Kidney cancer does not usually cause symptoms until it is fairly advanced. In fact, kidney masses are often found incidentally during an ultrasound for something else. The larger the mass, the more likely it is to be kidney cancer. Growths that are less than 4 cm are more likely to be benign. However it is very hard to do a kidney biopsy and the mass is usually surgically removed in order to obtain a diagnosis. Kidney cancers are resistant to radiation and chemotherapy. Surgery is considered the primary treatment for most cancers.
The choice of treatment for kidney cancer depends on the aggressiveness of the tumor, whether and how much the disease has spread, and the patient’s general health and lifestyle considerations. Surgery is considered the primary treatment for most kidney cancers:
- Radical Nephrectomy
The surgeon removes the kidney, surrounding tissue, often including the adrenal gland and nearby lymph nodes (if needed).
- Partial Nephrectomy
A partial nephrectomy removes tumors and a small amount of surrounding healthy kidney tissue. Both radical and partial nephrectomies can be performed through open surgery or using the DaVinci® SI robot.
Advanced kidney cancer is resistant to most chemotherapy drugs. The most effective treatment to date is immunotherapy, the use of drugs to stimulate an immune response against cancer. Because these medications may cause severe side effects, they are given at the hospital so that patients can be monitored.
Cryotherapy is a method of killing cancer cells by freezing them. This treatment may be appropriate for people with small, early stage kidney cancers, less than 4cm across.
- Active Surveillance
One option for some patients with kidney tumors that are less than 3cm is to watch the tumor to see if it grows. If it grows fast enough or gets larger than 4 cm − a little over 1½ inches – it is removed. This approach is most often used in elderly or frail patients as it avoids the risks of treatment. Often, a biopsy is done before deciding to watch the tumor to see if the growth is really cancer.