Together, you and your treatment team — which may include a surgeon, a
doctor who specializes in disorders of the urinary organs (urologist), a
cancer specialist (oncologist) and an oncologist who specializes in
treating cancer with radiation (radiation oncologist) — will discuss all
of your options. The best approach for you may depend on a number of
factors, including your general health, the kind of kidney cancer you
have and whether the cancer has spread.
Renal cell carcinoma
Treatments for renal cell carcinoma include:
Until recently, the standard treatment for cancer that was confined
to the kidney was surgical removal of the entire kidney (radical or
simple nephrectomy). In a radical nephrectomy, surgeons remove the
kidney along with the adrenal gland that sits atop the kidney, a
border of normal tissue and adjacent lymph nodes. A simple
nephrectomy involves removing the entire kidney, although not the
adrenal gland or lymph nodes. But studies by researchers
show that removing just the tumor (nephron-sparing surgery), rather
than the whole kidney, results in survival rates similar to those of
more radical procedures. In addition, people who have
nephron-sparing surgery appear less likely to develop chronic kidney
failure and are more likely to enjoy a better quality of life than
do those who have the whole kidney removed.
may choose to remove the entire kidney because of the extent and the
location of the tumor. In that case, laparoscopic nephrectomy may
offer advantages over traditional open surgery because it typically
results in less postoperative pain, faster recovery time and less
scarring. In a laparoscopic procedure, a tiny camera is inserted
into your body through a small incision. The camera transmits video
images that allow your surgeon to see the kidney in great detail.
Your surgeon then inserts surgical instruments through two or three
other small incisions and performs the operation. The recovery time
and side effects of any type of kidney surgery will vary, but it's
likely you'll feel tired and weak for a time, even with laparoscopic
In this procedure, a radiologist injects a special material into the
main blood vessel leading to the kidney. By clogging this vessel,
the tumor is deprived of oxygen and other nutrients. Arterial
embolization may be used before an operation or to relieve pain and
bleeding when surgery isn't possible. Side effects may include
temporary nausea, vomiting or pain.
This therapy uses radiation to kill cancer cells. It's usually used
to relieve pain when kidney cancer has spread to the bones. In
general, you'll receive radiation treatment at a clinic or hospital
on an outpatient basis — often five days a week for several weeks.
The effects of radiation are cumulative, and you may become very
tired in the last few weeks of treatment. The skin in the treated
area may become red, tender or itchy. You may also have other side
effects, such as nausea and vomiting, depending on the part of your
body being treated.
This treatment uses your body's immune system to fight cancer. An
oncologist may administer a substance known as a biological response
modifier, such as interferon or interleukin-2. Normally produced by
the body, these substances are also made in laboratories to help
treat disease. Studies show that people may do better when they're
treated with both interferon and surgery, rather than with
interferon alone. Biological response modifiers can have serious
side effects, including chills, fever, nausea, vomiting and loss of
appetite. You may bruise easily after treatment and feel extremely
tired. Interleukin and interferon therapies can also affect liver
and kidney function. These side effects usually disappear once
treatment is stopped.
This therapy uses drugs to treat cancer. It works by attacking
rapidly dividing cells, which means it affects not only cancer cells
but also healthy cells, especially those in your bone marrow,
gastrointestinal tract, reproductive system and hair follicles.
Although chemotherapy is an effective treatment for some types of
cancer, it hasn't proven useful for renal cell carcinoma.
Transitional cell cancer
To treat transitional cell cancer in its early stages, surgeons remove
an area surrounding the tumor while trying to save the kidney itself. If
the tumor is too large or too centrally located, the kidney and ureter
may need to be removed along with the portion of the bladder that's
connected to the ureter. This helps decrease the risk of cancer cells
spreading to the bladder. Chemotherapy is often used to treat
transitional cell cancer that has spread.
Treatment for children with Wilms' tumor depends on the child's age,
overall health, the type of tumor and whether the cancer has spread. In
many cases, treatment may include surgical removal of the tumor followed
by chemotherapy or radiation.
kidney cancer has spread, standard treatments are seldom very effective.
For that reason, you may choose to participate in a clinical trial.
These trials test the effectiveness and side effects of new treatments.
Those who take part have a chance to receive a treatment that may be
promising but not yet widely available. If you're interested in clinical
trials, talk to your doctor.
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