A kidney cancer diagnosis can feel overwhelming, but advances in medicine have made a wide variety of treatment options available. Depending on the stage and type of your cancer, as well as your overall health, your care team may recommend different approaches. From traditional surgery to cutting-edge immunotherapy, there’s a lot to know about the primary kidney cancer treatment options available in the United States today.
Surgery: The First Line of Defense
For many patients, surgery is the primary treatment for kidney cancer, especially if the cancer is localized (contained within the kidney).
Partial Nephrectomy
In a partial nephrectomy, the surgeon removes only the tumor and a small margin of healthy tissue around it. This option is often recommended when the cancer is small and the goal is to preserve as much kidney function as possible. Minimally invasive techniques, such as robotic-assisted surgery, are commonly used to speed up recovery.
Radical Nephrectomy
A radical nephrectomy involves removing the entire kidney, often along with nearby structures such as the adrenal gland or surrounding lymph nodes if the cancer has spread. This is usually done when tumors are large or centrally located in the kidney.
Ablative Treatments: An Option for Some Patients
For individuals who cannot undergo traditional surgery due to age, health issues, or other factors, ablative treatments may be an alternative.
Cryoablation
Cryoablation uses extreme cold to freeze and destroy cancer cells. It’s typically performed with imaging guidance (like CT scans) and can be done percutaneously (through the skin) or laparoscopically.
Radiofrequency Ablation (RFA)
Radiofrequency ablation uses high-energy radio waves to heat and kill cancer cells. Like cryoablation, RFA is minimally invasive and often used for small tumors.
Targeted Therapy: Attacking Cancer at Its Source
Targeted therapy focuses on specific molecules within cancer cells that help them grow and survive. These drugs are often used when kidney cancer has spread beyond the kidney (metastasized).
Types of Targeted Therapies
- Tyrosine kinase inhibitors (TKIs) such as sunitinib (Sutent) and pazopanib (Votrient)
- mTOR inhibitors like everolimus (Afinitor)
- VEGF inhibitors that block blood vessel growth to the tumor
Targeted therapies are typically taken orally and can often be combined with other treatments to improve effectiveness.
Immunotherapy: Harnessing the Power of Your Immune System
One of the most exciting advances in kidney cancer treatment has been the development of immunotherapy. This approach helps your body’s immune system recognize and destroy cancer cells more effectively.
Immune Checkpoint Inhibitors
Immune checkpoint inhibitors, such as nivolumab (Opdivo) and ipilimumab (Yervoy), have shown success in treating advanced kidney cancer. These drugs block the proteins that prevent the immune system from attacking cancer cells.
Combination Immunotherapy
Often, two immunotherapy drugs are used together or combined with targeted therapies for a stronger response. Your oncologist will determine the best combination based on your individual case.
Radiation Therapy: A Limited but Useful Tool
Radiation therapy isn’t commonly used as the main treatment for kidney cancer, but it can be helpful in certain situations.
- Controlling cancer that has spread to other parts of the body (such as bones or brain)
- Alleviating pain or other symptoms
Advanced techniques like stereotactic body radiation therapy (SBRT) can deliver high doses of radiation with pinpoint accuracy.
Active Surveillance: Monitoring Instead of Immediate Treatment
In select cases, especially when the tumor is small and slow-growing, doctors may recommend active surveillance. This approach involves regular imaging and monitoring instead of immediate intervention, allowing patients to avoid or delay the side effects of treatment.
When It’s Considered
- Older patients
- Patients with significant other health issues
- Tumors less than 4 cm in size
Clinical Trials: Accessing Tomorrow’s Treatments Today
Many promising new treatments for kidney cancer are currently being tested in clinical trials across the United States. Participating in a clinical trial can give patients access to novel therapies that are not yet widely available and may offer new hope for difficult-to-treat cases.
If you’re interested in a clinical trial, talk to your oncologist about whether it might be a good fit for you.
Finding the Right Treatment Plan
Kidney cancer treatment is not one-size-fits-all. Factors like tumor size, location, stage, your age, overall health, and personal preferences will all influence your care plan. At top cancer centers across the U.S., a multidisciplinary team—including urologists, oncologists, radiologists, and pathologists—works together to design the most effective treatment strategy for you.
It’s important to discuss all of your options with your healthcare team and consider getting a second opinion if you have any doubts. With today’s wide range of treatments, many people with kidney cancer are living longer, healthier lives than ever before.
