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People with kidney cancer have unique needs. Our specialized kidney cancer team at Columbia Cancer works with you to develop a personal care plan to give you the best care possible.
We prioritize minimally invasive surgery and partial nephrectomy (kidney removal) as much as possible. Studies show that people do better when healthy parts of the affected kidney stays in your body.
If you have more advanced disease, your medical oncologist will make a treatment plan based on best practices and your priorities. You might be eligible for radiation therapy or for a clinical trial that evaluates promising new treatments.
Surgery and Procedures
If kidney cancer hasn’t spread to other parts of your body, you may be a candidate for an operation to remove the tumor or your whole kidney.
Your surgeon may remove your tumor and a small amount of surrounding tissue if you have a small tumor. They leave the rest of your kidney in your body. This is called a partial nephrectomy. When your surgeon takes out your entire kidney, that’s a radical nephrectomy.
These operations, especially minimally invasive operations, can be challenging. Our surgeons have been at the forefront of making better surgical techniques for kidney cancer for decades. We work with colleagues in other areas of NewYork-Presbyterian Hospital on complex surgeries, such as with heart surgeons if your tumor is close to vital parts of your heart.
Minimally Invasive Surgery
We can often take out all or part of your kidney using minimally invasive surgery, including robotic and laparoscopic techniques. Your surgeon will make three or four small incisions to place surgical instruments and a camera to guide the operation. Minimally invasive surgery can result in much less pain, smaller scars, a shorter hospital stay, and more rapid recovery than traditional open surgery.
Traditional Open Surgery
We can also remove the tumor or your kidney through traditional surgery. This is called an open radical nephrectomy or partial nephrectomy. During this operation, your surgeon takes out the tumor or your entire affected kidney through a large incision in your flank. Open surgery may be necessary depending on the size and location of the tumor.
Some patients with very small tumors located in certain parts of the kidney may be candidates to have a percutaneous ablation. This procedure is performed by an interventional radiologist. A probe is placed through the skin and into the tumor, and then the tumor is either frozen (cryoablation) or heated (microwave ablation). These procedures work to kill the tumor cells without damaging the surrounding kidney.
Many patients with small kidney tumors can be managed with careful monitoring only. For this treatment, you would come see your doctor one or two times per year and have imaging of your kidneys using ultrasound, CT scan, or MRI.
Late-stage kidney cancer—cancer that has spread to other parts of the body—is usually resistant to regular chemotherapy and radiation.
Immunotherapy drugs use your own immune system to fight cancer. For kidney cancer, these are often combined with targeted therapies (described in the section below).
Checkpoint inhibitors are a type of immunotherapy that releases the brake on the immune system. These drugs stop the interaction of two molecules, called PD-1 and PD-L1, on the surface of cancer cells. This blocks the “off switch” of the immune system, allowing the body’s immune cells, called T-cells, to recognize and attack tumor cells.
There are several checkpoint inhibitor drugs that are FDA-approved for the treatment of kidney cancer. We also offer clinical trials investigating new checkpoint inhibitors for kidney cancer. You should talk to your doctor about any potential options.
Targeted therapy is a newer treatment that targets genes, proteins, or the “tissue environment” that allow a tumor to grow and spread. You may be able to have targeted therapy alone or in combination with immunotherapy.
Studies have shown these drugs can halt cancer growth or reduce the size of tumors. This controls the cancer and improves your quality of life. These drugs have specific side effects that require close monitoring. Your medical oncologists at Columbia Cancer have years of experience using these drugs in personalized care.
Tyrosine kinase inhibitors are drugs that enter cancer cells to block cell growth signals that happen through the vascular endothelial growth factor, or VEGF, pathway. This pathway causes new blood vessels to grow. This is called angiogenesis. The drugs stop angiogenesis, starving the tumor.
Bevacizumab is an IV anti-angiogenesis drug that can slow tumor growth. You sometimes get this drug alongside immunotherapy.
mTOR inhibitors target a protein that causes kidney cancer cells to grow.
Radiation therapy causes cancer cells to break or die by targeting the DNA with high-energy particles, such as X-rays, gamma rays, electron beams, or protons. Radiation oncology specialists direct these particles to the tumor site from outside of your body to precisely target cancer cells, often sparing nearby tissue.
Radiation therapy for kidney cancer is rarely recommended. You should talk with your doctor and care team about what course of treatment is right for you.