What is the best treatment for kidney cancer?
What is the best treatment for kidney cancer?
What is stage 3 renal cancer?
Is Stage 3 kidney cancer curable?
Is Stage 4 kidney cancer a terminal?
Can you be cured from kidney cancer?
Kidney cancer
Kidney cancer is cancer that begins in the kidneys. Your kidneys are two bean-shaped organs, each about the size of your fist. They’re located behind your abdominal organs, with one kidney on each side of your spine.
In adults, renal cell carcinoma is the most common type of kidney cancer. Other less common types of kidney cancer can occur. Young children are more likely to develop a kind of kidney cancer called Wilms’ tumor.
The incidence of kidney cancer seems to be increasing. One reason for this may be the fact that imaging techniques such as computerized tomography (CT) scans are being used more often. These tests may lead to the accidental discovery of more kidney cancers. Kidney cancer is often discovered at an early stage, when the cancer is small and confined to the kidney.
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Stages I, II, or III
Stage I and II cancers are still contained within the kidney. Stage III cancers have either grown into nearby large veins or have spread to nearby lymph nodes.
These cancers are usually removed with surgery when possible. There are two common approaches:
- Partial nephrectomy (removing part of the kidney). This is often the treatment of choice in tumors up to 7 cm (a little less than 3 inches) if it can be done.
- Radical nephrectomy (removing the entire kidney).
The lymph nodes near the kidney may be removed as well, especially if they are enlarged.
If the cancer has grown into nearby veins (as with some stage III cancers), your surgeon may need to cut open these veins to remove all of the cancer. This may require putting you on bypass (a heart-lung machine), so that the heart can be stopped for a short time to remove the cancer from the large vein leading to the heart.
After surgery, some people at high risk of the cancer returning might be helped by getting the targeted drug sunitinib (Sutent) for about a year, which can help lower this risk. Treatment given after surgery is known as adjuvant therapy. Sunitinib can have side effects, so it’s important to talk to your doctor about the benefits and risks. Clinical trials are also looking at other adjuvant treatments for kidney cancer. Ask your doctor if you are interested in learning more about adjuvant therapies being studied in clinical trials.
If you cannot have kidney surgery because of other serious medical problems, you might benefit from other local treatments such as cryotherapy, radiofrequency ablation, or arterial embolization. Radiation therapy may be another option. These treatments are generally only given when surgery can’t be done. Although these types of treatments can have similar outcomes to surgery as far as the chances of the cancer spreading to other parts of the body, some studies show the cancer might be more likely to come back in the same area.
Active surveillance is another option for some people with small kidney tumors. With active surveillance, the tumor is watched closely (with CTs or ultrasounds) and only treated if it grows.
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Stage IV
Stage IV kidney cancer means the cancer has grown outside of the kidney or has spread to other parts of the body such as distant lymph nodes or other organs.
Treatment of stage IV kidney cancer depends on how extensive the cancer is and on the person’s general health. In some cases, surgery may still be a part of treatment.
In rare cases where the main tumor appears to be removable and the cancer has only spread to one other area (such as to one or a few spots in the lungs), surgery to remove both the kidney and the metastasis (the outside area of cancer spread) may be an option if a person is in good enough health. Otherwise, treatment with immunotherapy, one of the targeted therapies, or a combination of the two is usually the first option.
If the main tumor is removable but the cancer has spread extensively elsewhere, removing the kidney may still be helpful. This would likely be followed by systemic therapy, which might consist of one of the targeted therapies, immunotherapy, or a combination of the two. It’s not clear if any one of these therapies or any particular sequence is better than another, although temsirolimus appears to be most helpful for people with kidney cancers that have a poorer prognosis (outlook).
For cancers that can’t be removed surgically (because of the extent of the tumor or the person’s health), first-line treatment is likely to be one of the targeted therapies, immunotherapy, or a combination.
Because advanced kidney cancer is very hard to cure, clinical trials of new combinations of targeted therapies, immunotherapy, or other new treatments are also options.
