Kidney Cancer Treatment Options You Should Know About
If you have been diagnosed with kidney cancer, your doctor will discuss the best options to treat it. Your treatment plan will depend on the cancer stage and your overall health.
Other considerations are side effects, the probability of your being cured, relieving symptoms, life quality and extension of life.
Kidney cancer treatment options include surgery, ablation, targeted therapy, immunotherapy, chemotherapy, radiation therapy or a combination of these therapies.
Surgery for Kidney Cancer
Kidney cancer surgery is a standard procedure for patients. There are two types of surgical options available to patients.
Radical Nephrectomy
Radical nephrectomy involves removing the affected kidney and neighboring lymph nodes. Sometimes, adrenal gland removal is included.
A radical nephrectomy either involves open surgery or a laparoscopic surgery, using several small cuts to insert a tiny video camera and surgical tools. It can also be done robotically, where the doctor guides a robot to maneuver surgical tools and perform the surgery.
Partial Nephrectomy
A partial nephrectomy involves removing the tumor and a small part of the healthy area around it. The kidney is not removed. Like a radical nephrectomy, it can either be an open surgery, laparoscopic or robotic.
Partial nephrectomies are used in small kidney cancers or when removal of a kidney is not an option, i.e. if someone only has one kidney. Saving as much kidney tissue as possible will also reduce complications down the road, such as kidney failure or need for dialysis.
The type of surgery recommended will depend on the stage of your cancer and your overall health. After all, surgery comes with many risks, including bleeding and infections.
Ablation for Kidney Cancer
For some kidney cancer patients, surgery is not an option and a cryoablation or radiofrequency ablation is considered.
Cryoablation
Cryoablation freezes cancer cells and used for small tumors or if you cannot undergo surgery. Using X-ray as a guide, a special needle is inserted into the kidney tumors to send gas through to freeze the cancer cells.
RFA
Similarly to cryoablation, radiofrequency ablation (RFA) sends a needle through the skin into the kidney tumors using X-ray. An electrical current is then sent through the needle to burn up the cancer cells.
Both cryoablation and RFA require sedation and local anesthesia to numb the needle area. It is possible you will have severe pain, lasting several days, following these procedures.
Side effects of ablation include infection and bleeding. It is also possible for the ureter (a tube that carries urine from kidney to bladder) to become damaged.
Targeted Therapy Drugs for Kidney Cancer
By learning about molecular and genetic changes in cancer-causing cells, researchers have been able to create drugs to target these. These target drugs are different than chemotherapy and will sometimes work even when chemotherapy doesn’t.
Targeted therapies have less severe side effects than chemotherapy and often used to treat kidney cancer. Chemotherapy has not been proven to be effective in treating kidney cancer.
These targeted drugs may either block the growth of vessels that encourage cancer cells or proteins that help them to grow and stay. Some of these drugs may do both.
Researchers and doctors are still learning the best ways to employ these drugs with advanced kidney cancer. Generally, they are being used one at a time, and when doesn’t work, another is tried.
Studies are also being done on the best ways to use targeted therapies for kidney cancer. In particular, research is looking at whether combining them might be helpful and which ones are more effective.
Immunotherapy (Biologic Therapy)
Immunotherapy, also called biologic therapy or biotherapy, uses your immune system to fight cancer. It works to stimulate your immune system to work harder and attack diseased cells and also, by giving you man-made immune proteins to help your immune system do its job.
Immunotherapy works for some cancers better than others. It works better when combined with other kidney cancer treatment options, but it also works on its own.
Nivolumab is a newer immunotherapy drug being used to treat kidney cancer. It is given intravenously (through a vein) every two weeks.
Nivolumab works to stop or slow down the immune system response, including the anti-tumor response. Basically, it tells the immune system to stop allowing tumor activity.
In 2013, nivolumab was investigated in a large phase I trial, which included 34 kidney cancer patients with advanced stage disease. Twenty-nine percent of the kidney cancer patients were showing promising results from its anti-tumor fighting agents.
After numerous phase studies, nivolumab was approved by the Food and Drug Administration in 2015 for treating kidney cancer.
Chemotherapy
Chemotherapy drugs are given intravenously and work to destroy cancer cells by stopping their ability to grow and spread. But, as mentioned, kidney cancer is often resistant to chemotherapy.
For some patients, a combination of several different chemotherapy drugs may shrink temporary tumors. The side effects of chemotherapy — fatigue, infection, nausea, vomiting, hair loss, diarrhea and loss of appetite — can be harsh but go away after treatment is complete.
Even though chemotherapy doesn’t cure kidney cancer, you can still talk to your doctor about whether it is an option for you.
Radiation Therapy
Radiation therapy involves the use of high-energy particles to destroy cancer cells. Like chemotherapy, it has not been effective in treating kidney cancer so it's rarely used alone.
Radiation therapy will only be used if you cannot have surgery and only on areas where the cancer has spread outside the kidney, such as the bones, and not the kidney tumor itself. If used on the kidney, it would damage the healthy parts.
Radiation has its side effects, including fatigue, skin reactions, stomach upset and diarrhea. Internal radiation may cause bleeding, injury to nearby issues, or infections, but most side effects go away once treatment has completed.
Managing Kidney Cancer Treatment Expectations
Any cancer diagnosis is scary and overwhelming. And there are a lot of unknowns when it comes to diagnosis, staging, treatments, and prognosis.
Remission from kidney cancer is not always possible and if your cancer cannot be cured or managed, your diseased is labeled as advanced stage or terminal. But this isn’t a reason for despair.
Things may worsen, stay the same, get better, or they will keep changing. Your cancer will be tracked with CT scans and your doctor will discuss all results and disease progression along the way
Sometimes, the information you receive may be disappointing and scary, but clarifications of things like "stable disease" helps, because this isn’t necessarily a failure. It simply means that things haven’t gotten worse, and, most importantly, you still have options.
Your doctors won't give up until they exhausted every kidney cancer treatment option so don’t let disappointment stop you from fighting to live and get better. Choose to learn from your experiences and believe things will get better.