when you will be able to get back to doing everyday activities such as shopping, driving, having sex, playing sport or going to work.

Before you leave hospital, you will be given an appointment for a check-up. This is usually about 6 weeks after your operation. It will be at an outpatient clinic. The appointment is a good time to talk about any problems you have after your operation.

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 cancerinformationteam@macmillan.org.uk

    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 www.annalsofoncology.org/action/showPdf?pii=S0923-7534%2819%2931157-3 (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 www.uroweb.org/guideline/renal-cell-carcinoma (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 www.nice.org.uk/guidance/ta581 (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.