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Surgery for Kidney Cancer

Treatment

Many people with kidney cancer want to take an active part in making decisions about their medical care. They want to learn all they can about their disease and their treatment choices. However, shock and stress after the diagnosis can make it hard to think of everything they want to ask the doctor. It often helps to make a list of questions before an appointment. To help remember what the doctor says, people may take notes or ask whether they may use a tape recorder. Some also want to have a family member or friend with them when they talk to the doctor to take part in the discussion, to take notes, or just to listen.

The doctor may refer the patient to a specialist, or the patient may ask for a referral. Specialists who treat kidney cancer include doctors who specialise in diseases of the urinary system (urologists) and doctors who specialize in cancer (medical oncologists and radiation oncologists).

Preparing for Treatment

Treatment depends mainly on the stage of disease and the patient's general health and age. The doctor can describe treatment choices and discuss the expected results. The doctor and patient can work together to develop a treatment plan that fits the patient's needs.

Methods of Treatment - Three forms of Surgical Treatments:

Surgery is the most common treatment for kidney cancer. It is a type of local therapy. It treats cancer in the kidney and the area close to the tumour.

An operation to remove the kidney is called a nephrectomy. There are several types of nephrectomies. The type depends mainly on the stage of the tumour. The doctor can explain each operation and discuss which is most suitable for the patient:

Partial nephrectomy: A surgical procedure to remove the cancer within the kidney and some of the tissue around it. A partial nephrectomy may be done to prevent loss of kidney function when the other kidney is damaged or has already been removed.

Simple nephrectomy: A surgical procedure to remove the kidney only.

Radical nephrectomy: A surgical procedure to remove the kidney, the adrenal gland, surrounding tissue and, usually, nearby lymph nodes.

In the past Kidney surgery was traditionally performed using an open approach, which requires a large abdominal incision. In recent times, technological advances permit a less invasive approach to the removal of the kidney. This is called a laparoscopic partial nephrectomy or radical nephrectomy. It offers numerous potential benefits over a conventional open surgery, including:
  • Significantly less pain
  • Less blood loss with fewer transfusions
  • Less risk of infection
  • Less scarring
  • Shorter hospital stay and shorter recovery time
  • Better clinical outcomes, in many cases
  • Arterial Embolisation

    Arterial embolisation is a type of local therapy that shrinks the tumour. Sometimes it is done before an operation to make surgery easier. When surgery is not possible, embolisation may be used to help relieve the symptoms of kidney cancer.

    The doctor inserts a narrow tube (catheter) into a blood vessel in the leg. The tube is passed up to the main blood vessel (renal artery) that supplies blood to the kidney. The doctor injects a substance into the blood vessel to block the flow of blood into the kidney. The blockage prevents the tumor from getting oxygen and other substances it needs to grow.

    Radiation Therapy

    Radiation therapy (also called radiotherapy) is another type of local therapy. It uses high-energy rays to kill cancer cells. It affects cancer cells only in the treated area. A large machine directs radiation at the body. The patient has treatment at the hospital or clinic, 5 days a week for several weeks.
    A small number of patients have radiation therapy before surgery to shrink the tumour. Some have it after surgery to kill cancer cells that may remain in the area. People who cannot have surgery may have radiation therapy to relieve pain and other problems caused by the cancer.

    Biological Therapy

    Biological therapy is a type of systemic therapy. It uses substances that travel through the bloodstream, reaching and affecting cells all over the body. Biological therapy uses the body's natural ability (immune system) to fight cancer.

    For patients with metastatic kidney cancer, the doctor may suggest interferon alpha or interleukin-2. The body normally produces these substances in small amounts in response to infections and other diseases. For cancer treatment, they are made in the laboratory in large amounts.

    Chemotherapy

    Chemotherapy is also a type of systemic therapy. Anticancer drugs enter the bloodstream and travel throughout the body. Although useful for many other cancers, anticancer drugs have shown limited use against kidney cancer. However, many doctors are studying new drugs and new combinations that may prove more helpful.

    Follow-up Care

    Follow-up care after treatment for kidney cancer is important. Even when the cancer seems to have been completely removed or destroyed, the disease sometimes returns because cancer cells can remain in the body after treatment. The doctor monitors the recovery of the person treated for kidney cancer and checks for recurrence of cancer. Checkups help ensure that any changes in health are noted. The patient may have lab tests, chest x-rays, CT scans, or other tests.

    For more information on kidney cancer visit kidney cancer UK at http://www.kcuk.org or http://www.cancerresearchuk.org/