Controlling the symptoms of kidney cancer

If you have advanced kidney cancer it may not be possible to cure it. Advanced kidney cancer means the cancer has

• Spread to another part of the body from where it started in the kidney, or
• Come back some time after you were first treated

Kidney cancer can spread into organs close to the kidney, such as the bowel or liver. Or it can spread in the lymphatic system or bloodstream to another part of the body, such as the bones, lungs, brain or the other kidney.

Although kidney cancer that has spread can't usually be cured, some treatments can keep the cancer under control for some time and reduce symptoms. 

These treatments include

• Biological therapies
• Surgery
• Cryotherapy
• Radio wave treatment
• Radiotherapy
• Chemotherapy
• Blocking the tumour's blood supply

• Hormone therapy with medroxyprogesterone

Biological therapies

Biological therapies can often keep the cancer under control and stop it growing for some months or sometimes years. These treatments include drugs such as

• Sunitinib (Sutent)
• Sorafenib (Nexavar)
• Pazopanib (Votrient)
• Bevacizumab (Avastin)
• Interferon (Roferon A)
• Temsirolimus (Torisel)
• Everolimus (Afinitor)

You can read about biological therapy for advanced kidney cancer in this section.

Surgery

Surgery is sometimes possible for secondary kidney cancers. If the cancer has come back in the area of the kidney or has spread to only one other area, it may be possible to remove it. There is quite a bit of research evidence to show that removing a cancerous kidney, for example, can control symptoms and help people to live longer even if it won't cure the cancer. Kidney cancers can produce chemicals that circulate round the body and cause odd symptoms, for example fevers, weakness, muscle pain or nerve problems. 

Treating the tumour reduces the amount of these chemicals that the cancer makes. So it can help to control the symptoms. As kidney cancer can be inactive at times, taking out a secondary cancer may temporarily stop the growth of the cancer and help you to stay well for longer. There is information about surgery for advanced kidney cancer in this section.

Cryotherapy

Cryotherapy (also called cryosurgery) is a way of killing cancer cells by freezing them. Doctors put a freezing probe into the cancer through the skin. Your doctor may suggest it on an area of cancer that is less than 4cm across. You can have the treatment again if you need to.

Radio wave treatment

Radiofrequency ablation (RFA) uses heat made by radio waves to kill cancer cells. Radiofrequency is a type of electrical energy. The electrical energy heats up the tumour and kills the cancer cells. This treatment is only available in specialist cancer centres. It can help to shrink a cancer and control symptoms. Your surgeon may suggest it if you have a small area of cancer in the kidney or in the liver. 

Radiotherapy

Radiotherapy can shrink advanced kidney cancers and reduce symptoms such as bleeding into the urine or pain. Shrinking lung secondaries may help relieve breathlessness.  

Chemotherapy

Chemotherapy can shrink advanced kidney cancer in some people but so far it has not worked very well. Trials are trying to find out whether combining chemotherapy with biological therapies can work better. You can find out about research trials on the research into kidney cancer page.

Blocking the tumour's blood supply

A procedure called arterial embolisation can help to shrink kidney cancers and control symptoms. The doctor injects small pieces of foam or gelatine beads into the main artery leading to the area where the cancer is. This cuts off the blood supply to the tumour. The tumour can shrink and this relieves symptoms such as pain and bleeding. This procedure can also treat secondary tumours in the liver.

Hormone therapy with medroxyprogesterone

In some people with advanced kidney cancer a hormone therapy called medroxyprogesterone (Provera) can shrink the cancer and control symptoms. But it is not commonly used now because the biological therapies tend to work better. It can also cause side effects such as

• Water retention
• Weight gain
• Indigestion
• Sleeplessness

Which treatment is best for you depends on

• The size of the cancer and where it is
• Where the cancer has spread to
• The treatment you have already had
• Your general health

If you have only one area of cancer spread, it may be best to use a local treatment, such as surgery or radiotherapy. If the cancer is in more than one area, biological therapy is a better option. When considering surgery, your doctor will need to think about your general health and how easy it will be for you to recover. 

If you've had a certain type of treatment before, it may not help to repeat it. Or with radiotherapy, it may not be possible. These are the sorts of things your doctor has to take into account. But you and your doctor will take the final decisions together after you have discussed all the options.

It can be difficult to decide which treatment to try, or whether to have treatment at all when you have an advanced cancer. You may want to think about your quality of life while you are having the treatment. This includes side effects, as well as stresses such as travelling back and forth to the hospital. Most importantly, you will need to understand what can be achieved with the treatment you are being offered. 

It can be helpful to talk over difficult decisions with someone outside your circle of family and friends. You can contact the Cancer Research UK nurses to talk through your situation in confidence on 0808 800 4040, from 9am to 5pm, from Monday to Friday. Or you could contact a counselling organisation to find out about counselling and how to find a counsellor in your area.

If you want to find people to share experiences with online, you could use CancerChat, our online forum. Or go through My Wavelength. This is a free service that aims to put people with similar medical conditions in touch with each other.

Symptoms such as pain, sickness and nausea, diarrhoea and constipation can all be helped with medicines. Some people find complementary therapies such as relaxation and massage can relieve pain or sickness. And they can certainly help to reduce anxiety and stress.

There are many different painkillers and ways of taking them. With the help of your doctor or specialist nurse, it should be possible for you to be pain free most of the time. It may not be possible to ensure you are completely pain free when you are moving around, but you should be when you are resting. You and your family can learn to help combat pain yourselves, for example with relaxation or breathing exercises. We have a section about cancer and pain control, which you may find helpful.

Sickness can also be helped with medicines. There are several different types of anti sickness medicine, and which one you need depends on what is causing your sickness. It will help your doctor or symptom control nurse if you are able to tell them what relieves your sickness and what seems to make it worse. There is detailed information about causes of sickness and how to control it in the coping with cancer section.