Controlling the symptoms of kidney cancer

If you have advanced kidney cancer it may not be possible to cure it. Advanced kidney cancer means the cancer has

• Spread from where it started in the kidney, or
• Come back some time after you were first treated

Kidney cancer can spread to nearby lymph nodes and other tissues near to where it started in the kidney. Doctors call this local spread. Or it can spread via the lymphatic system or bloodstream to another part of the body, such as the bones, lungs, brain or the other kidney.

Even if your cancer can’t be cured, there is treatment available to control your symptoms. This treatment may also shrink the cancer and slow it down, even if it cannot get rid of it altogether. There is quite a bit of research evidence to show that removing a cancerous kidney, for example, can control symptoms and prolong life even if it won't cure the cancer. Kidney cancers can produce chemicals that circulate round the body and cause odd symptoms, for example fevers, weakness, muscle pain or nerve problems. Treating the tumour will reduce the amount of these chemicals that it makes. So it can help to control the symptoms.

If you are not well enough for major surgery, you may be able to have embolisation. This is a way of cutting off the blood supply to the tumour. This can shrink it and relieve symptoms such as pain and bleeding. Embolisation can also be used to treat secondary cancers.

Surgery is sometimes possible for secondary kidney cancers. If you have only one area of cancer spread, it may be possible to remove it. As kidney cancer can be inactive at times, taking out a secondary cancer may temporarily halt the progress of the cancer and help you to stay well for longer.

The National Institute for Health and Clinical Excellence (NICE) guidelines for the treatment of cancers of the urinary system say that a biological therapy, such as interferon, interleukin or sunitinib, should be made available to anyone with advanced kidney cancer. These treatments do not work for everyone. Generally they will cause some shrinking of the cancer and relief of symptoms. But on occasion they can work extremely well and shrink a cancer completely.

Radiotherapy can be used to help control symptoms by shrinking a cancer so that it does not cause pressure and pain. Shrinking lung secondaries may help relieve breathlessness.

All the treatments listed below can be used for advanced kidney cancer. The links will take you to the relevant page in this section of CancerHelp UK for more information about them.

• Biological therapy
• Radiotherapy
• Chemotherapy
• Surgery
• Embolisation
• Hormone therapy with medroxyprogesterone

Which treatment is best for you depends on

• The size of the cancer and where it is
• Whether the cancer has spread to another part of the body, and where
• The treatment you have already had
• Your general health

If you have only one area of cancer spread, it may be best to use a local treatment, such as surgery or radiotherapy. If you have more widespread disease, it may be better to have a treatment that circulates throughout the body, such as biological therapy. When considering surgery, your doctor will need to think about your general health and how easy it will be for you to recover. If you've had a certain type of treatment before, it may not help to repeat it. Or with radiotherapy, it may not be possible. These are the sorts of things your doctor has to take into account. But you and your doctor will take the final decisions together after you have discussed all the options.

It can be difficult to decide which treatment to try, or whether to have treatment at all when you have an advanced cancer. You may want to think about your quality of life while you are having the treatment. This includes side effects as well as stresses such as travelling back and forth to the hospital. Most importantly, you will need to understand what can be achieved with the treatment you are being offered. 

It can be helpful to talk over difficult decisions with someone who is outside your circle of family and friends. Contact a counselling organisation to find out more about counselling and how to find a counsellor in your area.

Symptoms such as pain, sickness and nausea, diarrhoea and constipation can all be helped with medicines. Some people find complementary therapies such as relaxation and massage can relieve pain or sickness. And they can certainly help to reduce anxiety and stress.

There are many different painkillers and ways of taking them. With the help of your doctor or specialist nurse, it should be possible for you to be pain free most of the time. It may not be possible to ensure you are completely pain free when you are moving around, but you should be when you are resting. You and your family can learn to help combat pain yourselves, for example with relaxation or breathing exercises. There is a section of CancerHelp UK about cancer and pain control, which you may find helpful.

Sickness can also be helped with medicines. There are several different types of anti-sickness medicine, and which one you need depends on what is causing your sickness. It will help your doctor or symptom control nurse if you are able to tell them what relieves your sickness and what seems to make it worse. There is detailed information about causes of sickness and how to control it in the coping with cancer section of CancerHelp UK.