Kidney Cancer Treated with Multimodality approach. It's most often treated with surgery, targeted therapy, immunotherapy, or a combination of these treatments. Radiation therapy and chemotherapy are occasionally used.
Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. If the cancer has not spread beyond the kidneys, surgery to remove the tumor may be the only treatment needed. Surgery to remove the tumor may mean removing part or all of the kidney, as well as possibly nearby tissue and lymph nodes.
Types of surgery used for kidney cancer include the following procedures:
Radical nephrectomy. Surgery to remove the tumor, the entire kidney, and surrounding tissue is called a radical nephrectomy. If nearby tissue and surrounding lymph nodes are also affected by the disease, a radical nephrectomy and lymph node dissection is performed. During a lymph node dissection, the lymph nodes affected by the cancer are removed. If the cancer has spread to the adrenal gland or nearby blood vessels, the surgeon may remove the adrenal gland during a procedure called an adrenalectomy, as well as parts of the blood vessels. A radical nephrectomy is usually recommended to treat a large tumor when there is not much healthy tissue remaining. Sometimes the renal tumor will grow directly inside the renal vein and enter the vena cava on its way to the heart. If this happens, complex cardiovascular surgical techniques are needed.
Partial nephrectomy. A partial nephrectomy is the surgical removal of the tumor. This type of surgery preserves kidney function and lowers the risk of developing chronic kidney disease after surgery. Research has shown that partial nephrectomy is effective for T1 tumors whenever surgery is possible. Newer approaches that use a smaller surgical incision, or cut, are associated with fewer side effects and a faster recovery.
Laparoscopic and robotic surgery (minimally invasive surgery). During laparoscopic surgery, the surgeon makes several small cuts in the abdomen, rather than the one larger cut used during a traditional surgical procedure. The surgeon then inserts telescoping equipment into these small keyhole incisions to completely remove the kidney or perform a partial nephrectomy. Sometimes, the surgeon may use robotic instruments to perform the operation. This surgery may take longer but may be less painful. Laparoscopic and robotic approaches require specialized training. It is important to discuss the potential benefits and risks of these types of surgery with your surgical team and to be certain that the team has experience with the procedure.
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