Kidney Cancer : Methods of Treatment

by National Cancer Institute

(Page 3 of 4)

People with kidney cancer may have surgery, arterial embolization, radiation therapy, biological therapy, or chemotherapy. Some may have a combination of treatments.

At any stage of disease, people with kidney cancer may have treatment to control pain and other symptoms, to relieve the side effects of therapy, and to ease emotional and practical problems. This kind of treatment is called supportive care, symptom management, or palliative care.

A patient may want to talk to the doctor about taking part in a clinical trial, a research study of new treatment methods.

Surgery

Surgery is the most common treatment for kidney cancer. It is a type of local therapy. It treats cancer in the kidney and the area close to the tumor.

An operation to remove the kidney is called a nephrectomy. There are several types of nephrectomies. The type depends mainly on the stage of the tumor. The doctor can explain each operation and discuss which is most suitable for the patient:

Radical nephrectomy: Kidney cancer is usually treated with radical nephrectomy. The surgeon removes the entire kidney along with the adrenal gland and some tissue around the kidney. Some lymph nodes in the area also may be removed.

Simple nephrectomy: The surgeon removes only the kidney. Some people with Stage I kidney cancer may have a simple nephrectomy.

Partial nephrectomy: The surgeon removes only the part of the kidney that contains the tumor. This type of surgery may be used when the person has only one kidney, or when the cancer affects both kidneys. Also, a person with a small kidney tumor (less than 4 centimeters or three-quarters of an inch) may have this type of surgery.

People may want to ask the doctor these questions before having surgery:

• What kind of operation do you recommend for me?
• Do I need any lymph nodes removed? Why?
• What are the risks of surgery? Will I have any long-term effects? Will I need dialysis?
• Should I store some of my own blood in case I need a transfusion?
• How will I feel after the operation?
• How long will I need to stay in the hospital?
• When can I get back to my normal activities?
• How often will I need checkups?
• Would a clinical trial be appropriate for me?

Arterial Embolization

Arterial embolization is a type of local therapy that shrinks the tumor. Sometimes it is done before an operation to make surgery easier. When surgery is not possible, embolization may be used to help relieve the symptoms of kidney cancer.

The doctor inserts a narrow tube (catheter) into a blood vessel in the leg. The tube is passed up to the main blood vessel (renal artery) that supplies blood to the kidney. The doctor injects a substance into the blood vessel to block the flow of blood into the kidney. The blockage prevents the tumor from getting oxygen and other substances it needs to grow.

People may want to ask the doctor these questions before having arterial embolization:

• Why do I need this procedure?
• Will I have to stay in the hospital? How long?
• What are the risks and side effects?
• Would a clinical trial be appropriate for me?

Radiation Therapy

Radiation therapy (also called radiotherapy) is another type of local therapy. It uses high-energy rays to kill cancer cells. It affects cancer cells only in the treated area. A large machine directs radiation at the body. The patient has treatment at the hospital or clinic, 5 days a week for several weeks.

A small number of patients have radiation therapy before surgery to shrink the tumor. Some have it after surgery to kill cancer cells that may remain in the area. People who cannot have surgery may have radiation therapy to relieve pain and other problems caused by the cancer.

People may want to ask the doctor these questions before having radiation therapy:

• Why do I need this treatment?
• What are the risks and side effects of this treatment?
• Are there any long-term effects?
• When will the treatments begin? When will they end?
• How will I feel during therapy?
• What can I do to take care of myself during therapy?
• Can I continue my normal activities?
• How often will I need checkups?
• Would a clinical trial be appropriate for me?

Biological Therapy

Biological therapy is a type of systemic therapy. It uses substances that travel through the bloodstream, reaching and affecting cells all over the body. Biological therapy uses the body's natural ability (immune system) to fight cancer.

For patients with metastatic kidney cancer, the doctor may suggest interferon alpha or interleukin-2 (also called IL-2 or aldesleukin). The body normally produces these substances in small amounts in response to infections and other diseases. For cancer treatment, they are made in the laboratory in large amounts.

Chemotherapy

Chemotherapy is also a type of systemic therapy. Anticancer drugs enter the bloodstream and travel throughout the body. Although useful for many other cancers, anticancer drugs have shown limited use against kidney cancer. However, many doctors are studying new drugs and new combinations that may prove more helpful.

People may want to ask the doctor these questions before having biological therapy or chemotherapy:

• Why do I need this treatment?
• How does it work?
• What are the expected benefits of the treatment?
• What are the risks and possible side effects of treatment? What can I do about them?
• When will treatment start? When will it end?
• Will I need to stay in the hospital? How long?
• How will treatment affect my normal activities?
• Would a clinical trial be appropriate for me?

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