Metastatic renal cell carcinoma (RCC) is a form of kidney cancer that has spread beyond the kidneys to other parts of your body. If you’re undergoing treatment for metastatic RCC and don’t feel like it’s working, it might be time to talk to your doctor about other treatments.

There are several different types of treatments available for people living with metastatic RCC. This includes enrolling in a clinical trial or trying a complementary therapy. Learn more about your options, as well as tips to start this conversation with your doctor.

The treatments that are appropriate for you depend on the stage of your cancer, the types of treatment you’ve tried in the past, and your medical history, among other factors.

Talk to your doctor about any of the following options that you haven’t already tried.

Surgery

People with metastatic RCC may benefit from cytoreductive surgery. This is a procedure that involves removing the primary cancer in the kidneys. It also removes some or all the cancer that has spread to other parts of the body.

Surgery can remove the cancer and ease some of your symptoms. It can also improve survival, especially if you undergo surgery before beginning targeted therapy. However, there are risk factors that you should consider before choosing this treatment method. Talk to your doctor for more information.

Targeted therapy

Targeted therapy is typically recommended for people whose RCC is spreading fast or causing severe symptoms. Targeted therapy drugs work by attacking specific molecules within your cells and slowing the growth of tumors.

There are many different targeted therapy drugs available. A few examples include:

  • sorafenib (Nexavar)
  • sunitinib (Sutent)
  • everolimus (Afinitor)
  • pazopanib (Votrient)

Targeted therapy drugs are typically used one at a time. However, researchers are experimenting with newer targeted therapies as well as combination therapy. So, if the drug you’re currently taking isn’t working, you may be able to try a different drug or combine with another drug under this family of chemotherapies.

Immunotherapy

Immunotherapy works to either enhance the body’s immune system or help your immune system to directly attack the cancer. It does this by using natural and artificial substances to attack and reduce the growth of cancer cells.

There are two main types of immunotherapy treatment for RCC: cytokines and checkpoint inhibitors.

Cytokines have been shown to be effective in a small percentage of patients, but also carry the risk of severe side effects. As a result, checkpoint inhibitors are used more commonly today, like the drugs nivolumab (Opdivo) and ipilimumab (Yervoy).

Radiation therapy

Radiation therapy uses high-energy rays to destroy cancer cells, shrink tumors, and control advanced RCC symptoms. Kidney cancers aren’t typically sensitive to radiation. So, radiation therapy is often used as a palliative measure to help ease symptoms like pain and bleeding.

If you’ve tried one or more of the treatment options above with limited success, you may want to consider participating in a clinical trial. Clinical trials offer you access to experimental treatments. This means they haven’t yet been approved by the FDA.

Organizations like the National Cancer Institute and the American Cancer Society often provide clinical trial listings on their websites. The clinicaltrials.gov database is also a trusted source for a list of all privately and publicly funded clinical studies conducted around the world. Your doctor can also recommend any relevant clinical trials that may be taking place in your area.

Complementary therapies are extra forms of treatment you can use along with your current cancer treatment. These are often products and practices that aren’t considered part of mainstream medicine. But they may be useful in relieving your symptoms and improving your quality of life.

Some forms of complementary treatment that you might find beneficial include:

  • massage therapy
  • acupuncture
  • herbal supplements
  • yoga

It’s important to check with your doctor before starting any new complementary therapies. It’s possible that they could cause unwanted side effects or interact negatively with other medications you’re taking.

Your doctor wants to provide you with the best treatment possible. So, if you don’t think your current treatment for RCC is working, raise this concern as soon as possible. Don’t be afraid to ask a lot of questions, and make sure to have your doctor clarify anything that you’re confused or uncertain about.

Questions that can get the conversation started include:

  • Why isn’t my current treatment working?
  • What are my other options for treatment?
  • What are the risks associated with other treatment options?
  • What complementary therapies do you recommend?
  • Are there any clinical trials available in my area?

Remember that if your current metastatic RCC treatment stops working, it doesn’t necessarily mean that you’re out of options. Work with your doctor to figure out the best steps to take moving forward, and don’t give up hope.