Renal Cell Carcinoma Treatment 1 surgery
Surgery is the initial treatment commonly used in with renal cell carcinoma patients. The surgery that either removes parts of the kidney, or all of the kidney is called nephrectomy. The type of surgery your doctor recommends will be based on the tumor size, location and stage and personal preferences. Surgery carries a risk of bleeding and infection, the surgical oncologist may choose to remove the entire kidney (radical nephrectomy) or just the portion affected by cancer (partial nephrectomy). There are several types of nephrectomy performed in renal cell carcinoma patients:
A. Open nephrectomy is a type of surgery where part of the kidney or the entire kidney is removed through a 10 to 12 inches flank or abdominal incision. Sometimes, during this procedure the surgeon has to remove a rib to have a better access to the kidney.
There are three types of open nepherectomies:
1. Radical nephrectomy. A surgical procedure to remove the entire kidney, the adrenal gland, surrounding tissue, and usually, nearby lymph nodes (regional lymphadenectomy).
2. Partial nephrectomy. During this type of surgery, the surgeon removes only part of the kidney where usually the tumor is located. This type of surgery is performed in patients that (1) have only one kidney, (2) the cancer is present in both kidneys, or (3) the tumor is small.
3. Simple nephrectomy. A surgical procedure to remove the kidney only without other additional tissues or structures.
The most common side effects of nephrectomy are:
- Bleeding during and after surgery.
- Wound infections.
- Damages caused to nearby organs or blood vessels during surgery (such as the spleen, pancreas, aorta, vena cava, large or small bowel)
- Kidney failure
B. Laparoscopic nephrectomy, also known as “keyhole” surgery, is a type of surgery where part of the kidneys or the entire kidney is removed through small incisions. The advantages offered by this surgery are: a fast recovery, less postoperative pain, and less blood loss. The surgery, where the incisions are made in the cavity that surrounds the kidneys, is called retroperitoneoscopic nephrectomy. A laparoscopic nephrectomy can be performed in patients that developed small tumors confined to the kidney.
A person can live with part of 1 working kidney, but if both kidneys are removed or not working, the person will need dialysis (a procedure to clean the blood using a machine outside of the body) or a kidney transplant (replacement with a healthy donated kidney). A kidney transplant may be done when the disease is in the kidney only and a donated kidney can be found. If the patient has to wait for a donated kidney, other treatment is given as needed.
Treatments when surgery isn’t possible
For some people, surgery may be too risky. These people have other options for treating their kidney cancers, including:
A. Blocking blood flow to the tumor (Arterial Embolization)
In this procedure, a special material is injected into the main blood vessel leading to the kidney. By clogging this vessel, the tumor is deprived of oxygen and other nutrients. Arterial embolization also may be used before an operation or to relieve pain and bleeding when an operation isn’t possible. Side effects may include temporary nausea, vomiting or pain.
The most common side effects of the arterial embolization include:
- Pack pain
- Fever
- Nausea and vomiting
B. Energy Ablative Techniques
Another minimally invasive surgery technique uses either heat or cold energy to treat tumors in place, without having to remove the kidney.
Cryoablation freezes the tumor to -150 degrees Centigrade with a long, thin probe inserted into the tumor. Intensive follow-up with X-rays or other imaging procedures is required to ensure that the tumor has been destroyed. Cryoablation is ideal for smaller kidney tumors in patients considered at high risk for surgery.
Radiofrequency Ablation (RFA) is similar to cryoablation, but heat is used to kill the tumor instead of cold. RFA does have good potential for appropriate patients.
Another Kidney Cancer Surgery Information Page: ACS:Surgery
