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Treatments for kidney cancer
If you have kidney cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for kidney cancer, your healthcare team will consider:
- the stage
- whether one or both of your kidneys are working
- whether the cancer is in one or both kidneys
- the type of kidney cancer
- your overall health
You may be offered the following treatments for kidney cancer.
Surgery is the main treatment for kidney cancer. It is used to remove part or all of the kidney. This surgery is called a nephrectomy. The type of nephrectomy you have will depend on the size of the tumour, location in the kidney and stage of the cancer. Doctors will use a partial nephrectomy whenever possible, to leave part of the kidney in place. In some cases, they need to use a radical nephrectomy, which removes the whole kidney, to try to completely remove a kidney tumour.
Surgery may also be used to relieve pain or ease symptoms of advanced kidney cancer. This is called palliative surgery.
Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells. The type of targeted therapy used will depend on the type of kidney cancer, the level of risk and any targeted therapies you have already received.
Targeted therapy is used to treat kidney cancer that can’t be completely removed with surgery because it has advanced too far. This includes cancer that has spread to other parts of the body and kidney cancer that comes back after treatment.
Ablation therapy uses heat or cold to destroy the kidney tumour. It destroys kidney cancer cells while keeping as much of the surrounding kidney tissue as possible. There are 2 types of ablation therapy used to treat kidney cancer. Radiofrequency ablation uses heat. Cryoablation uses cold.
It may be offered to people who can’t have surgery or who need to keep as much of their kidney as possible.
A kidney tumour needs blood to grow. Arterial embolization blocks the blood supply to a kidney tumour to help shrink it. It may be done before surgery so there is less bleeding when a large kidney tumour is removed. It can also be used to relieve pain when someone with advanced kidney cancer can’t have surgery.
External radiation therapy (also called external beam radiation therapy) uses a machine outside the body to direct radiation at a tumour and surrounding tissue. It is not usually given to the tumour in the kidney itself but may be used to treat areas where the cancer has spread, especially the bone and brain.
Radiation therapy is also used to relieve pain or to control the symptoms of advanced kidney cancer.
Immunotherapy uses the immune system to help destroy cancer cells. Cancer, and some cancer treatments, can weaken the immune system. Sometimes the immune system doesn’t recognize cancer cells as different, so it doesn’t work to destroy them. Immunotherapy boosts the immune system to help it recognize and fight cancer cells.
There are 2 types of immunotherapy used in Canada: immune checkpoint inhibitors and cytokine drugs. Cytokine drugs are not usually used in Canada because targeted therapy is better at treating kidney cancer. But it may be used in specialized centres that have experience using immunotherapy.
If you have kidney cancer but don’t have any symptoms, you may be offered active surveillance. This means that your healthcare team watches the cancer closely rather than giving treatment right away. Treatment is given when you develop symptoms or the cancer changes.
You may be offered active surveillance if you have a serious medical condition making you unable to tolerate treatment or if the kidney tumour is smaller than 4 cm (1-1/2 in).
If you can’t have or don’t want cancer treatment
You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.
Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.
Follow-up after treatment is an important part of cancer care. You will need to have regular follow-up visits, especially in the first 3 years after treatment has finished. These visits allow your healthcare team to monitor your progress and recovery from treatment.
Talk to your doctor about clinical trials open to people with kidney cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.
Questions to ask about treatment
To make the decisions that are right for you, ask your healthcare team questions about treatment.
A description of the extent of cancer in the body, including the size of the tumour, whether there are cancer cells in the lymph nodes and whether the disease has spread from its original site to other parts of the body.
Stages are based on specific criteria for each type of cancer.
The process of determining the extent of cancer in the body based on exams and tests is called staging.