Kidney Cancer Treatment

Surgical treatment of kidney cancer can take one of three forms:

• Partial nephrectomy: Removal of the cancerous tissue from the kidney while preserving the healthy remainder of the kidney. Your urologist will discuss with you the risks and potential benefits of partial nephrectomy. Together, you will determine if this surgery is right for you. Northwestern Medicine surgeons are specialists in both open and minimally invasive partial nephrectomy using highly advanced robotic equipment for better precision.
• Radical nephrectomy: For larger tumors or when partial nephrectomy is not feasible, this surgery removes the entire diseased kidney, tissues surrounding the kidney and a portion of the tube that connects the kidney to the bladder.
• Ablation: This technique destroys cancerous tissue without removing it, either by freezing it or applying high heat through a special device.

A person can live with part of one working kidney, but if both kidneys are removed or not working, the person will need dialysis (a procedure to clean the blood using a machine outside of the body) or a kidney transplant (replacement with a healthy donated kidney). A kidney transplant may be done when the disease is in the kidney only and a donated kidney can be found. If the patient has to wait for a donated kidney, other treatment is given as needed.

When surgery to remove the cancer is not possible, a treatment called arterial embolization may be used to shrink the tumor. A small incision is made and a catheter (thin tube) is inserted into the main blood vessel that flows to the kidney. Small pieces of a special gelatin sponge are injected through the catheter into the blood vessel. The sponges block the blood flow to the kidney and prevent the cancer cells from getting oxygen and other substances they need to grow.

After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.

Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:

• External radiation therapy uses a machine outside the body to send radiation toward the cancer.
• Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat renal cell cancer, and may also be used as palliative therapy to relieve symptoms and improve quality of life.

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy. The following types of biologic therapy are being used or studied in the treatment of renal cell cancer:

• Nivolumab: Nivolumab is a monoclonal antibody that boosts the body’s immune response against renal cell cancer cells.
• Interferon: Interferon affects the division of cancer cells and can slow tumor growth.
• Interleukin-2 (IL-2): IL-2 boosts the growth and activity of many immune cells, especially lymphocytes (a type of white blood cell). Lymphocytes can attack and kill cancer cells.

Targeted therapy uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Targeted therapy with antiangiogenic agents are used to treat advanced renal cell cancer. Antiangiogenic agents keep blood vessels from forming in a tumor, causing the tumor to starve and stop growing or to shrink. Monoclonal antibodies and kinase inhibitors are two types of antiangiogenic agents used to treat renal cell cancer.

Monoclonal antibody therapy uses antibodies made in the laboratory, from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins or radioactive material directly to cancer cells. Monoclonal antibodies used to treat renal cell cancer attach to and block substances that cause new blood vessels to form in tumors.

Kinase inhibitors stop cells from dividing and may prevent the growth of new blood vessels that tumors need to grow. An mTOR inhibitor is a type of kinase inhibitor. Everolimus and temsirolimus are mTOR inhibitors used to treat advanced renal cell cancer.

We are committed to advancing the understanding and treatment of disease. Our physicians offer leading-edge treatments, such as immunotherapy and cancer-targeted therapies, through clinical trials.

• Immunotherapy is a treatment that increases the ability of your own immune system to fight cancer. Substances made by your body or made in a laboratory are used to boost, direct or restore your body's natural defenses against cancer.
• Targeted therapy uses medications or other substances to identify and attack specific cancer cells without harming healthy cells.
  • Targeted therapy using antiangiogenic agents can be used to treat advanced kidney cancer. Antiangiogenic agents keep blood vessels from forming in a tumor, causing the tumor to stop growing or shrink. Monoclonal antibodies and kinase inhibitors are two types of antiangiogenic agents used to treat kidney cancer.
  • Kinase inhibitors stop cells from dividing and may prevent the growth of new blood vessels that tumors need to grow. An mTOR inhibitor is a type of kinase inhibitor. Everolimus and temsirolimus are mTOR inhibitors used to treat advanced kidney cancer.
• Embolization uses particles to block the flow of blood to a tumor or abnormal area of tissue, causing it to stop growing or shrink.

Browse our Clinical Trials to learn more about ongoing trials at the Polsky Institute.