Surgery is the most common treatment for kidney cancer. The goal is to remove the tumor(s). It is also to keep as much kidney function as possible. The type of surgery depends on the stage of the cancer. The impact on kidney function varies. It depends on the stage, the type of surgery, and overall health. It is possible to function with one partial or full kidney.
If both kidneys need to be removed dialysis will be needed. Dialysis supports the function of the kidneys. It filters wastes and excess fluids from the blood. Dialysis is a permanent treatment unless a kidney transplant is an option. A healthy kidney can be donated from a relative, friend, or organ donor.
Surgery for Early Stage and Advanced Kidney Cancer
If the tumor is small and has not spread beyond the kidney, a partial nephrectomy may be done. The tumor is cut out along with a border of healthy tissue. This is to make sure all the cancer is removed. This procedure preserves kidney function.
This surgery removes the kidney. It can be done for both early stage and advanced cancers. The adrenal gland, blood vessels, and some fat and connective tissue are also removed. If the tumor is in the lower kidney, it may be possible to save the adrenal gland. A radical nephrectomy results in the loss of one functioning kidney. If the remaining kidney is healthy, it can do the work of both.
Cancer can spread to the lymph nodes in areas outside of the kidney. Once there, it can travel to other parts of the body. During the surgery, a lymph node dissection may be done. This means lymph nodes which may have cancer will be taken and tested.
Both types of nephrectomies can be done as:
Both types of nephrectomies can be done as:
- Open surgery—A cut is made in the belly or back. This exposes the organs that need to be removed. They will be removed through the cut.
- Laparoscopic surgery —Tubes are inserted into small cuts. Lights, a camera, and small tools can be used through the tube. Pictures from the laparoscope are seen on a monitor. Healing and recovery time for this surgery is often faster than for open surgery
- Robot-assisted surgery —Robotic arms are inserted through small cuts. This allows for greater range of movement than a doctor's hand.
Other Surgery for Kidney Cancer
Sometimes a radical nephrectomy cannot be done. Other surgeries may be considered instead. They may be done to ease symptoms of tumors in the kidney. Or, they may treat cancer that has spread to other parts of the body. They may include:
- Radiofrequency ablation —A CT-guided probe is inserted through the skin to the tumor site. The probe emits high energy radio waves which kill cancer cells with high heat.
- Cryosurgery—An ultrasound-guided probe is inserted through the skin to the tumor site. Cancer cells are killed by freezing them.
- Arterial embolization—A catheter (small tube) is put through an artery in the thigh to the kidney's main artery. A substance is injected into the renal artery. The substance will block blood flow to both the tumor and kidney.
References
Drangsholt S, Huang WC. Current trends in renal surgery and observation for small renal masses. Urol Clin North Am. 2017;44(2):169-178.
General information about renal cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/kidney/patient/kidney-treatment-pdq. Accessed April 25, 2022.
Kidney cancer (adult)—renal cell carcinoma. American Cancer Society website. Available at: https://www.cancer.org/cancer/kidney-cancer.html. Accessed April 25, 2022.
Renal cell carcinoma. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/renal-cell-carcinoma. Accessed April 25, 2022.
Renal cell carcinoma. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancers/renal-cell-carcinoma. Accessed April 25, 2022.