Kidney cancer is cancer that starts in the kidneys, the two bean-shaped organs that filter your blood. The
Surgery is the main treatment for kidney cancer. In fact, there are many times that surgery can result in complete remission of this cancer.
Below, we’ll explore how surgery is used to treat kidney cancer, what the procedure involves, and more.
The type of surgery that’s recommended for kidney cancer depends on factors such as the stage of the cancer and where exactly it’s located. There are two types of surgeries that are used for kidney cancer: radical nephrectomy and partial nephrectomy.
A radical nephrectomy removes the entire kidney, including the cancer. This surgery is often recommended if the tumor is large or has spread to lymph nodes or other tissues. Many people can function well with only one kidney.
In addition to removing the kidney, a radical nephrectomy typically also involves the removal of the following tissues:
- the associated adrenal gland (adrenalectomy)
- nearby lymph nodes (lymphadenectomy)
- surrounding fatty tissue
A radical nephrectomy can be done through a large incision in the abdomen. When one large incision is used, it’s called an open surgery. However, many doctors now prefer to use minimally invasive procedures where possible.
Minimally invasive procedures involve several smaller incisions instead of one big one and often have a faster recovery time. There are two types of ways this type of surgery may be done:
- Laparoscopically. This type of surgery is done using a laparoscope, which is a long, thin tube with a camera on the end.
- Robotically assisted. In this type of surgery, a robot that’s controlled by the surgeon performs the laparoscopic procedure.
A partial nephrectomy only removes the cancer and some surrounding kidney tissue. This type of surgery is preferred for individuals who have early stage kidney cancer, meaning that the cancer still has not grown beyond the kidney.
A major benefit of a partial nephrectomy is that you can retain some function of the affected kidney. However, a partial nephrectomy may not be possible in some situations, including if:
- the tumor is very large
- there are multiple tumors in the kidney
- the tumor is located in the middle of the kidney
- the cancer is at a later stage, having spread into other tissues
Similar to a radical nephrectomy, many partial nephrectomies are performed by using minimally invasive procedures.
Here’s what you can generally expect from kidney cancer surgery.
Before your procedure
Prior to your procedure, your medical care team will perform a series of tests to get an idea of your general health. These may include blood tests, an electrocardiogram (ECG), and a chest X-ray.
Your surgeon will also give you instructions on how to prepare for your surgery. These will include when to start fasting and which medications, supplements, or herbal remedies you can take and when.
It’s important to follow these instructions carefully. Never make any medication changes without talking with your surgeon first.
During your procedure
Kidney cancer surgery is done under general anesthesia. That means that you’ll be in a sleep-like state during your procedure.
The number of incisions your surgeon makes will depend on the type of procedure being used. There may be one larger incision (open surgery) or several smaller incisions (minimally invasive surgery).
Typically, kidney cancer surgery takes between 2 and 3 hours. Once the surgery is complete, the incisions will typically be closed with stitches. Doctors may also use surgical staples to close an incision, which will need to be removed when the incision has healed.
After your procedure
After your procedure, you’ll be taken to a recovery room until you come out of your anesthesia. This can take up to a couple of hours.
After you come out of anesthesia, you’ll be taken to your room in the hospital.
Open kidney cancer surgeries typically involve a hospital stay of several days. If you’re in poor overall health or you experience any medically concerning effects (adverse effects) due to your surgery, you may need to stay longer.
For minimally invasive surgeries, you may only need to stay in the hospital for a day or two.
Before you’re discharged, you’ll be given instructions on what to do at home. These can include things such as:
- how to care for your incision
- how to manage any pain you may experience
- when you can start returning to your daily activities
- how to recognize adverse effects and when to contact a doctor
Recovery times for kidney cancer surgery may range anywhere from 6 to 12 weeks. Your specific recovery time can depend on factors such as your overall health and what type of procedure you had.
Generally speaking, minimally invasive procedures have a shorter recovery time than open procedures.
In the weeks after your procedure, your surgeon will want to schedule a follow-up appointment with you. During this time, they’ll check on how your recovery is going.
