What are the treatment options for kidney cancer?
The primary treatment options for kidney cancer include surgery, radiofrequency ablation, radiotherapy, chemotherapy, targeted therapies and immunotherapy. Tumours that are small and confined to the kidney may only require active surveillance to monitor the cancer through regular tests and scans. The type of treatment you receive will depend on a number of different considerations, such as the type of kidney cancer you have, its stage, your overall health and your treatment preferences. This page aims to give you a comprehensive overview of how kidney cancer treatment works.
Types of kidney cancer treatment
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Surgery
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Radiofrequency ablation
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Radiotherapy
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Chemotherapy
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Targeted therapies
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Immunotherapy
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Surgery for kidney cancer
Surgery is often the first step in treating kidney cancer. In most cases, part or all of the kidney is removed. If the cancer has spread beyond the kidney, other cancerous tissue, including surrounding lymph nodes, may also be removed.
Surgical options for the treatment of kidney cancer include:
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Radical nephrectomy
A radical nephrectomy involves surgically removing the entire kidney, as well as a section of the surrounding healthy tissue. In some cases, nearby lymph nodes and adrenal glands may also be removed. A nephrectomy may be performed through a single incision to the abdomen or through laparoscopic surgery, where several small incisions are made to access the kidney through the abdomen.
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Partial nephrectomy
A partial nephrectomy, also referred to as kidney-sparing or nephron-sparing surgery, is a procedure which removes the cancerous tumour from within the kidney along with a small amount of surrounding healthy tissue. Unlike a radical nephrectomy, only part of the kidney will be removed. This type of surgery is the preferred course of treatment, as it may save kidney function.
Radiofrequency ablation for kidney cancer
Radiofrequency ablation is a less common treatment option for kidney cancer and is typically used for patients who are considered unfit to undergo surgery. This method destroys cancer cells through inserting a needle directly into the tumour, which then directs electrical currents into the cancerous tissue.
Radiotherapy for kidney cancer
Types of radiotherapy commonly used for people with kidney cancer include:
Most patients who receive radiotherapy for kidney cancer will receive external beam radiotherapy. The most common type of EBRT treatment for kidney cancer is stereotactic radiotherapy, which is used to treat small tumours in the kidney with well-defined edges when surgery is not recommended.
Chemotherapy for kidney cancer
Chemotherapy uses a range of drugs to kill and slow the growth of kidney cancer cells. Typically, chemotherapy is only used to treat advanced kidney cancer that does not respond to other treatments, including targeted therapies and immunotherapy. In certain circumstances, chemotherapy drugs may be used in combination with targeted therapy and immunotherapy to help shrink kidney cancer cells.
Targeted therapy for kidney cancer
Targeted therapies use specialised drugs to destroy specific proteins in kidney cancer cells. They are commonly used to treat advanced kidney cancer and kidney cancer that is growing quickly.
Tyrosine kinase inhibitors (TKIs)
These drugs work by blocking a protein called VEGF (vascular endothelial growth factor growth) on the surface of kidney cancer cells. By blocking the VEGF protein, kidney cancer cells no longer get the nutrients they need to grow and spread. These medications are usually taken orally as a tablet or capsule once or twice daily.
Immunotherapy for kidney cancer
Immunotherapy treatment uses your own immune system to destroy and slow the growth of kidney cancer cells. Like other drug-based therapies, immunotherapy is usually only recommended for the treatment of advanced kidney cancers and to help prevent kidney cancer from returning.
Immunotherapy drugs can be combined with targeted therapy drugs to treat advanced (or metastatic) kidney cancer.
Monoclonal antibody drugs
Most immunotherapy drugs that are used to treat kidney cancer are knowns as monoclonal antibody drugs, which belong to a class of drugs called checkpoint inhibitors. They work by binding onto certain ‘checkpoints’ (PD-1, PD-L1 and CTL-4) on the surface of T cells, which allows them to detect and destroy cancer cells or slow their growth.
Treatment by stage of kidney cancer
When you are diagnosed with kidney cancer, your oncologist will develop your treatment plan as part of a multidisciplinary team based on the stage of your cancer.
Learn more about the treatment options for each stage of kidney cancer below.
Stage I and II kidney cancer
For early-stage kidney cancers, active surveillance may be an option if tumours are small and confined to the kidney. If further treatment is required, a partial or radical nephrectomy is usually performed while the cancer is still contained to the kidney. A lymphadenectomy may also be performed to remove surrounding lymph nodes.
Stage III kidney cancer
Stage III kidney cancers are treated similarly to stage I and II kidney cancer. Treatment will usually begin with a radical nephrectomy and lymphadenectomy. Following surgery, you may receive targeted therapies and immunotherapy to lower the risk of your cancer returning.
Stage IV kidney cancer
Treatment for stage IV kidney cancer typically begins with surgery. However, advanced kidney cancer is considered very difficult to cure and, in many cases, treatment will focus on palliative care to manage your pain. After surgery, you may receive immunotherapy, targeted therapy or chemotherapy to treat your cancer and manage your symptoms. Radiotherapy may also be used to treat areas in which the cancer has spread.
References
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