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Treatment

The treatment for kidney cancer depends on the size of the cancer and whether it has spread to other parts of the body.

The main treatments are:

  • surgery to remove part or all of the affected kidney – this is the main treatment for most people
  • ablation therapies – where the cancer cells are destroyed by freezing or heating them
  • targeted therapies (also called biological therapies) – medicines that help stop the cancer growing or spreading
  • embolisation – a procedure to cut off the blood supply to the cancer
  • radiotherapy – where high-energy radiation is used to target cancer cells and relieve symptoms

Cancer that has not spread out of the kidney can usually be cured by having an operation to remove some or all of the kidney. Sometimes cryotherapy or radiofrequency ablation may be used instead.

A complete cure may not be possible if the cancer has spread, but it may be possible to slow its progression and treat any symptoms with surgery, medicine and/or radiotherapy.

Surgery

There are 2 main types of surgery for kidney cancer:

  • an operation to remove the part of the kidney containing the cancer – called a partial nephrectomy
  • an operation to remove the entire kidney – called a radical nephrectomy

A partial nephrectomy is usually done if the cancer is small and easy for the surgeon to get to. A radical nephrectomy may be necessary for larger cancers or if the cancer has spread beyond the kidney.

It's possible to live a normal life with only 1 kidney. Your other kidney can usually make up for the kidney that was removed.

Surgery for kidney cancer can be done in 2 ways:

  • through a single large cut in the tummy or back – known as "open" surgery
  • using surgical tools inserted through smaller cuts – known as laparoscopic or "keyhole" surgery

Keyhole surgery tends to have a faster recovery time, but it can only be done by trained surgeons and it is not always suitable. Talk to the surgeon about the pros and cons of each method.

Ablation therapies

Ablation therapies are treatments that destroy cancer cells by either:

  • freezing them (cryotherapy)
  • heating them (radiofrequency ablation)

Either technique may be recommended in certain circumstances (for example, to ensure your kidney keeps working), or if the tumour is small. Both treatments are only available in specialist centres, so you may need to travel to another hospital to have it done.

Radiofrequency ablation is done by inserting a needle-like probe through your skin, so no large cuts are needed.

Cryotherapy is done using needles inserted into the tumour. This can be done through your skin (percutaneous cryotherapy) or through a small cut (laparoscopic cryotherapy).

Side effects of ablation therapies can include bleeding around the kidney and damage to the tube that carries pee from the kidney to the bladder (the ureter).

Targeted therapies

If your cancer is advanced, you may be offered targeted therapies (also called biological therapies). These are medicines, usually taken once or twice a day, that help stop the cancer growing and spreading.

There are many different biological therapies, including:

  • sunitinib 
  • pazopanib
  • cabozantinib
  • axitinib
  • everolimus
  • bevacizumab and interferon
  • nivolumab
  • tivozanib

At present, sunitinib, pazopanib, cabozantinib, axitinib, everolimus, nivolumab and tivozanib are recommended for routine use on the NHS.

Some people with advanced kidney cancer may be offered a medicine called lenvatinib, to take along with everolimus.

Other medicines are not currently recommended, but some may be available through the Cancer Drugs Fund.

Side effects

Sunitinib, pazopanib, cabozantinib, axitinib and tivozanib are all taken as tablets. Possible side effects include:

Nivolumab is given by a drip directly into a vein every 2 weeks. It works by helping your body's immune system destroy the cancer cells. Side effects are uncommon, but can include:

Embolisation

Embolisation is a procedure to block the blood supply to the tumour, causing it to shrink.

It's sometimes recommended if you have advanced kidney cancer and you're not in good enough health to have surgery to remove the affected kidney.

During embolisation, the surgeon will insert a small tube called a catheter into a blood vessel in your groin and then guide it to the blood vessel supplying the tumour.

A substance will be injected through the catheter to block the blood vessel.

Radiotherapy

Radiotherapy is a treatment where radiation is used to target or destroy cancerous cells. It cannot usually cure kidney cancer, but it can slow down its spread and help control your symptoms.

It may be recommended if you have advanced kidney cancer that has spread to other parts of the body, such as your bones or brain.

Radiotherapy uses a large machine to carefully direct beams of radiation at the cancerous cells. It's often done for a few minutes every day, over a few weeks.

Side effects of radiotherapy can include:

  • tiredness
  • feeling and being sick
  • diarrhoea
  • reddening of the skin in the treatment area