Treatment

The treatment for kidney cancer depends on the size of the cancer and whether it has spread to other parts of the body. The main treatments are: surgery to remove part or all of the affected kidney this the main treatment for most people ablation therapies where the cancerous cells are destroyed by freezing or heating them biological therapies medications that help stop the cancer growing or spreading embolisation a procedure to cut off the blood supply to the cancer radiotherapy where high-energy radiation is used to target cancer cells and relieve symptoms Cancer that hasn't spread out of the kidney can usually be cured by removing some or all of the kidney, although sometimes cryotherapy or radiofrequency ablation may be used instead. A complete cure may not be possible if the cancer has spread, but it may be possible to slow its progression and treat any symptoms with surgery, medication and/or radiotherapy. Surgery There are two main types of surgery for kidney cancer: an operation to just removepart of the kidney containing the cancer called a partial nephrectomy an operation to remove the entire affected kidneycalled a radical nephrectomy A partial nephrectomy is usually done if the cancer is small and easy for the surgeon to access. A radical nephrectomy may be necessary for larger cancers or if the cancer has spread beyond the kidney. It's possible to live a normal life with only one kidney. Your other kidney can usually make up for the kidney that was removed. Surgery for kidney cancer can be carried out in one of two ways: through a single large incision (cut) in the tummy or back known as "open" surgery using special surgical tools inserted through smaller incisions known as Laparoscopy Keyhole surgery tends to have a faster recovery time, but can only be done bysurgeons with special training and it isn't always suitable. Talk to your surgeon about thepros and cons ofeach method. Want to know more? NICE: single-port laparoscopic nephrectomy NICE: laparoscopic partial nephrectomy NICE: laparoscopic nephrectomy Cancer Research UK: surgery for kidney cancer Ablationtherapies Ablation therapies are treatments that involve either: destroying cancer cells by freezing them (cryotherapy) destroying cancer cells by heating them (radiofrequency ablation) Either technique may be recommended in special circumstances (for example, to ensure your kidney keeps working), or if your tumour is small. Both treatments are only available in specialist centres, so you may need to travel to another hospital to have it. Radiofreqency ablation is carried out by inserting a needle-like probe through your skin, so no large incisions are needed. Cryotherapy is carried out using needles inserted into the tumour. This can be done through your skin (percutaneous cryotherapy) or through a small incision (laparoscopic cryotherapy). Side effects of ablation therapies can include bleeding around the kidney and damage to the tube that carries urine from the kidney to the bladder (the ureter). Want to know more? NICE: percutaneous cryotherapy for renalcancer NICE: laparoscopic cryotherapy for renal cancer Cancer Research UK: cryotherapy for kidney cancer NICE: percutaneous radiofrequency ablation for renal cancer Cancer Research UK: radiofrequency treatment for kidney cancer Biological therapies If your cancer is advanced, treatment with biological therapies may be offered. These are medications, usually taken once or twice a day, that help stop the cancer growing and spreading. There are many different biological therapies, including: sunitinib pazopanib axitinib everolimus bevacizumab and interferon nivolumab At present, sunitinib, pazopanib, axitinib and nivolumab are recommended for routine use on the NHS. Other medicines aren't currently recommended, but some may be available through the Cancer Drugs Fund . Side effects Sunitinib, pazopanib and axitinib are all taken as regular tablets. Possible side effects include: feeling and being sick indigestion diarrhoea high blood pressure a sore mouth loss of appetite and weight loss tiredness infertility Nivolumab is given as a drip directly into a vein every two weeks. It works by helping the body's immune system destroy the cancer cells. Side effects are uncommon, but can include: a rash diarrhoea a cough and shortness of breath tiredness Want to know more? NICE: sunitinib for the first-line treatment of advanced and/or metastatic renal cell carcinoma NICE: pazopanibfor the first-line treatment of renal cell carcinoma NICE: axitinib for treating advanced renal cell carcinoma after failure of prior systemic treatment NICE: nivolumab for previously treated advanced renal cell carcinoma Cancer Research UK: biological therapies for kidney cancer Macmillan: side effects of biological therapies for kidney cancer Embolisation Embolisation is a procedure to block off the blood supply to the tumour, causing it to shrink. It's sometimes recommended if you have advanced kidney cancer and you're not in good enough health to have surgery to remove the affected kidney. During embolisation, the surgeon will insert a small tube called a catheter into a blood vessel inyour groin and then guide it to the blood vessel supplying the tumour. A substance will be injected through the catheter to block the blood vessel. Radiotherapy Radiotherapy is a treatment where radiation is used to target or destroy cancerous cells. It can't usually cure kidney cancer, but it canslow down its progress and help control your symptoms. It may be recommended if you have advanced kidney cancer that has spread to other parts of the body, such as your bones or brain. The treatmentinvolves a large machine directing a carefully aimed beam of radiation at the cancerous cells. It's often carried outfor a few minutes every day, over a few weeks. Side effects of radiotherapy can include: tiredness feeling and being sick diarrhoea reddening of the skin in the treatment area Want to know more? Cancer Research UK: radiotherapy for kidney cancer