What are the treatment options for kidney cancer (renal cell cancer)?
Treatment options which may be considered include surgery, radiotherapy, arterial embolisation and immunotherapy. (In general, chemotherapy does not work as well for kidney cancer as for some other types of cancer. Therefore it is not often used as a treatment.) The treatment advised for each case depends on various factors such as the stage of the cancer (how large the cancer is and whether it has spread), the exact sub-type or 'grade' of the cancer, and your general health.
You should have a full discussion with a specialist who knows your case. They will be able to give the pros and cons, likely success rate, possible side-effects, and other details about the various possible treatment options for your type of cancer.
You should also discuss with your specialist the aims of treatment. For example:
- In some cases, the treatment aims to cure the cancer. Some kidney cancers can be cured, particularly if they are treated in the early stages of the disease. (Doctors tend to use the word 'remission' rather than the word 'cured'. Remission means there is no evidence of cancer following treatment. If you are 'in remission', you may be cured. However, in some cases a cancer returns months or years later. This is why doctors are sometimes reluctant to use the word cured.)
- In some cases, the treatment aims to control the cancer. If a cure is not realistic, with treatment it is often possible to limit the growth or spread of the cancer so that it progresses less rapidly. This may keep you free of symptoms for some time.
- In some cases, treatment aims to ease symptoms. For example, if a cancer is advanced then you may require treatments such as painkillers or other treatments to help keep you free of pain or other symptoms. Some treatments may be used to reduce the size of a cancer which may ease symptoms such as pain.
Surgery
An operation to remove all (or sometimes part) of the affected kidney is the most common treatment. If the cancer is at an early stage and not spread then surgery alone may be curative. If the cancer has spread to other parts of the body, surgery to remove the affected kidney may still be advised, often in addition to other treatments.
In some cases, surgery is done to remove a secondary kidney tumour which has spread to another part of the body. For example, some secondary tumours which develop in the liver or lung can be removed.
Radiotherapy
Radiotherapy is a treatment which uses high energy beams of radiation which are focussed on cancerous tissue. This kills cancer cells, or stops cancer cells from multiplying. (There is a separate leaflet which gives more details about radiotherapy.) Radiotherapy may be advised in addition to surgery which aims to kill any cancerous cells which may have been left behind following an operation. It may be used to treat the primary cancer instead of surgery if your general health is poor. Radiotherapy is also commonly used to treat kidney cancer which has spread to other sites such as secondary tumours which develop in a bone or the brain.
Arterial embolisation
This may be used instead of surgery (for example, if you are not well enough for surgery). The aim of this treatment is to block off the blood vessel (artery) which is supplying a kidney tumour with blood. To do this a catheter is inserted into a blood vessel in the groin. (A catheter is a long thin, flexible, hollow tube. ) Using x-ray pictures for guidance, the catheter is pushed up into the blood vessel in the affected kidney. When it is in the right place a substance is injected down the catheter into the blood vessel to block the blood vessel. The tumour is then deprived of it's blood supply and so dies.
Immunotherapy (sometimes called biological therapy)
This treatment uses drugs to stimulate the immune system to attack cancerous cells. Two drugs are commonly used to treat kidney cancer - interferon and aldesleukin (sometimes called interleukin 2).
Other immune therapies such as using 'vaccines' to stimulate your immune system to fight cancer cells and using monoclonal antibodies to attack cancer cells are being investigated as possible new treatments for kidney cancer.
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