Kidney cancer treatment focuses on preserving kidney function and quality of life
By Jessica Saenz
Kidney cancer begins in the fist-sized organs that filter waste and water from your blood to produce urine. Each year in the U.S., about 50,000 people are diagnosed with this type of cancer. Unfortunately, there are no established screening procedures for the general population.
Symptoms of kidney cancer can be vague, so it's often diagnosed by accident. "A patient may undergo scans for another reason, and kidney cancer is incidentally noted," says Thai Ho, M.D., Ph.D., a Mayo Clinic oncologist specializing in genital and urinary cancers. The good news, he says, is that treatments have improved, and people whose kidney cancer is diagnosed at later stages now have more treatment options and better quality of life.
Here's what Dr. Ho wants you to know about kidney cancer treatment:
Treatments vary based on cancer stage, and kidney preservation is the goal.
After kidney cancer is diagnosed, your health care team will perform additional testing to stage your cancer, which helps them determine how to treat it. Tests may include ultrasounds, MRIs or CT scans.
Your kidney cancer treatment will depend on whether your tumor is metastatic or localized. "Metastatic kidney cancer has spread beyond the kidney — stage IV. Localized means the cancer is contained within the kidney," says Dr. Ho. "When it's localized, we can surgically remove or destroy the tumor with radiation, heat or cold therapies."
If your kidney cancer requires surgery, your care team will try to remove all cancer while leaving as much as possible of your normal kidney intact. This surgery is called a partial nephrectomy. "Our goal is to try to preserve the normal kidney function so we reduce the risk of a patient going into kidney failure later," says Dr. Ho.
Your immune system can help destroy kidney cancer.
Immunotherapy, which strengthens the body's ability to attack cancer cells, may be used to treat kidney cancer if it has spread and surgery cannot remove it all. "If the tumor is metastatic, we can unlock the power of the patient's immune system to fight cancer," says Dr. Ho.
Immunotherapy can be given through a vein. Dr. Ho says these treatments work by "turning off" the checkpoints that prevent the immune system from attacking the cancer cells. Though immunotherapy can be effective, Dr. Ho says leveraging the immune system requires caution and expertise. "We have to attack the tumor without the immune system attacking the patient's normal cells," he says.
Immunotherapy is improving, notes Dr. Ho. "We're getting better at managing the side effects and finding ways to increase the potency of the immune system. And the advantage of using the patient's immune system is that the treatment is individual to that person, and they can use it to attack their tumor over their lifetime."
Your cancer's characteristics help guide your treatment.
Kidney cancer tumors can have characteristics that make them unique from person to person, and understanding these characteristics helps your cancer care team find the best treatment. "There are probably about five or six mutations that can alter the course of treatment," says Dr. Ho. " I get input from a pathologist who looks at the patient's tumor and tells me how aggressive it is as well as the changes in the DNA of the tumor."
Based on the tumor's aggressiveness and the changes in its DNA, your care team should be able to select a drug therapy likely to work best, Dr. Ho says. If there is a potential that a patient's cancer stems from an inherited cancer syndrome, this can also be helpful information for family members. In such cases," this allows us to screen family members who might be at risk of kidney cancer, so we're not just treating the patient, we're treating family members as well," he says.
Collaborative care can improve outcomes and quality of life.
Treating kidney cancer requires collaboration from different specialists who can determine the best approach for each patient and offer aggressive treatment that preserves kidney function and quality of life. "A lot of kidney cancer patients are older and may have other diseases that interfere with some therapies. We must identify these ahead of time to develop a personalized treatment plan for each patient," says Dr. Ho.
Addressing all aspects of kidney cancer — from risk factors and hereditary mutations to individual tumor characteristics — can help ensure the best outcome.
Dr. Ho says there's plenty of room for hope. "It's difficult for patients to understand what living with kidney cancer is like. While in therapy, you can still have meaningful relationships, travel and do what you love," he says. "I've skied with some of my patients, and you would never know they're affected by kidney cancer."
Learn more about kidney cancer and find a kidney cancer clinical trial at Mayo Clinic.
Watch Dr. Ho discuss kidney cancer and treatment options in this "Mayo Clinic Minute" video:
Dr. Scott Cheney discusses different types of kidney cancers, how smoking can affect the kidneys and why treatment usually involves surgery.
A study by Mayo Clinic researchers finds that immune checkpoint inhibitors may have negative consequences in some patients, including acute kidney inflammation, known as interstitial nephritis.