How Renal Cell Carcinoma Is Treated

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Renal cell carcinoma is the most common type of kidney cancer, accounting for 90% of all cases. In renal cell carcinoma, cancerous cells develop in very small tubes in the kidneys that help filter and clean the blood.

If you develop kidney cancer, there are many therapies and procedures available to treat your disease. This article discusses these options, which depend on the size of your tumor, your overall health, how advanced your cancer is, and other factors.

Doctor performing surgery and assistant hands out instruments inside modern operating room

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Surgeries and Other Procedures

There are different types of procedures available to treat renal cell carcinoma, and they are performed in different ways.

Surgery

Surgery is the gold-standard method for treating most kidney cancers.

Some surgeons use laparoscopic and robotic approaches, which require smaller incisions and usually result in a shorter recovery period.

Possible risks of surgery include:

  • Bleeding
  • Infection
  • Blood clots
  • Damage to organs and blood vessels
  • Unwanted air in the chest cavity
  • Hernias
  • Urine leakage into the abdomen
  • Kidney failure

The two major types of surgeries for kidney cancer are:

  • Partial nephrectomy: With a partial nephrectomy, surgeons remove the cancer along with some of the surrounding kidney tissue. This procedure helps preserve kidney function and lowers your chances of developing kidney disease down the road. It’s an option for smaller tumors.
  • Radical nephrectomy: A radical nephrectomy typically involves removing the entire kidney, nearby lymph nodes, the adrenal gland, and the fatty tissue around the kidney. You can still live with one functioning kidney. This procedure is usually an option for treating large tumors when there’s not a lot of healthy tissue left. If the tumor grows inside the renal vein and affects the heart, you may need to undergo certain heart procedures, so surgeons can safely remove it.

Other Procedures

If surgery isn’t an option for renal cell carcinoma, healthcare providers might recommend:

  • Cryotherapy (cryoablation): With this technique, a needle is inserted into the tumor, and extremely cold gases are passed through it to destroy the tumor. Possible risks include damage to the kidneys or other organs, as well as bleeding.
  • Radiofrequency ablation (RFA): RFA uses high-energy radio waves to heat and kill tumors. RFA is usually done as an outpatient procedure. Side effects are rare, but as with cryotherapy, they include bleeding and damage to organs.
  • Arterial embolization: With this procedure, a small incision is made, and a catheter is inserted into the main blood vessel that flows to the kidney. Pieces of a special sponge are injected to block the blood flow to the kidney and prevent cancer cells from receiving the substances they need in order to grow.

Radiation Therapy

Radiation therapy uses high-energy X-rays or other particles to destroy cancer cells. It’s rarely used as a primary treatment for kidney cancer, but it’s sometimes recommended if a patient can’t have surgery and the cancer has spread.

Radiation can also be used as a palliative treatment to help relieve symptoms, such as bone pain. Side effects of radiation may include skin irritation, nausea, diarrhea, or tiredness.

Active Surveillance for Renal Cell Carcinoma

Sometimes, healthcare providers will suggest a plan called active surveillance for kidney cancer. This means they will closely watch the tumor and perform regular diagnostic testing. You won't receive any treatment unless the cancer progresses to the point that you need treatment. Active surveillance may be an option for people with kidney cancer who are older, have smaller tumors, or have another serious medical condition.

Prescriptions

There are several types of medical therapies used to treat renal cell carcinoma. These may be given one at a time or in combination with each other. They may also be used along with surgery or another procedure.

Targeted Treatments

Targeted therapies focus on certain abnormalities in cancer cells.

Most of the targeted treatments used for kidney cancer work by blocking the growth of new blood vessels that fuel cancer or proteins in cancer cells. Some targeted treatments do both. They can be given as a pill or intravenously.

Side effects from targeted therapies depend on the drug used but may include diarrhea, fatigue, nausea, vomiting, and others.

Renal cell carcinoma has different subtypes, with clear cell being the most common one.

