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Early stage and locally advanced kidney cancer treatment

Men and women discussing kidney cancer

This page gives you an overview of the treatment options for early stage and locally advanced kidney cancer. There is information about

 

A quick guide to what's on this page

Your doctors plan your treatment by taking into account a number of factors, including your age and general health, the size of the tumour and its position in the kidney. They will also take into account whether the cancer has spread into the nearby lymph nodes.

Surgery

Surgery is the main treatment for kidney cancer that has not spread to other parts of the body. Stage 1 and 2 kidney cancers are contained within the kidney and are often cured with surgery. Stage 3 cancers have spread into a nearby lymph node, or the adrenal gland, or into the vein leading to the kidney. They are called locally advanced cancers and can sometimes be cured if it is possible to remove all the cancer. 

For small cancers, surgeons try to remove just the tumour and leave as much kidney tissue behind as possible. They call this a partial nephrectomy or nephron sparing surgery. For larger tumours the surgeon removes the whole kidney. They call this a complete or radical nephrectomy. People who have a high risk of the cancer coming back in the area may have radiotherapy after the surgery.

Monitoring

If you have a very small kidney cancer it may grow very slowly. Your doctor may suggest monitoring the cancer rather than having treatment straight away. This is called active surveillance and you have regular scans. If the cancer starts growing your doctor would advise you to have treatment to destroy or remove the cancer.

If you can't have surgery

If you have a small tumour and are not well enough to have surgery your doctor may recommend treatment that freezes the cancer cells (cryotherapy) or radiowave treatment (radiofrequency ablation).

Biological therapy

Biological therapies are drugs made from natural substances from the body, or that change cell processes. Doctors are using these drugs after surgery in some clinical trials to see if they can help to lower the risk of kidney cancer coming back.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating kidney cancer section.

 

 

Surgery

Surgery is the main treatment for kidney cancer that has not spread to other parts of the body. 

Stage 1 and 2 kidney cancers are contained within the kidney and are often cured with surgery. 

Stage 3 cancers have spread into a nearby lymph node, the adrenal gland or the major vein leading to the kidney. They are called locally advanced kidney cancers and can sometimes be cured if it is possible to remove all the cancer.

If the cancer is small, surgeons usually try to just remove the tumour and leave behind as much of the kidney as possible. They call this partial nephrectomy or nephron sparing surgery. The nephron is the part of the kidney that filters the blood to make urine.

If the cancer is larger than 7cm or so your surgeon may remove the whole kidney (a complete nephrectomy). If the cancer has spread into nearby lymph nodes, the adrenal gland, or the vein leading to the kidney, your surgeon will remove them during the surgery. 

If there is a risk of the cancer coming back in the kidney area after surgery your doctor may recommend radiotherapy to the area. There is information about radiotherapy in this section.

There is detailed information about surgery for kidney cancer in this section.

 

Monitoring the cancer

Some kidney cancers are found by chance when patients have scans for other reasons. Many of these tumours are small and some may not cause any problems for a long time even without treatment. Small kidney cancers are very unlikely to spread into surrounding tissue or elsewhere in the body.

So if you have a kidney cancer that is less than 3cm and are older or unwell, your doctor may advise having no treatment at first. But they will watch the cancer carefully. You have regular scans to see if the cancer grows. Doctors call this active surveillance. There is information about monitoring kidney cancer in this section. If the cancer starts to grow you usually have treatment to destroy or remove it.

 

If you can’t have surgery

It may not be possible for you to have surgery if you have other medical problems. In this case, if you have a small cancer the doctor might use one of the following treatments

Your doctor may also suggest these treatments if you have a rare inherited form of kidney cancer and have more than 1 tumour, or if you have cancer affecting both kidneys.

If you have a larger cancer, or the cancer is causing symptoms such as pain or bleeding, your doctor may suggest radiotherapy to shrink the cancer and reduce symptoms. Or they may suggest a treatment called arterial embolisation that blocks the blood supply to the kidney. There is information about arterial embolisation on the page in this section about surgery for kidney cancer.

 

Freezing therapy (cryotherapy)

Cryotherapy is also called cryosurgery or cryoablation. It is a way of killing cancer cells by freezing them. For kidney cancer a surgeon puts a cryotherapy probe into the area of cancer in the kidney. They can do this through keyhole surgery through the skin or by making a larger cut (incision in the skin). You have this treatment under local anaesthetic or general anaesthetic.

There is information about cryotherapy for kidney cancer in this section.

 

Radio wave treatment (RFA)

Radio wave treatment uses high frequency radio waves to heat the cancer cells. It is called percutaneous radiofrequency ablation (RFA). Your surgeon puts one or more needle electrodes through the skin into the tumour. They use images (like ultrasound) to guide the needles into place. When the electrodes are in place a radiofrequency electrical current passes through them to destroy the cancer cells. There is information about radiofrequency ablation for kidney cancer in this section.

 

Radiotherapy

Radiotherapy uses high energy X-rays to kill cancer cells. It is not used often for cancer of the kidney because kidney cancer cells are not as sensitive to radiation as some other types of cancer. But your doctor may suggest radiotherapy to help control the symptoms of an early cancer if you are not well enough to have other treatments. There is information about radiotherapy in this section.

 

Biological therapy

Biological therapies are treatments that use natural substances from the body, or drugs that change cell processes. Some clinical trials are using biological therapies to try to lower the risk of kidney cancer coming back after surgery. Doctors call this adjuvant treatment. Our kidney cancer research page has information about these treatments, as well as details about clinical trials of biological therapies for kidney cancer.

 

If kidney cancer comes back

In some people kidney cancer comes back in the area of the kidney after surgery. In this situation your doctor may recommend surgery to remove the cancer or the whole kidney again. This further surgery can get rid of the cancer completely for some people. Your doctor may recommend treatment with biological therapies such as sunitinib (Sutent) or sorafenib (Nexavar) to try to reduce the chance of the cancer coming back again. 

There is information about biological therapy for kidney cancer in this section.

If the cancer comes back in another part of the body it is called advanced or metastatic kidney cancer. Your treatment will depend on where the cancer is. You usually have surgery if it is possible to remove the cancer. If the cancer is in an area where surgery is not possible you usually have biological therapy treatments to stop the cancer from growing and keep it under control. These treatments can control the cancer for months or sometimes years. 

You can read about these treatments on the page about treating advanced kidney cancer.

 

Planning your treatment

Your doctors plan your treatment by taking into account a number of factors, including

  • Your general health and fitness for different types of treatment
  • The size of your cancer and where it is in the kidney
  • Whether the cancer has spread into lymph nodes close to the kidney

You will be under the care of a multi disciplinary team. This is a team of health professionals who work together to discuss your case and how best to manage your treatment and care. The team includes

  • Doctors, including a specialist surgeon (urologist), a cancer specialist (oncologist), a specialist in scans and X-rays (radiologist) and a specialist in analysing tissue samples (pathologist)
  • A specialist nurse for information and support
  • Symptom control specialists
  • Dieticians
  • Physiotherapists and occupational therapists
  • Psychologists and counsellors
 

More information about kidney cancer treatment

If you would like more information about treatments for early or locally advanced kidney cancer you are welcome to contact the Cancer Research UK nurses. The number to call is freephone 0808 800 4040 and the lines are open from 9am to 5pm, Monday to Friday. 

You can also contact one of the kidney cancer organisations or look at our kidney cancer reading list

If you want to find people to share experiences with online, you could use Cancer Chat, our online forum.

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Updated: 13 January 2014