If you have been diagnosed with kidney cancer, you probably have many questions regarding treatment. What are the various treatments available? What are the newest kidney cancer treatments? What will your oncologist suggest? While this may seem overwhelming, the good news is researchers are making great strides in treatment of kidney cancer. There are more options now than in the past. Making a Kidney Cancer Treatment Plan Before you can make any decisions about kidney cancer treatment, your oncologist needs to know exactly what type of kidney cancer you have. The most common type of kidney is renal cell carcinoma, or RCC. It makes up about 85 to 90% of all kidney cancer cases in the United States. Your oncologist also needs to know the stage of the cancer. Later or more advanced stages of the disease require a different approach than kidney cancer in the early stages. First Line Treatment: Surgery Surgery is most often the first step in kidney cancer treatment. In the early stages, surgery may be the only treatment necessary. Surgery may involve removing the whole kidney (nephrectomy), the tumor and only part of the kidney (partial nephrectomy), or the kidney and some surrounding tissue and lymph nodes (radical nephrectomy). If you have a more advanced stage, surgery may still be an option. In this case, removing the tumor or the kidney may help slow the progress of the cancer or relieve pain or discomfort from the tumor. If you have surgery and your surgeon and oncologist believe that the cancer has not spread, you may not need any further treatment. At this point, your doctor would monitor your health with regular checkups to ensure the cancer has not returned. As with all surgeries, there are some risks with kidney cancer surgery, including: Damage to other nearby internal organs Excessive bleeding Infection If Surgery Isn’t an Option Although surgery is the most common approach to treatment, it is not an option for everyone. If you can’t have surgery, your doctor may recommend another treatment to destroy cancer cells in the kidney. These treatments include cryotherapy or cryoablation, radiofrequency ablation (RFA), or rarely, arterial embolization. Cryotherapy uses extreme cold to freeze the cancer cells. Using a needle and ultrasound guidance, your surgeon inserts a hollow probe into your kidney. Once it reaches the tumor, the surgeon sends a cold gas through the probe to the tumor. RFA uses an electric current to destroy the cancer cells. As with cryotherapy, your surgeon uses a probe and locates the tumor. When the needle is in place, an electric current heats up the cancer cells and destroys them. Arterial embolization doesn’t touch the tumor directly. Instead, it cuts off the blood supply to the tumor, depriving it of the nutrients it needs to grow. Your surgeon inserts a small catheter (tube) into an artery in your groin and threads it to the renal artery. This artery brings blood from the aorta to the kidney. The doctor injects material into the artery to block it, cutting off the blood supply. Complications from these procedures are rare, but they are the same as for surgery. Immunotherapy and Targeted Therapy Traditional therapies aim to remove cancerous tumors or destroy cancer cells. Immunotherapy treatments boosts your immune system to fight cancer. Targeted therapies target specific parts of the cancer cells to kill the cells or prevent them from reproducing and spreading. These treatments are currently reserved for patients with advanced kidney cancer and may not cure the disease. However, they can often stop certain types of kidney cancers from progressing for a significant amount of time. Immunotherapy and targeted therapy may also help if you previously had kidney cancer but it has returned, called recurrent kidney cancer. The risk and severity of side effects are usually lower with these drugs than standard chemotherapy. However, side effects can occur and they can be serious for some people. They include: Diarrhea or abdominal pain Extreme fatigue Heart attacks High fever and chills Intestinal bleeding Kidney damage Low blood pressure Rapid heart beat Shortness of breath As with all cancer treatments, prognosis varies considerably depending on the type and stage of cancer. Chemotherapy Chemotherapy is usually not effective as a main treatment for kidney cancer. However, your doctor may recommend it if other treatments have failed. If this is the case, combination treatments with other therapies, such as immunotherapy, may be necessary. You usually take chemotherapy in cycles. The frequency of the cycles will depend on the specific medications. Side effects of chemotherapy range from mild to severe and can include: Constipation Diarrhea Fatigue Hair loss Increased risk of infection Mouth sores Nausea and vomiting Radiotherapy As with chemotherapy, doctors do not typically use radiation therapy to treat kidney cancer. Your doctor may recommend it to ease symptoms from the tumor, such as pain. Side effects can include: Fatigue Nausea Sunburn-like changes to the skin where the radiation is directed Vomiting Kidney cancer, especially advanced kidney cancer, used to be extremely difficult to treat. New advances in cancer care medicine has improved the survival rate. Speaking with your oncologist about your options will help you make the right decisions for your care.