For some people, palliative treatments such as embolization or radiation therapy may be the best option. A special form of radiation therapy called stereotactic radiosurgery can be very effective in treating single brain metastases. Surgery or radiation therapy can also be used to help reduce pain or other symptoms of metastases in some other places, such as the bones. You can read more about palliative treatment for cancer in Palliative (Supportive) Care or in Advanced Cancer, Metastatic Cancer, and Bone Metastasis.
Having your pain controlled can help you maintain your quality of life. Medicines to relieve pain do not interfere with your other treatments, and controlling pain will often help you be more active and continue your daily activities.
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What is the best treatment for kidney cancer?
The treatment for kidney cancer depends on the size of the cancer and whether it has spread to other parts of the body.
The main treatments are:
- surgery to remove part or all of the affected kidney this is the main treatment for most people
- ablation therapies where the cancer cells are destroyed by freezing or heating them
- targeted therapies (also called biological therapies) medicines that help stop the cancer growing or spreading
- embolisation a procedure to cut off the blood supply to the cancer
- radiotherapy where high-energy radiation is used to target cancer cells and relieve symptoms
Cancer that has not spread out of the kidney can usually be cured by having an operation to remove some or all of the kidney. Sometimes cryotherapy or radiofrequency ablation may be used instead.
A complete cure may not be possible if the cancer has spread, but it may be possible to slow its progression and treat any symptoms with surgery, medicine and/or radiotherapy.
Surgery
There are 2 main types of surgery for kidney cancer:
- an operation to remove the part of the kidney containing the cancer called a partial nephrectomy
- an operation to remove the entire kidney called a radical nephrectomy
A partial nephrectomy is usually done if the cancer is small and easy for the surgeon to get to. A radical nephrectomy may be necessary for larger cancers or if the cancer has spread beyond the kidney.
It’s possible to live a normal life with only 1 kidney. Your other kidney can usually make up for the kidney that was removed.
Surgery for kidney cancer can be done in 2 ways:
- through a single large cut in the tummy or back – known as “open” surgery
- using surgical tools inserted through smaller cuts known as laparoscopic or “keyhole” surgery
Keyhole surgery tends to have a faster recovery time, but it can only be done by trained surgeons and it is not always suitable. Talk to the surgeon about the pros and cons of each method.
Ablation therapies
Ablation therapies are treatments that destroy cancer cells by either:
- freezing them (cryotherapy)
- heating them (radiofrequency ablation)
Either technique may be recommended in certain circumstances (for example, to ensure your kidney keeps working), or if the tumour is small. Both treatments are only available in specialist centres, so you may need to travel to another hospital to have it done.
Radiofrequency ablation is done by inserting a needle-like probe through your skin, so no large cuts are needed.
Cryotherapy is done using needles inserted into the tumour. This can be done through your skin (percutaneous cryotherapy) or through a small cut (laparoscopic cryotherapy).
Side effects of ablation therapies can include bleeding around the kidney and damage to the tube that carries pee from the kidney to the bladder (the ureter).
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Targeted therapies
If your cancer is advanced, you may be offered targeted therapies (also called biological therapies). These are medicines, usually taken once or twice a day, that help stop the cancer growing and spreading.
There are many different biological therapies, including:
- sunitinib
- pazopanib
- cabozantinib
- axitinib
- everolimus
- bevacizumab and interferon
- nivolumab
- tivozanib
Some people with advanced kidney cancer may be offered a medicine called lenvatinib, to take along with everolimus.
Side effects
Sunitinib, pazopanib, cabozantinib, axitinib and tivozanib are all taken as tablets. Possible side effects include:
- feeling and being sick
- indigestion
- diarrhoea
- high blood pressure (hypertension)
- a sore mouth
- loss of appetite and weight loss
- tiredness
- infertility
Nivolumab is given by a drip directly into a vein every 2 weeks. It works by helping your body’s immune system destroy the cancer cells. Side effects are uncommon, but can include:
- a rash
- diarrhoea
- a cough and shortness of breath
- tiredness
Embolisation
Embolisation is a procedure to block the blood supply to the tumour, causing it to shrink.
It’s sometimes recommended if you have advanced kidney cancer and you’re not in good enough health to have surgery to remove the affected kidney.
