There are several treatment options available one the diagnosis of Kidney cancer is confirmed. Kidney cancer is most often treated with surgery, targeted therapy, immunotherapy or a combination of these treatments Radiation therapy and chemotherapy are rarely used. For non-metastatic disease (localized disease), surgery is the mainstay and often the sole treatment. For a disease which has spread to distant sites, immunotherapy & oral tyrosine kinase inhibitors (targeted therapy) play the most vital role.
Surgery is for the removal of the tumor and some surrounding healthy tissue during an operation. If the cancer has not spread beyond the kidneys, surgery to remove the tumor may be the only treatment needed. Surgery to remove the tumor may mean removing part or all of the kidney, as well as possibly nearby tissues and lymph nodes. Surgeries can be performed by traditionally open abdomen surgery by taking a larger incision on the abdomen/back or by using a laparoscopic approach
Types of surgery used for kidney cancer include the following procedures:
- Radical nephrectomy: Surgery to remove the tumor, the entire kidney and surrounding tissue is called a radical nephrectomy. If nearby tissue and surrounding lymph nodes are also affected by the disease, a radical nephrectomy and lymph node dissection is performed. During a lymph node dissection, the lymph nodes affected by the cancer are removed. If the cancer has spread to the adrenal gland or nearby blood vessels, the surgeon may remove the adrenal gland during a procedure called adrenalectomy, as well as parts of the blood vessels. A radical nephrectomy is usually recommended to treat a large tumor when there is not much healthy tissue remaining.
- Partial nephrectomy: A partial nephrectomy is the surgical removal of the tumor. This type of surgery preserves kidney function and lowers Ire risk of developing chronic kidney disease after surgery
- Non-surgical tumor treatments: Sometimes surgery is not recommended because of characteristics of the tumor or the patients overall health. The following procedures may be recommended.
- Radiofrequency ablation: Radiofrequency ablation (RFA) is the use of a needle inserted into the tumor to destroy the cancer with an electrical current. Used rarely in some early stage cancers.
Cryoablation, also called cryotherapy or cryosurgery, is the freezing of cancer cells with a metal probe inserted through a small incision. The metal probe is placed into the cancerous tissue. A CT scan and ultrasound are used to guide the probe.
Therapies using medication
The types of systemic therapies used for kidney cancer include:
- Immunotherapy: Immunotherapy, also called biologic therapy, is designed to boost the body's natural immunity to fight cancer cells. Immunotherapy targets checkpoints, that the cancer cells use to evade the Immune system. Immunotherapy is the mainstay of treatment in metastatic renal cell cancer.
- Tyrosine Kinase Inhibitors: Patients with metastatic renal cell cancer also have an option of oral targeted tyrosine kinase inhibitors which identifies & targets specific types of cancer cells while causing less damage to normal cells.
- Chemotherapy: Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing and making more cells.A chemotherapy regimen or schedule usually consists of a specific number of cycles given over a set period of time.It is important to remember that transitional cell carcinoma, also called urothelial carcinoma, and Wilms tumor are much more likely to be successfully treated with chemotherapy.
- Radiation therapy: Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. Radiation therapy is not effective as a primary treatment for kidney cancer. It is very rarely used alone to treat kidney cancer because of the damage it causes to the healthy kidney. Radiation therapy is used only in the palliative setting to reduce pain — mostly when the disease has spread to bones or the brain.