Early stage kidney cancer

Surgery is the main treatment for kidney cancer that has not spread. Stage 1 and 2 kidney cancer is often cured with surgery. Even some stage 3 cancers can be cured if it is possible to remove all the cancer.

Removing a kidney is called a nephrectomy. This comes from the Greek word for kidney, ‘nephros’. You may have either the whole kidney or part of the kidney removed

• Radical nephrectomy means removing the whole kidney
• Partial nephrectomy means removing part of the kidney

Surgeons sometimes call partial nephrectomy 'nephron sparing surgery'. The nephron is the working unit of the kidney that filters the blood. So this just means that your surgeon is trying to leave some functioning kidney behind after the operation to remove the cancer. Generally, nephron sparing surgery (partial nephrectomy) is suitable for you if

• You have a small kidney tumour (the exact size limit varies, but less than 7 cm across at the very most)
• You only have one kidney, and that has a tumour in it
• You have cancer in both kidneys
• Your unaffected kidney doesn't work as well as it should

If you do not have at least one working kidney, then you will have to have kidney dialysis for the rest of your life. Dialysis is a way of doing the job your kidneys would do if they were working properly. That is, removing the waste products and extra water that you don’t need from your body.

There is more about surgery for kidney cancer in this section of CancerHelp UK.

It may not be possible for you to have surgery because you have other medical problems. In this case the doctor might use

• Radiotherapy
• Arterial embolisation
• Experimental treatment methods

Radiotherapy treats cancer by using high energy rays that destroy the cancer cells, while doing as little harm as possible to normal cells. It is only helpful in a relatively small number of people with cancer of the kidney. It is not often used with kidney cancer that is likely to be curable. But it can be useful for shrinking the cancer and controlling pain or bleeding. You may be offered radiotherapy after surgery if your surgeon thinks some cancer cells may have been left behind after your operation.

There is more about radiotherapy for kidney cancer in this section of CancerHelp UK.

Biological therapies are treatments that use natural substances from the body, or drugs made from these substances. Some clinical trials are using the biological therapies interferon or interleukin (IL-2) to try to stop kidney cancer from coming back after surgery. Doctors call this adjuvant treatment. Our kidney cancer research page has information about these treatments, as well as details about clinical trials of biological therapies for kidney cancer.

Arterial embolisation blocks the blood vessels to the area of the kidney containing the cancer. This reduces the supply of oxygen and food to the cancer, and may make it shrink. This is not a cure, however. The cancer is not removed and there is a high chance of cells breaking away in the future and spreading to other parts of the body. Embolisation is also sometimes used before surgery to reduce the risk of bleeding.

This minor operation is done in the X-ray department. You will have to stay in hospital at least overnight, so you will be admitted to a ward. You will be asked to change into a hospital gown and will be taken to the X-ray department.

You will be asked to lie on the X-ray table. Then you will be given something to make you sleepy. The doctor will give you some local anaesthetic and then put a long tube (a catheter) into the main blood vessel in your groin. Watching on an X-ray screen, the doctor will feed the catheter up through your blood vessels until it is in exactly the right place. Then, the doctor will inject small pieces of gelatine sponge or some plastic beads into the main blood vessels that carry blood to the kidney. Then the catheter will be removed. You will have a tight dressing put on to the small wound site in your groin and you will be taken back to the ward to rest. You will not be allowed to get up for at least 4 hours in case moving around makes the wound bleed. You will be asked to stay in hospital overnight. If there is no bleeding from your groin, you will be able to go home the following day.

Side effects

You may have some pain for 12 to 24 hours following this treatment. You will be given painkillers while you are in hospital and to take home with you. If you are still having pain after the painkillers, do tell your nurse or doctor and ask for more or something stronger.

The aim of the treatment is to kill off the cancer in your kidney. When the cancer cells die off, they may release toxins into your bloodstream. These toxins can cause

• Fever
• Sweats
• Weakness and lack of energy

These side effects will wear off after a few days. At least they are a sign that your treatment is working! If you find them troublesome, try taking paracetamol every 6 hours until the side effects improve.

There are several different methods of killing (or 'ablating') kidney tumours being investigated. There is information on all these in our kidney cancer research page. They include

• Cryotherapy - freezing the tumour
• Radio frequency ablation (RFA) - killing the tumour with heat
• HIFU - high intensity ultrasound, which also produces heat to kill the tumour

These techniques can all be done in different ways. They can be used during a regular operation. But researchers and doctors are working on ways to use them that are 'less invasive'. For example, RFA may be done by putting probes through the skin so you don't have to have an operation. We must stress, though, that these are all experimental techniques. They have to be tested, and those who have taken part in trials followed up for some years, before we can be sure that they work as well as surgery to remove kidney cancer.