Supportive care helps people meet the physical, practical, emotional and spiritual challenges of cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.
Recovering from kidney cancer and adjusting to life after treatment is different for each person, depending on the extent of the disease, the type of treatment and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A person who has been treated for kidney cancer may have the following concerns.
Living with one kidney
A person can live a normal and healthy life with 1 working kidney, or even part of a kidney. The remaining kidney tissue can filter waste and excess water from the blood.
It's important to take care of the remaining kidney.
If you smoke, get help to quit. Smoking is the strongest risk factor for developing kidney cancer.
Dietary changes
When the remaining kidney is healthy, you usually do not need to make any changes to your diet.
If the remaining kidney is not completely healthy, or you have only part of a kidney remaining, talk to a dietitian about changing your diet.
- A diet with low or moderate amounts of protein (meat, fish, eggs, milk and milk products, beans) may help protect the kidney.
- When the body digests protein, a waste product called urea is produced. Urea is filtered from the blood by the kidneys. If there is a large amount of urea in the blood from eating a diet that is high in protein, the remaining kidney has to work harder.
- Reduce the amount of salt in your diet.
- The kidneys filter sodium from the blood. If there are high levels of sodium in your food, the remaining kidney has to work harder.
- Limit the amount of alcohol you drink.
- Drinking large amounts of alcohol can cause kidney damage. If you choose to drink alcohol, limit the amount you drink.
- men – less than 2 drinks a day
- women – less than 1 drink a day (pregnant women should avoid alcohol)
Dialysis
Dialysis removes wastes from the blood in people who do not have working kidneys. Some people with kidney cancer may require dialysis after surgery if:
- the remaining kidney or partial kidney does not work properly (kidney failure)
- Kidney failure may be a short-term or long-term side effect.
- both kidneys had to be removed – rare
- the kidney that was removed was the only working kidney
There are 2 methods of dialysis.
Hemodialysis
Hemodialysis uses a machine to filter the wastes and excess water from the blood. It is done 3 times a week.
- A special tube (dialysis catheter) is placed into a large vein. The blood is removed from the body in small amounts, filtered by the machine and then returned to the body.
- If a person has to be on dialysis for the rest of their life, a permanent access to the bloodstream can be created by joining an artery to a vein during surgery. This creates an arteriovenous fistula (AVF) to provide better blood flow to the dialysis machine.
- A person has to be connected to the machine for a number of hours for each hemodialysis session.
Peritoneal dialysis
This is also called continuous ambulatory peritoneal dialysis (CAPD).
Peritoneal dialysis uses the membrane (peritoneum) that surrounds the organs in the abdominal cavity.
- A tube (catheter) is placed permanently through the abdominal wall.
- During dialysis, bags containing a special dialysis solution are attached to the catheter. The solution flows into the abdomen. The peritoneum allows waste products and extra fluid to pass from the blood into the dialysis solution.
- The dialysis solution remains in the abdomen for several hours absorbing the wastes. The solution is then drained and replaced with fresh solution.
The advantage of peritoneal dialysis is that the procedure can be done at home, which allows the person to continue with their activities of daily living.
A dietitian may suggest a special diet to help keep the person healthy while on dialysis:
- restricted amount of fluids
- high protein
- Because protein is lost during dialysis, a person must eat more to maintain good nutrition.
- low sodium and potassium
- vitamin supplements
Kidney transplant
In rare situations where a person with kidney cancer has had both kidneys removed, they will need to be on dialysis for the rest of their life. The only alternative to dialysis is a kidney transplant through organ donation.
To be considered for a kidney transplant, a person must be free from cancer for 5 years after treatment.
The risks and benefits of a kidney transplant should be discussed with the transplant surgeon. One of the major risks is an increased chance of developing another form of cancer because of the immunosuppressive drugs that prevent the body from rejecting the new kidney. These drugs increase the risk of developing a second cancer.
See a list of questions to ask your doctor about supportive care after treatment.