Kidney cancer is one of the top 10 cancers diagnosed in both men and women, according to the
There are several different types of treatment for kidney cancer. The type of treatment you receive can depend on a variety of factors, including the exact type of cancer, its stage, your age, and your overall health.
Keep reading as we break down the treatments for kidney cancer, how they work, and when they’re used.
After a doctor diagnoses kidney cancer, they will also assess the extent of the cancer. This is called staging.
Stage 1 and 2 kidney cancer is when the cancer still remains localized to the kidney. In stage 3, the cancer has spread to nearby tissues and lymph nodes. Stage 4 cancer is when the cancer spreads to more distant tissues or organs.
A cancer’s stage is one of the many factors influencing kidney cancer treatment. Often, different treatment types are combined or used one after another.
For most people, surgery is the primary treatment for stages 1 to 3. Targeted and immunotherapy are generally reserved for more advanced stages.
The table below helps to break down when certain types of treatment may be used.
| Treatments | |
|---|---|
| Stage 1 | active surveillance ablation surgery (partial or radical nephrectomy) |
| Stage 2 | surgery targeted therapy immunotherapy |
| Stage 3 | surgery targeted therapy immunotherapy |
| Stage 4 | surgery targeted therapy immunotherapy radiation therapy chemotherapy |
Many small renal (kidney) masses are slow-growing. Quite a few of them are benign, or noncancerous. For these reasons, a doctor may recommend an approach called active surveillance.
Active surveillance means that your doctor will carefully monitor the cancer for signs of significant growth. They’ll typically do this with imaging technology, such as:
These assessments typically take place
Active surveillance is typically used for small tumors, often in older adults and people with poorer overall health, who may not be able to tolerate other types of treatment well.
Ablation involves destroying the tumor cells. This can be accomplished using extreme cold, known as cryoablation, or heat, known as radiofrequency ablation.
Cryoablation is done with a probe inserted into the tumor. A surgeon will insert the probe either through the skin (percutaneous) or through a small incision (laparoscopic). Radiofrequency ablation is done through the skin. The probes are guided using imaging.
Surgery is generally the preferred local treatment for kidney cancer. However, ablation may be used for smaller tumors that cannot be removed with surgery, typically due to other medical conditions that are affecting your overall health.
Surgery can potentially cure kidney cancer that’s still localized to the kidney. Two types of surgery are used:
- Partial nephrectomy. A partial nephrectomy is surgery that removes the area of the kidney that contains the cancer. This is typically done when the tumor is smaller and easier to access.
- Radical nephrectomy. A radical nephrectomy removes the entire kidney that contains the cancer. It often removes the adrenal gland as well. This may be recommended when a tumor is large or has spread beyond the kidney.
If the cancer has spread into nearby lymph nodes or the nearby lymph nodes appear enlarged or atypical, these lymph nodes will also be removed during surgery.
Surgery for kidney cancer is now often done with laparoscopy. This uses surgical tools that are inserted through a very small incision. Laparoscopic surgeries generally have a faster recovery time than more traditional, open surgeries.
Today, many laparoscopic nephrectomies are done with robotic assistance. A 2020 review found that this approach may improve dissection techniques and preserve more renal function.
Sometimes, kidney cancer that’s removed using surgery can come back, or recur. A small 2019 study estimated that cancer recurrence happens in about 20 percent of people who undergo surgery for kidney cancer that’s still localized to the kidney.
If you’re at a high risk of recurrence, your doctor may recommend targeted therapy or immunotherapy after surgery. This is called adjuvant therapy.
Targeted therapy uses drugs to hone in on and inhibit proteins that are found on or inside cancer cells. Several different types of targeted therapy drugs can be used for kidney cancer.
One of the main ways that targeted therapy drugs act against kidney cancer is by targeting factors associated with the growth of blood vessels that supply the tumor. Drugs that do this include:
- axitinib (Inlyta)
- belzutifan (Welireg)
- bevacizumab (Avastin)
- cabozantinib (Cabometyx)
- lenvatinib (Lenvima)
- pazopanib (Votrient)
- sorafenib (Nexavar)
- sunitinib (Sutent)
- trivozanib (Fotivda)
Another type of targeted therapy drug for kidney cancer targets a protein called mTOR. This protein is involved in the growth and division of cancer cells. Examples of mTOR inhibitors include everolimus (Afinitor) and temsirolimus (Torisel).