Some targeted drugs used for the clear cell subtype of renal cell cancer include:

  • Cabometyx (cabozantinib)
  • Lenvima (lenvatinib)
  • Avastin (bevacizumab)
  • Inlyta (axitinib)
  • Fotivda (tivozanib)
  • Welireg (belzutifan)
  • Torisel (temsirolimus)
  • Afinitor (everolimus)
  • Sutent (sunitinib)
  • Nexavar (sorafenib)

Initial treatment options for the clear cell subtype of renal cell carcinoma are combinations of targeted agents and immunotherapy, including:

  • Nivolumab plus ipilimumab
  • Pembrolizumab plus axitinib 
  • Nivolumab plus cabozantinib 

Immunotherapy

Immunotherapy uses your body’s own immune system to fight cancer. These drugs are usually given as an injection or infusion.

Side effects will depend on the type of immunotherapy, but some common reactions to these drugs include flulike symptoms, skin problems, diarrhea, and weight changes. Certain immunotherapies can cause more serious side effects.

The two types of immunotherapies used for kidney cancer are:

  • Checkpoint inhibitors: These medicines work by targeting checkpoint proteins, which helps the immune system fight cancer cells. Some checkpoint inhibitors include Keytruda (pembrolizumab), Opdivo (nivolumab), Bavencio (avelumab), and Yervoy (ipilimumab).
  • Cytokines: These medicines are used in a small number of people with kidney cancer. They work by boosting the body’s immune system response. Examples of cytokines include Proleukin (interleukin-2 or IL-2) and interferon-alpha.

Chemotherapy

Chemotherapy involves using drugs to kill cancer cells in the body.

Generally, kidney cancer cells don’t respond well to chemo, which is why it’s not often a standard treatment. It’s usually an option after targeted treatments and immunotherapy drugs have already been tried.

However, some types of chemo, such as Platinol (cisplatin), Fluoroplex (5-fluorouracil or 5-FU), and Gemzar (gemcitabine), have been found to help a small number of patients with kidney cancer.

Clinical Trials for Renal Cell Carcinoma

Some people with kidney cancer may be eligible to participate in a clinical trial. These research studies might give you the chance to receive a new treatment that's not yet available to the general public. Your oncologist (physician specializing in cancer care) or other healthcare provider can provide more information about clinical trials and help you decide if it's a good option.

Complementary and Alternative Medicine

There are no alternative methods that have been shown to cure kidney cancer, but some approaches may help ease the side effects of treatment or the cancer itself.

Common complementary and alternative medicine (CAM) therapies may include:

  • Massage
  • Meditation
  • Yoga
  • Exercise
  • Music therapy
  • Acupuncture
  • Art therapy

Additionally, patients with advanced kidney cancer may benefit from palliative care, an approach that uses different strategies to lessen pain and make you more comfortable. Talk to your oncologist or other healthcare provider if you're interested in learning more about these treatments.

Home Remedies and Lifestyle

While there isn’t a specific diet or lifestyle plan for people living with kidney cancer, taking care of yourself may help you feel better.

Here are some general tips:

  • Eat plenty of fruits and vegetables: Try to include these foods in every meal.
  • Exercise: Aim for at least 30 minutes every day.
  • Avoid alcohol: If you do decide to drink, do so in moderation.
  • Don’t smoke: Staying away from tobacco will lower your risk of having a cancer recurrence.
  • Keep your medical appointments: Stay up to date on all your health screenings.

Summary

Renal cell carcinoma can be treated using a variety of methods, including surgery, radiation, chemotherapy, immunotherapy, and other targeted drug options. Your chosen treatment option will depend on several factors, including your overall health, how advanced your disease is, and the size of your tumor. Adopting new habits and making certain lifestyle changes can also help relieve pain, improve symptoms, and make you feel better.

A Word From Verywell

A cancer diagnosis can be scary. Working with a healthcare provider to understand all of your treatment options can help. It's also beneficial to surround yourself with a support network throughout your journey. You might want to consider joining an online or in-person support group to connect with people who have also been diagnosed with renal cell carcinoma.

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10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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