Renal cell carcinoma treatment choices by stage
The treatment options for renal cell carcinoma depend on many factors, such as the type of RCC, the tumor size, location, the general health state and age of the patient. One of the most important factors is the cancer STAGE. First, click this simplified stage form, you will need to know your cancer stage before continuing.
Stage I or stage II:
Patients with stage I and II RCC most often have their cancers surgically removed by either removes parts of the kidney or the entire kidney is called nephrectomy. Research shows that if the main tumor is removable but the cancer has spread extensively elsewhere, removing the kidney may still be helpful. Other than as part of a clinical trial, additional (adjuvant) treatments such as targeted therapy, chemotherapy, radiation therapy, or immunotherapy after surgery for stage I or stage II RCC are usually not recommended, as the benefit of additional therapy has not been proven.
Patients who are unable to tolerate kidney surgery because of other serious medical problems are often treated by experimental procedures such as cryoablation (which is the use of extreme cold to freeze and destroy cancer cells), radiofrequency ablation (which is the use of electrodes to heat and destroy cancer cells), or arterial embolization (As palliative treatment, this procedure cuts off blood supply to the tumor). With surgical treatment, the 5-year survival for stage I patients is between 88% and 100% and the 5-year survival for stage II patients is between 65% and 75%.
Stage III:
Radical nephrectomy is the most common treatment for stage III RCC. Sometimes, a patient will have an arterial embolization procedure in attempt to reduce the amount of bleeding during nephrectomy. There is no distant metastasis in stage III, however if the cancer extends into nearby veins, the surgeon may need to cut open these veins and to completely remove the cancer. The 5-year survival for stage III patients varies widely and is between 40% and 70%, depending on the local extent of the cancer.
Stage IV:
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. When one or a few metastases are present and the surgeon considers it possible to remove them without serious side effects, an aggressive surgical approach to removing the kidney tumor and these metastases may be beneficial. Unfortunately, most patients who appear to have only 1 or 2 metastases on imaging tests actually may have cancer that cannot be surgically resected. For cancers that can’t be removed surgically (because of the extent of the tumor or a person’s health), first-line treatment would likely be one of the targeted therapies or cytokine therapy, such as Sutent, IL-2, and Afinitor(everolimus) is just approved by FDA.
For some patients, palliative treatments such as embolization or radiation therapy may be the best option. 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. (How to relieve cancer pain)
Recurrent RCC
In rare cases, a patient will have a solitary site of recurrence of RCC detected several years after nephrectomy. In these exceptional cases, surgical removal of the solitary site of recurrence may be possible after extensive imaging tests have shown no other evidence of cancer spread. Otherwise, treatment with targeted therapiesor cytokine immunotherapy will be recommended. Clinical trials of new treatments are an option as well. Radiation therapy can be used to reduce symptoms of some metastases. Controlling symptoms such as pain is an important part of treatment at any stage of the disease, proper treatment of pain often helps people with cancer to be more active and continue their usual activities.
A book and an audio CD I recommend:
Health Journeys: A Meditation to Promote Successful Surgery
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