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Kidney cancer

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Urinary Tract



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:

  • Surgical removal. 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. 

  • Sometimes surgeons 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 nephrectomy.

  • Arterial embolization. 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.

  • Radiation therapy. 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.

  • Immunotherapy. 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.

  • Chemotherapy. 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.

Wilms' tumor
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.

Clinical trials
If 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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