Treatment of Kidney Cancer by Stage
The type of treatment(s) your doctor recommends will depend on the stage of the cancer and on your overall health. This section sums up the options usually considered for each stage of kidney cancer.
Stages I, II, or III
Stage I and II cancers are still contained in the kidney. Stage III cancers either have grown into nearby large veins or have spread to nearby lymph nodes.
These cancers are usually removed with surgery when possible. There are two common approaches:
Partial nephrectomy (removing part of the kidney). This is often the treatment of choice in tumors up to 7 cm (a little less than 3 inches) if it can be done.
Radical nephrectomy (removing the entire kidney).
The lymph nodes near the kidney may be removed as well, especially if they are enlarged.
If the cancer has grown into nearby veins (as with some stage III cancers), your surgeon may need to cut open these veins to remove all of the cancer. This may require putting you on bypass (a heart-lung machine), so that the heart can be stopped for a short time to remove the cancer from the large vein leading to the heart.
After surgery, some people at high risk of the cancer returning might be helped by getting the targeted drug sunitinib (Sutent) for about a year, which can help lower this risk. Treatment given after surgery is known as adjuvant therapy. Sunitinib can have side effects, so it’s important to talk to your doctor about the benefits and risks. Clinical trials are also looking at other adjuvant treatments for kidney cancer. Ask your doctor if you are interested in learning more about adjuvant therapies being studied in clinical trials.
If you can't have kidney surgery because of other serious medical problems, you might benefit from other local treatments such as cryotherapy or radiofrequency ablation. Radiation therapy may be another option. These treatments are generally only given when surgery can’t be done. Although these types of treatments can have outcomes similar to surgery as far as the chances of the cancer spreading to other parts of the body, some studies show the cancer might be more likely to come back in the same area.
Active surveillance is another option for some people with small kidney tumors. With active surveillance, the tumor is watched closely (with CTs or ultrasounds) and only treated if it grows.
Stage IV
Stage IV kidney cancer means the cancer has grown outside of the kidney or has spread to other parts of the body such as distant lymph nodes or other organs.
Treatment of stage IV kidney cancer depends on how extensive the cancer is and on the person’s general health. In some cases, surgery may still be a part of treatment.
In rare cases where the main tumor appears to be removable and the cancer has only spread to one other area (such as to one or a few spots in the lungs), surgery to remove both the kidney and the metastasis (the outside area of cancer spread) may be an option if a person is in good en
