Surgery for kidney cancer

Surgery is the main treatment for kidney cancer and it may be the only treatment you need. The operation will depend on the stage of the cancer and your general health. There are different types of surgery:

  • kidney-sparing surgery –removing only part of the kidney
  • nephrectomy – removing the kidney entirely.

Kidney-sparing surgery is often used to treat small cancers (under 4cm). The surgeon only removes the affected part of the kidney. This type of surgery is also used with people who have only one kidney or suffer from a kidney disease.

During a nephrectomy the surgeon removes the whole kidney. This is a big operation but you can live with only one kidney.

There are different ways a surgeon can operate on the kidney; open, laparoscopic and robotic surgery.

If you have advanced kidney cancer, surgery will not cure the cancer. But removing the kidney may help the other treatments work better and reduce some symptoms. You will need to discuss the benefits and the risks of the operation with your specialist.

Surgery for kidney cancer

Surgery may be the only treatment you need. The type of operation you have will depend on the stage of the cancer and on your general health. It’s important to talk over the operation with your surgeon and specialist nurse before you have it.

Removing part of the kidney (kidney-sparing surgery)

This is the most common operation for cancers that are smaller than 4cm. But it may sometimes be done with larger cancers.

The surgeon removes only the part of the kidney containing the cancer. This is called a partial nephrectomy or kidney-sparing surgery. The aim is to remove the cancer. And to leave you with as much normal kidney tissue as possible so the kidney can still work.

Kidney-sparing surgery may also be done if it’s important to try to keep the affected kidney. For example, if you have only one working kidney or have kidney disease. If you have an inherited type of kidney cancer, you may be offered this operation. This is because there is a risk you could develop a cancer in your other kidney.

Removing the whole kidney (nephrectomy)

This is when the surgeon removes the whole kidney and some surrounding tissue. Your surgeon may also remove lymph nodes close to the kidney to check them for cancer cells.

You can live a normal life with just one kidney. It will do the work usually shared by both kidneys. Removing a kidney is a big operation. You will need to be reasonably fit. This type of surgery isn’t suitable for everyone.

If there is cancer in one of the large blood vessels leaving the kidney, it may be possible to have an operation to remove it. But this is a more complex operation. You will need to go to a specialist unit to have it done.

Removing the kidney when the cancer has spread

If the cancer has already spread to other places in the body, removing the kidney won’t usually cure the cancer. But it may help other treatments work better and reduce cancer symptoms.

You need to consider the possible advantages of having the kidney removed as well as the effects of having a big operation. Your doctors can talk over the possible benefits and disadvantages with you.

Open, laparoscopic and robotic surgery

There are different ways a surgeon can operate on the kidney.

Open surgery

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

Open surgery kidney scars
Open surgery kidney scars

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Laparoscopic surgery

Laparoscopic surgery is also sometimes called keyhole surgery. The surgeon makes 2–3 small cuts and one larger cut. They use a laparoscope to see and work inside the tummy (abdomen).

The laparoscope is a thin tube with a light and a camera that sends video images to a TV monitor. The surgeon puts the laparoscope into the abdomen through a small cut in the skin. A larger cut is usually made close to the belly button and is used to remove the kidney. The position of the cuts may vary from person to person. Your surgeon can advise you on this.

The surgeon may use a specialised machine to help with keyhole surgery. Instruments attached to the machine are controlled by the surgeon. This is called robotic surgery. It makes it possible for the surgeon to carry out very precise surgery.

Laparoscopic surgery leaves a small wound so recovery is quicker than with open surgery.

Keyhole kidney scars
Keyhole kidney scars

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Surgery to remove a secondary cancer

Rarely, an operation may be done to remove a secondary cancer in another part of the body. This is very specialised surgery. It’s generally only possible if the cancer has spread to a limited area – usually just to one place in the body.

It’s also important that you’re fit enough to cope with the operation. Removing a secondary cancer may help to control the cancer for longer. Occasionally, it may be used to try to cure the cancer.

Back to Surgery explained

Who might I meet?

A team of specialists will plan your surgery. This will include a surgeon who specialises in your type of cancer.

What happens after surgery?

You’ll be monitored very closely after your operation. You will be tired so it’s important to rest and look after yourself.