Treatment Options for Renal Cell Carcinoma

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Your kidneys are responsible for making urine, which removes waste products and excess fluid from your body. Tiny tubes, called tubules, in your kidneys help filter the waste and extra fluid from your blood. Sometimes cancer cells can develop in the lining of these tubules. This is called renal cell carcinoma (RCC). It’s the most common type of kidney cancer, accounting for almost 9 out of every 10 cases. Several treatment options exist for this disease, and your doctor will determine the best fit for you based on different factors.

Kidney cancer treatment is dependent on its stage.

If you are diagnosed with kidney cancer, your doctor will perform tests to look at the size of the tumor and determine whether the cancer has spread to other parts of the body. Based on this, your cancer will be given a stage from I to IV, and this stage can be used to guide treatment decisions. The following criteria are used to stage kidney cancer:

  • Stage I: In this earliest stage, the cancer has not spread outside of the kidney, and the tumor is less than 7 centimeters.

  • Stage II: With this stage, the cancer is still located only in the kidney, but the tumor is larger than 7 centimeters.

  • Stage III: The tumor can be any size in stage III, but it has now spread to nearby lymph nodes or other blood vessels or tissues around the kidneys.

  • Stage IV: When the cancer spreads to distant parts of the body, it is considered stage IV. This is also called metastatic cancer.

Generally, the earlier the stage of renal cell carcinoma, the better prognosis after treatment. But it’s sometimes hard to catch kidney cancer early since the most common symptoms don’t appear until the later stages. These symptoms include blood in the urine, pain on the side of the body, a lump on the abdomen, weight loss, and fever.

What types of treatment are available for renal cell carcinoma?

After determining the stage of your kidney cancer and considering your overall health, your doctor may recommend one or more of the following treatments:

  • Surgery: Most people with kidney cancer have surgery to try and remove the cancer. Depending on the size of the tumor and if it has spread, this may include removing just a portion of the kidney, the entire kidney, or the entire kidney plus the adrenal gland, lymph nodes and tissue around it. Luckily, even if a full kidney must be removed, most people can function with just the one remaining.

  • Radiation: High-energy radiation can be used to destroy cancer cells or keep them from growing. With renal cell carcinoma, a machine directs an external beam of radiation at the area with cancer. Radiation may be used in cases where surgery isn’t an option or to help ease the symptoms of the cancer.

  • Local therapies: Other options for when surgery can’t be performed include cryotherapy, radiofrequency ablation, and arterial embolization. With cryotherapy, an extremely cold needle is inserted into the tumor to try and destroy it. Radiofrequency ablation uses electric current in an attempt to kill the cancer cells. Arterial embolization tries to shrink the tumor by blocking the blood supply to the kidney and preventing the cancer cells from getting what they need to grow.

  • Targeted therapy: These drugs are able to specifically identify cancer cells and attack them, while preserving healthy cells. Two types of targeted therapy, called monoclonal antibodies and kinase inhibitors, are used to stop blood vessels from developing within the tumors so that the tumors can’t survive. Patients receiving targeted therapy usually experience fewer, less severe side effects compared to traditional chemotherapy.

  • Immunotherapy: Also called biologic therapy, this type of treatment boosts the body’s own immune system to fight against the cancer. This is often used for stage IV kidney cancer. For example, two proteins known as interleukin-2 (IL-2) and interferon have demonstrated some success with helping to shrink tumors. Another drug called nivolumuab (Opdivo) helps the immune system recognize the cancer cells, so it can better attack them.

  • Chemotherapy: Chemotherapy may be given as a pill or injected into a vein to try and kill cancer cells. Though it can be effective for other types of cancer, chemotherapy doesn’t always work as well to treat kidney cancer. It may still be used when other treatment options have been exhausted.

Research remains underway to discover new, and potentially even better, methods of treating renal cell carcinoma. Scientists are studying the genes involved in the development of kidney cancer and are also working to develop vaccines that fight cancer. As new treatments reach their final stages of research, clinical trials will be conducted to determine if they are safe and effective in people. If you are interested in participating in a clinical trial, discuss the risks and benefits of this with your doctor.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Mar 7
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  2. Renal Cell Cancer
    Treatment (PDQ®)–Patient Version. National Cancer Institute. https://www.cancer.gov/types/kidney/patient/kidney-treatment-pdq
  3. Treatment Choices by Stage for Kidney Cancer. American
    Cancer Society. https://www.cancer.org/cancer/kidney-cancer/treating/by-stage.html
  4. Types
    of Kidney Cancer. UCLA Health.  http://urology.ucla.edu/types-of-kidney-cancer
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