Your doctor will also review with you the lab analysis of tissue taken from the tumor that was removed during your surgery. You and your doctor can discuss if any additional therapies are needed based on the results of the tissue analysis.
As with any procedure, there are some risks associated with kidney cancer surgery. These include:
- reactions to the anesthetic (the drug used to induce anesthesia)
- excessive bleeding
- serious blood clots
- damage to other nearby organs
- urine leaking into the abdomen (partial nephrectomy)
- kidney failure
Minimally invasive surgeries often have a lower risk of adverse effects. For example, a 2020 systematic review of studies noted that, compared with open partial nephrectomy, laparoscopic partial nephrectomy had:
- shorter hospital stays
- fewer estimated blood loss
- fewer adverse effects after surgery
After your surgery, a doctor will want to continue to periodically monitor your condition by using imaging to make sure that the cancer doesn’t come back (recur). This is called active surveillance.
For some individuals, there may be a higher risk of kidney cancer recurring after surgery. In this situation, you may receive additional treatment to help prevent a recurrence. This is called adjuvant therapy.
Adjuvant therapy following kidney cancer surgery typically involves the use of targeted therapy drugs such as sunitinib (Sutent) or immunotherapy drugs such as pembrolizumab (Keytruda).
Your care team can give you a better idea of whether or not you’ll need additional treatment after your surgery. It’s important to have a discussion with them about the optimal plan for your individual situation.
While surgery is often the preferred treatment for kidney cancer, there are also other options available. These can include:
- Active surveillance. Active surveillance involves monitoring a tumor through imaging
every 3 to 6 months. Treatment is started if the tumor shows signs of growth. This approach is typically used for small tumors.
- Ablation. Ablation removes cancer cells in the kidney by using either extreme cold or high heat. It can be used for small tumors or those for which surgery isn’t possible.
- Targeted therapy. Targeted therapy uses drugs that negatively impact specific proteins of kidney cancer cells that are important for growth. It’s often used for more advanced kidney cancers or those that have recurred.
- Immunotherapy. Immunotherapy drugs help your immune system fight cancer. Like targeted therapy, it’s typically used for advanced kidney cancers or cancers that have recurred.
- Radiation therapy. Radiation therapy uses high-energy radiation to kill cancer cells. For kidney cancer, it’s used more often to alleviate symptoms such pain than to directly treat the cancer.
- Chemotherapy. Chemotherapy uses drugs that target rapidly dividing cells. While it’s not effective for most kidney cancers, some rarer types of kidney cancer do respond to chemotherapy.
Here are answers to some frequently asked questions about kidney cancer surgery.
How fast does kidney cancer spread?
Many small kidney cancers are slow-growing. However,
Kidney cancer may not cause symptoms until a tumor has become large. This means that some people may not receive a diagnosis until their cancer is at a more advanced stage.
However, many kidney masses are found early during imaging studies related to another health condition.
Should I wait for kidney surgery or do it right away?
Sometimes a doctor will recommend active surveillance for a small kidney tumor. This is because many of these tumors are slow-growing and some are even benign (noncancerous).
However, if you have a kidney tumor that’s large, growing quickly, or has already spread to other tissues, treatment will often be recommended right away. This often involves some form of kidney surgery.
Can kidney cancer be cured with surgery?
Yes. In some cases, kidney cancer can go into complete remission with surgery. Complete remission after surgery is more likely when the tumor is small and has not grown beyond the kidney.
How successful is kidney cancer surgery?
Kidney cancer surgery can be quite successful, but this can depend on such things as:
- the type of kidney cancer that you have
- the stage of your kidney cancer
- your level of kidney function
- your age and overall health
Surgery is the main treatment for kidney cancer. In some cases, surgery can result in complete remission of kidney cancer.
Depending on the stage and location of the cancer, kidney cancer surgery can involve removing part of your kidney (partial nephrectomy) or your whole kidney (radical nephrectomy). Both surgeries can be done as either an open or a minimally invasive procedure.