During embolisation, the surgeon will insert a small tube called a catheter into a blood vessel in your groin and then guide it to the blood vessel supplying the tumour.
A substance will be injected through the catheter to block the blood vessel.
Radiotherapy
Radiotherapy is a treatment where radiation is used to target or destroy cancerous cells. It cannot usually cure kidney cancer, but it can slow down its spread and help control your symptoms.
It may be recommended if you have advanced kidney cancer that has spread to other parts of the body, such as your bones or brain.
Radiotherapy uses a large machine to carefully direct beams of radiation at the cancerous cells. It’s often done for a few minutes every day, over a few weeks.
Side effects of radiotherapy can include:
- tiredness
- feeling and being sick
- diarrhoea
- reddening of the skin in the treatment area
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What is stage 3 renal cancer?
Kidney cancer is also known as renal cell carcinoma. In stage 3 kidney tumor has grown beyond the kidney and may now extend into the adrenal glands or nearby tissues or organs. Though stage III renal cell cancers vary in size, they share a defining feature of spread of the cancer to a single lymph node. The cancer may also have spread to nearby blood vessels including the renal veins or vena cava but has not spread to distant sites in the body.
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Is Stage 3 kidney cancer curable?
The five-year survival rate for stage 3 kidney cancer is 53 percent. That means that out of 100 people, 53 people diagnosed with stage 3 kidney cancer will still be living five or more years after being diagnosed. Treatment for stage III renal cell cancer typically involves surgery to remove the affected kidney, affected lymph nodes, and any other cancer that may have spread near the kidney plus the attached adrenal gland and fatty tissue. This surgery is known as a radical nephrectomy. Results from clinical trials have shown that 38-70% of patients with stage III renal cell cancer are curable with surgery alone. However, patients with stage III disease have cancer that has spread outside the kidney, which places them at higher risk for cancer recurrence.
Is Stage 4 kidney cancer a terminal?
When patients are diagnosed with stage 4 kidney cancer, they have only a 1-in-10 chance of survival. Here, the odds are substantially higher. Stage 4 is the final mesothelioma stage and considered terminal. The average life expectancy for stage 4 mesothelioma is less than 12 months.
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Can you be cured from kidney cancer?
When kidney cancer detected early, kidney cancer is curable most of the time. Even in more advanced stages, new therapies and procedures have led to much improved, overall cure rates. The treatment for kidney cancer depends on the size of the cancer and whether it has spread to other parts of the body.
How is Stage 3 kidney cancer treated?
Treatment for stage III renal cell cancer typically involves surgery to remove the affected kidney, affected lymph nodes, and any other cancer that may have spread near the kidney plus the attached adrenal gland and fatty tissue. This surgery is known as a radical nephrectomy.
Does kidney cancer spread fast?
kidney cancer is a fast-growing cancer and often spreads to the lungs and surrounding organs. The average growth rate of kidney tumors in the study was 2.13 cm/year (SD 1.45 cm/year, range 0.2–6.5 cm/year).
How long do you have to live if you have kidney cancer?
The five-year survival rate for stage 1 kidney cancer is 81 percent. That means that out of 100 people, 81people diagnosed with stage 1 kidney cancer are still alive five years after their original diagnosis. Around 7 in 10 people live at least a year after diagnosis and around 5 in 10 live at least 10 years.
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What is the survival rate for stage 1 kidney cancer?
Survival depends on many different factors. So no one can tell you exactly how long you will live. It depends on your:
- type and stage of cancer
- level of fitness
- previous treatment
These are general statistics based on large groups of patients. Remember, they can’t tell you what will happen in your individual case. The five-year survival rate for stage 1 kidney cancer is 81 percent. That means that out of 100 people, 81people diagnosed with stage 1 kidney cancer are still alive five years after their original diagnosis.
Can stage 1 kidney cancer come back?
The chance of the cancer returning is highest soon after treatment. The longer away from the treatment, the more chance the cancer will not recur. After nephrectomy, the incidence of RCC recurrence has been reported to be 7% with a median time of 38 months for T1 tumors, 26% with a median time of 32 months for T2 disease, and 39% with a median time to recurrence at 17 months for T3 tumors.
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