Once you have a diagnosis and know your stage of kidney cancer, you and your doctor can plan treatment. You may want to gather information to help you feel more informed about your decision. Your doctor may refer you to a specialist for treatment. This could include an urologist, a medical or radiation oncologist, or a surgeon. Before beginning treatment, many people find it helpful to get a second opinion about the diagnosis of kidney cancer and the treatment plan.

Kidney cancer is one of the more common cancers to undergo spontaneous remission. However, the incidence is quite low (approximately 0.5%).

There are several standard types of treatment for kidney cancer. In most cases, surgery is the first step. Even if surgery removes the entire tumor, though, your doctor may suggest an extra treatment to kill any remaining cancer cells that can't be seen.

Surgery for kidney cancer

These are the main types of surgery for kidney cancer. Which type you have depends on how advanced your cancer is.

• Radical nephrectomy removes the kidney, adrenal gland, and surrounding tissue. It also often removes nearby lymph nodes. It is the most common surgery for kidney cancer and can now be done through a small incision with a lapascope.
• Simple nephrectomy removes the kidney only.
• Partial nephrectomy removes the cancer in the kidney along with some tissue around it. This procedure is used for patients with smaller tumors (less than 4 cm) or in those patients in which a radical nephrectomy might hurt the other kidney.

You can survive with just a part of one kidney as long as it is still working. If the surgeon removes both kidneys or if both kidneys are not working, you will need a machine to clean your blood (dialysis) or a new kidney (kidney transplant). A transplant is possible if your cancer was found only in your kidney and a donated kidney is available.

If surgery can't remove your kidney cancer, your doctor may suggest another option to help destroy the tumor.

• Cryotherapy uses extreme cold to kill the tumor.
• Radiofrequency ablation uses high-energy radio waves to "cook" the tumor.
• Arterial embolization involves inserting material into an artery that leads to the kidney. This blocks blood flow to the tumor. This procedure may be done to help shrink the tumor before surgery.

Biologic therapy for kidney cancer

This therapy uses your immune system to fight cancer by boosting, directing, or restoring your body's natural defenses. Substances for biologic therapy are made by your body or in a lab. Examples of biologic therapy for metastatic kidney cancer include interferon alpha or interleukin-2.

Targeted therapy for kidney cancer

This therapy uses drugs or other substances to find and target cancer cells without harming normal cells. One type of targeted therapy is anti-angiogenic agents. These keep blood vessels from feeding a tumor, causing it to shrink or stop growing. Another type of targeted agent is known as multikinase inhibitors or tyrosine kinase inhibitors. These oral drugs block an enzyme pathway that allows cancer cells to grow. A third type of targeted therapy is known as m-TOR inhibitors. There are two of these drugs available, one oral and one by IV. They block a pathway that allows blood vessels to help tumor cells grow. Each of these drugs has a unique place in the management of advanced kidney cancer.

Radiation therapy for kidney cancer

Often used to help with symptoms of kidney cancer or in patients who cannot have surgery, this treatment uses high-energy X-rays or other types of radiation to kill cancer cells or halt their growth. External radiation therapy sends radiation to the cancer from a machine outside the body.

Chemotherapy for kidney cancer

This therapy uses drugs to kill cancer cells or stop them from multiplying. Less effective for kidney cancer than for other types of cancer, chemotherapy is used when other types of treatment do not work well.

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