Kidney Cancer Treatments

Kidney cancer treatment involves surgery, chemotherapy, immunotherapy, targeted therapy, radiation therapy, active surveillance, ablation, and other treatment options.  After the cancer is discovered and staged, the treatment team will discuss the various treatment options with the patient.  It is essential that the patient take the time and really think about the different treatment options.  In deciding on a plan of treatment, one of the more important things to consider is the stage of the cancer.

Sometimes, the patient may be offered more than one type of treatment.  There may be different kinds of doctors involved in treating the patient with kidney cancer, depending on the treatment choices and the stage of the patient’s cancer.  These doctors may include a medical oncologist (who treats cancer using chemotherapy and other agents), a radiology oncologist (who uses radiotherapy to treat the cancer), and a urologist (who specializes in the treatment of urinary tract problems).

It is essential to discuss with the doctor all of the treatment choices available, as well as their possible side effects.   Because there are many choices of treatment, the patient may want to get a second opinion.  The primary care doctor or oncologist can help the patient find someone who can deliver the second opinion.  The person giving the second opinion needs to think of other treatment options available.

The patient may decide to take part in a clinical trial as part of their therapy. Clinical trials can help provide for the patient the most up-to-date treatment options available.  These clinical trials are often affiliated with a university-based medical center so the patient may wish to have their treatment done at this type of facility.  The patient needs to talk with their doctor about any clinical trials that are available.

Some patients may elect to use alternative and complementary treatments for their kidney cancer.  The patient can find out about any alternative treatment choices by talking with their primary care physician or by seeing a holistic practitioner.  Some complementary treatment options include massage, acupuncture, herbs, vitamins, and special diets.  They are often done along with traditional treatments for kidney cancer. 

The treatment team may be the patient’s first resource for support and information about the disease.  On the other hand, there are other resources the patient might make use of, such as forums involving cancer treatment, pamphlets, and support groups. Clinic-based or hospital-based support are also an important part of the patient’s care. 

Prior to surgery, the patient may need to have preoperative testing.  These tests may need to be done before surgery:  Chest X-ray, partial thromboplastin time (which measures for blood clotting, CBC, biochemical profile (such as electrolytes, creatinine, and BUN), and an electrocardiogram.

Aspirin and other blood thinners may need to be stopped for at least two weeks before the surgery to lessen the risk of bleeding during the procedure. The patient also needs to stop taking nonsteroidal anti-inflammatory medications at least 10 days before the procedure. The patient needs to stop taking any herbal preparations at least ten days prior to surgery.  Multivitamins containing vitamin E and garlic supplements need to be stopped as they can increase the bleeding risk during the procedure.

Two days before surgery, the patient needs to stop drinking any alcoholic beverages.  The patient also needs to call intake at the hospital to make sure they understand when to come for therapy and to pre-register for surgery.

The day before surgery, the patient needs to follow a clear liquid diet, such as juices, broth, and gelatin products.  They need to stay hydrated by drinking a lot of water.  Sodas and other carbonate beverages should be stopped on the day before surgery.  The patient should stop eating and drinking after midnight the night before surgery.

After surgery, the patient will be placed in the recovery room in order have their vital signs checked, their pain treated, and to recover from general anesthesia.  The patient may be disoriented right after surgery and this takes a while before it dissipates. 

The patient can expect to be hooked up to an EKG tracing machine, have an IV, and will probably have a Foley catheter in place.  There may be abdominal or chest tubes placed during surgery that will have to be managed after surgery.  Most patients can breathe on their own after surgery and don’t need to be on a respirator.

The patient may also have compression sleeves on their lower legs after the surgery.  These help prevent blood clots in the veins of the lower legs.  They will remain in place until the patient is fully ambulatory.   After becoming ambulatory, the patient will be encouraged to walk in order to prevent blood clots from occurring. 

The patient may have a nasogastric tube (NG) tube in their nose after surgery.  This allows for drainage of the stomach. It will be in place until the patient is able to eat normally.  The tube can cause a sore throat for which pain medications can be prescribed.

Surgery for kidney cancer can be done whenever there is pathological evidence that the patient has cancerous changes in the kidneys.  After surgery, chemotherapy and radiotherapy can be done in order to get rid of any remaining cancerous cells.  After these treatments, the patient will usually be cured of their cancer, although some may ultimately die from metastatic disease. 

After the treatment for kidney cancer, the patient may feel excited and stressed. They may be happy to complete treatment but will often worry that the cancer will come back.  It may take a long period of time for the patient to stop worrying that the cancer may return. 

Some patients will have success with treatment, while others will go into temporary remission, with return of the cancer after several months.  Should this occur, more surgery, radiation therapy, and chemotherapy may be recommended.