Cancer occurs when cells in the body change (mutate). These changes allow them to start growing out of control. These cells can form lumps of tissue called tumors. They can spread to other parts of the body. Cancer that starts in the cells that make up the kidney is called kidney or renal cancer.
Understanding the kidneys
The kidneys are 2 bean-shaped organs about the size of a fist. They're found in the low back. There's one kidney on each side of the spine. The kidneys help keep the body alive by filtering waste and extra fluid out of the blood. The kidneys send this liquid and waste (urine) to the bladder through tubes called the ureters. Urine then leaves the body through another tube called the urethra.
When kidney cancer forms
Kidney cancer starts when cells that make up the kidney change. These cells don't work the way they should and they grow out of control. Over time, this cancer can change the way the kidney works. Kidney cancer often starts in one kidney. But sometimes it's in both kidneys.
Kidney cancer may spread beyond the kidney to other parts of the body. This spread is called metastasis. The more cancer spreads, the harder it is to treat.
Treatment choices for kidney cancer
You and your healthcare provider will decide on a treatment plan that's best for you. Treatment choices may include:
This is the most common treatment for kidney cancer. Your healthcare provider may advise surgery if any of these apply to you:
You're healthy enough to have surgery. Your provider will only advise surgery if he or she expects you to be able to recover from it.
The tumor is small. In this case, a partial nephrectomy might be done. Only the part of the kidney that has the tumor is taken out. This allows you to keep some function in that kidney. This surgery might also be used if the tumor is larger but you have cancer in both kidneys or you have only one kidney. The benefit is that you keep part of your kidney. The risk is that there's a chance some cancer cells might be left behind.
The tumor is larger, but it's only in your kidney. The type of surgery you need is based on the size of the tumor and where it is. A simple nephrectomy may be an option. This is surgery to take out the whole kidney. Sometimes a radical nephrectomy is needed. This surgery takes out the whole kidney and the adrenal gland. (The adrenal gland is on the top of the kidney.) Much of the nearby fatty tissue is also taken out. Nearby lymph nodes will likely be removed, too. This is because cancer tends to travel to the nodes first. Taking out the lymph nodes may help prevent the spread of cancer to other parts of your body. Testing these lymph nodes helps your provider figure out the stage of the cancer. This is important in deciding if you need other treatments after surgery.
The kidney cancer has spread, but your providers believe that removing the original kidney tumor will still be useful along with other treatment. A radical nephrectomy and removal of nearby lymph nodes might be done. Any tumors in other parts of your body may also be removed, or you may get biologic therapy or chemotherapy. Even when surgery won’t cure the cancer, it can sometimes help ease symptoms such as pressure, pain, or bleeding.
You have symptoms. You may have pain, pressure, or bleeding from tumors that have spread. Surgery may be done to remove the tumors. This can help ease symptoms. But it doesn't cure the cancer. This is called palliative therapy.
Biologic therapy (Immunotherapy)
This treatment helps your immune system better fight the cancer. It uses medicines that work like the chemicals that your body’s immune system makes.
Chemotherapy (chemo) uses medicines to kill cancer cells. But it doesn't often work well against kidney cancer. Chemo has mostly been replaced by targeted and biologic therapy for kidney cancer treatment. Still, chemo is sometimes used for some types of kidney cancer. In rare cases it's also used when biologic therapy hasn't worked.
Radiation therapy uses strong energy rays to kill cancer cells. Radiation therapy doesn't work as well as other options for treating kidney cancer. But it may be used in these cases:
To treat someone who's not healthy enough to have surgery
To treat someone with kidney cancer that's not responding to other treatments
To treat kidney cancer that has spread to the brain or bones
Most often, radiation is used to treat problems caused by cancer. For instance, it might be used to treat kidney cancer that has spread to the bone (bone metastasis). It can also help stabilize a bone that's been weakened by metastasis and may be at risk for breaking.
These therapies use medicines that focus on or prevent changes in the cancer cells. The changes may be either in the cell's molecules or genes. Targeted therapy can help keep the cells from growing out of control and spreading to other parts of the body.
This treatment might be used after surgery to help keep the cancer form coming back (recurring).
Local treatment (ablative therapy)
Ablative treatments are used to destroy the tumor in the kidney. Doctors don’t know how well these treatments work over time. But they may be helpful if a person isn’t well enough to have surgery.
These treatments are done by putting a needle-like probe through your skin and right into the tumor. A CT scan or ultrasound is used to help the doctor see the tumor and put the probe in it. In radiofrequency ablation (RFA) , an electric current is sent through the probe to kill the cancer cells. Cryoablation is done by sending very cold gas through the probe to freeze the cancer cells. Medicines are used to make you sleep and not feel pain during these treatments.