Diagnosing Localized Kidney Cancer

Localized kidney cancer often does not cause symptoms. In fact, kidney masses are often found incidentally during an ultrasound or CT Scan performed for something else. These masses can either be cancerous or benign. The larger the mass (e.g. >4cm.), the more likely it is to be kidney cancer. However it is very hard to do a biopsy of the kidney and therefore the mass is usually surgically removed in order to obtain a diagnosis. 

Treatment Options

Choosing which treatment option is best for you can sometimes be a difficult one. We certainly recommend you ask as many questions as you need to feel comfortable about your choice, and our physicians are dedicated to being available to you to help make your decision. Never let yourself feel rushed and choose a place that offers state-of-the-art care that will continue to support you even after your treatment.

At Marin General Hospital, we are dedicated to providing an academic center level of surgical expertise with the personalized touch of a community hospital, all in your backyard. Not only are we committed to scheduling your procedure in a timely manner that works with your schedule, but our physicians and patient navigators are always just a phone call away from the time you walk into the hospital to the time of discharge to the day you come in for your follow-up appointment.

Active Surveillance

One option for some patients with kidney tumors that are less than 3cm is to watch the tumor to see if it grows. If it grows fast enough or gets larger than 4 cm − a little over 1½ inches – it is removed. This approach is most often used in elderly or frail patients as it avoids the risks of treatment. Often, a biopsy is done before deciding to watch the tumor to see if the growth is really cancer.

Surgical Treatments for Localized Kidney Cancer: Radical or Partial Nephrectomy

During a radical nephrectomy, the surgeon removes the kidney and surrounding tissue, often including the adrenal gland and nearby lymph nodes. A partial nephrectomy removes only the tumor and a small amount of surrounding tissue but leaves part of the affected kidney intact. Both radical and partial nephrectomies can be performed through open surgery or using the da Vinci® robotic system. Read More about the advantages of using robotic surgery for treatment of urologic conditions at Marin General Hospital.

It is important for you to know exactly what to expect before, during and after partial or radical nephrectomy.  Please review the following documents that were developed by our surgeons for more details regarding surgery:

Cryotherapy or Radiofrequency ablation

Surgery is the main treatment for most kidney cancers that can be removed. However, in some cases, other less invasive approaches can be used such as cryotherapy or radiofrequency ablation (RFA). Cryotherapy is a method of killing cancer cells by freezing them whereas RFA uses high energy radio waves to heat and kill the tumor.

Systemic Therapies for Cancer that has spread beyond the Kidney (Metastasized)

In cases where the cancer has spread beyond the kidney, systemic therapies that treat the whole body are usually required. The medical oncologists at Marin General  are able to offer patients  the most advanced therapies available.

Targeted Therapy

Targeted therapies for advanced kidney cancer involve oral medications that are taken by the patient at home. The targeted drugs work differently than standard chemotherapy and often have different (and less severe) side effects. Several targeted drugs have been approved by the FDA in the past 10 years for the treatment of kidney cancer that has spread beyond the kidney. These drugs block the growth of new blood vessels that nourish tumor cells and other proteins inside the cancer cells that are needed for the cells to grow and survive. These drugs often shrink or slow the growth of cancer, but cannot completely eradicate cancer from the body.

Immunotherapy (“Biologic” therapy)

The goal of immunotherapy is to boost the body’s immune system to help fight off or destroy cancer cells. The main immunotherapy drugs used in kidney cancer are man-made versions of natural proteins that activate the immune system. The drugs used most often are interleukin-2 (IL-2) and interferon-alpha. Both cytokines can cause kidney cancers to shrink in a small percentage of patients, but because the side effects can be severe, they are usually reserved for patients with cancers that are resistant to targeted therapies.