Kidney cancer treatments

 

We offer the full range of the most up-to-date surgical and medical treatment options for benign and malignant kidney tumours. There are often a number of possible treatment options which need to be considered for each patient.

The chosen treatment option depends on a number of factors including the size and position of the tumour, the appearance and function of the other kidney, and the other medical conditions/age of the patient. The treatment choice is reached as a fully informed and joint decision between the clinical team and each individual patient.

Treatments for small kidney tumors

For small renal tumours (generally considered to be those less than 4cm in diameter), treatments try and preserve the function of the affected kidney by using one of the following options:

  • Robotic-assisted partial nephrectomy

    This minimally invasive procedure involves using a surgical robot to assist in removal of the kidney tumour with a small area of surrounding normal tissue. 

    The da Vinci® robot has several advantages that may make it useful for laparoscopic partial nephrectomy in the treatment of kidney cancer. It has an excellent optical system that provides high-definition imaging and a 3D view for the surgeon.

    The da Vinci® system also offers the surgeon improved dexterity as it uses instinctive operative controls to move laparoscopic instruments with greater movement capabilities than the human wrist would normally allow. These controls may allow for greater operative precision during the reconstruction (rebuilding) of the kidney after the kidney cancer has been removed during the laparoscopic partial nephrectomy procedure.

  • Open partial nephrectomy

    Sometimes a partial nephrectomy is recommended for a small renal mass but due to complexity of the mass or other individual patient factors a robotic approach is not considered suitable. We have been performing open partial nephrectomy since 1999 and have completed over 350 cases.

    Find out more about the procedure in our leaflet having an open partial nephrectomy.

  • Radiofrequency ablation / cryotherapy

    These ablative treatment strategies use heat or freezing energy placed into the tumour to kill the cancerous cells with a rim of surrounding normal kidney tissue.

    They avoid the need to remove some, or all, of the kidney with an operation and may be suitable for people with smaller kidney tumours (stage T1a) who aren’t fit enough to have conventional surgery or who choose not to have it.

    They tend to cause fewer side effects and have quicker recovery times than standard operations for kidney cancer.

  • Observation

    This is suitable for older patients or those with significant other medical conditions who are not deemed fit enough for other intervention.

    Repeated CT or ultrasound scans enable the urology team to keep a close eye on the growth of the kidney tumour and only intervene if it grows rapidly or changes in other ways.

Treatments for large or advanced kidney tumors

For larger tumours a radical nephrectomy (complete kidney removal) is usually required. This can often be performed using keyhole techniques but may require open surgery depending on the tumour size and complexity.

For tumours that have spread outside the kidney, surgery may still be required in addition to a range of new drug treatments, often within clinical trials.

  • Laparoscopic radical nephrectomy

    This is a total removal of a kidney, the surrounding fat, and often the adrenal gland, via a key-hole technique. Originally developed over 10 years ago, this has become the standard technique for the removal of kidney tumours.

    See our kidney patient leaflets to find out more about the procedure.

  • Open radical nephrectomy

    Open surgery is required when tumours are very large, invading into other structures around the kidney or starting to grow down the main vein from the kidney. It may also be required if a patient has had multiple previous operations on the abdomen.

    We have a particular expertise in the removal of tumours which have spread up the vein into the heart. These operations are performed in conjunction with cardiac surgeons. We receive referrals for these operations from all over the South of England.

    See our kidney patient leaflets to find out more about the procedure.

  • Drug and immune treatments

    The treatment of advanced kidney cancer with drugs has been transformed since the introduction of effective drugs in the last 10 years. These shrink or slow the growth of many secondary cancers.

    If you require these treatments then you will see the oncology consultants within the multidisciplinary kidney cancer clinic to explain these options further. We offer a full range of these treatments but also collaborate with other centres across London to ensure our patients have access to the latest trials.