Targeted therapy is often used for kidney cancer that has spread to more distant areas of the body, or metastasized. It’s also often used for kidney cancer that has recurred.
Targeted therapy may also be recommended as an adjuvant therapy after surgery. Adjuvant therapies are additional treatments used to address any cancer remaining in the body after the first or primary treatments.
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Immunotherapy harnesses the immune system to fight cancer. Examples of immunotherapies that may be used for kidney cancer are
Immune checkpoints help to prevent your immune cells from attacking healthy cells. Immune checkpoint inhibitors can turn off these checkpoints, helping immune cells to find and destroy cancer cells. These can include:
Cytokines are immune proteins that can boost your immune response. In some situations, human-made versions of these proteins can be used to treat kidney cancer. These include interleukin-2 (IL-2) and interferon-alpha.
Similar to targeted therapies, immunotherapy is often used for kidney cancer that has metastasized or recurred. It may also be used as an adjuvant therapy after surgery. Immunotherapy can also be combined with targeted therapy.
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Radiation therapy uses high energy radiation to kill cancer cells. It cannot cure kidney cancer, but it can slow down the cancer’s growth and ease some symptoms.
A doctor will typically recommend radiation therapy as a palliative treatment, when cancer has metastasized to areas like the bones or brain.
Radiation therapy is given using a machine that directs the radiation to the area where the cancer is located. This is called external beam therapy.
There are several different types of kidney cancer. According to the ACS, about
RCC cells don’t respond well to chemotherapy, which is a type of cancer treatment that uses drugs to target rapidly growing cells. As such, chemotherapy isn’t often used for kidney cancer.
However, some rarer types of kidney cancer can respond well to chemotherapy. Examples include Wilms’ tumor and transitional cell carcinoma.
Chemotherapy may also be considered if kidney cancer has metastasized and preferred treatments like targeted therapy and immunotherapy haven’t been effective.
If you’ve recently received a kidney cancer diagnosis, a variety of healthcare professionals will be a part of your care team.
Your team will probably include a urologist, a doctor who specializes in treating diseases affecting the urinary system. Urologists are also surgeons and perform kidney surgeries. Certain urologists — urologic oncologists — specialize in treating malignancies of the urinary system.
Your team might also include:
- an oncologist, a doctor who specializes in treating cancer
- a surgeon, a doctor who has specialized training in performing surgery
- a radiation oncologist, a doctor who specializes in using radiation for treating cancer
- a radiologist, a doctor who specializes in reading and interpreting the results of medical imaging
- a pathologist, a doctor who specializes in analyzing tissue samples
- physical therapists, who can work with you to maintain your mobility, flexibility, and strength during your treatment
- mental health professionals, who can help you to cope mentally and emotionally with the effects of cancer and its treatment
- registered nurses and nurse practitioners, who will work closely with doctors to administer and manage your care
Coping with a kidney cancer diagnosis and treatment can feel overwhelming. The resources below can help.
- The ACS. The ACS has a wealth of information about different types of cancer and provides a variety of services, including a
24/7 cancer helpline and asearch tool for cancer resources close to you. - The National Kidney Foundation. The National Kidney Foundation aims to help all people affected by kidney disease. They provide informational resources on kidney cancer and available treatment options.
- CancerCare. CancerCare aims to give free support services to those with cancer. Their resources for kidney cancer include access to counseling, support groups, and educational workshops.
- Kidney Cancer Association. The Kidney Cancer Association is an international nonprofit dedicated to serving those with kidney cancer and their caregivers. Their site contains information on how to find a specialist as well as support services.
Another good resource is your care team. They may know about cancer support services or support groups that are available in your area, so be sure to ask about these resources.
Several different treatments can be used for kidney cancer. In some cases, surgery can cure kidney cancer that’s still localized to the kidneys.
However, it’s still possible for the cancer to recur after surgery. Adjuvant therapy with targeted therapy or immunotherapy can help to prevent this, though.
Surgery may also be used for more advanced kidney cancer. Other potential treatments can include targeted therapy, immunotherapy, and, in rare cases, chemotherapy.
The treatments you receive for kidney cancer will depend on things like the exact type of kidney cancer, its stage, your age, and your overall health. Your care team will take all of these factors into consideration when making treatment recommendations.