Arthur Smith Institute for Urology, New Hyde Park, NY :: 516.734.8500

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Kidney Cancer

Treatment

Several options exist for patients with renal carcinoma.

Observation:

Small renal tumors in older patients or individuals with multiple medical problems can be followed with x-ray studies every 6 to 12 months. If they grow to approach 3 cm in size consideration should be given to remove the tumor.

Surgery:

Localized renal tumors are best managed by surgical removal. For tumors less than 5cm in size on x-ray it may be possible to remove the tumor without the need to remove the entire kidney. This is dependent on tumor location. For larger tumors, the entire kidney may need to be removed with possibly the adrenal gland and lymph nodes. Surgery may also be recommended in patients who have significant symptoms from their tumors. It may be beneficial in select patients with spread of tumor to remove the kidney. Most kidney surgery including partial nephrectomy can be performed laparoscopically.

Percutaneous Ablation:

Some renal tumors can be treated by percutaneous ablation. The ability to perform this procedure is dependent upon the location and size of the tumor. This is a procedure where a needle is placed through the skin into the tumor. The needle can freeze or heat the tumor causing it to die over time. This procedure is performed with x-ray guidance (ultrasound or CAT scan). This can be performed with some sedation and a local anesthesia. In most cases this is accomplished as an outpatient. Close follow-up with x-rays is necessary to be certain that the tumor is completely gone and does not recur over time.

Chemotherapy/Immunotherapy:

Several protocols are available to treat patients with metastatic renal carcinoma. Interleukin and interferon have both shown some activity in treating metastatic renal carcinoma. Sometimes it is recommended to remove the kidney containing the tumor prior to beginning therapy.

Follow Up

The schedule for follow-up depends upon the stage of the tumor. All patients should have a yearly exam with blood tests to assess kidney and liver function. A yearly chest x-ray may also be recommended. Higher risk patients may require CT scans at scheduled intervals.