Renal cell carcinoma is often a fatal condition because it tends to go unnoticed until the cancer has reached the advanced stages of disease.
On deciding how a patient should be treated, a physician will take into consideration the stage and grade of the cancer as well as the patient’s age and general health status. If the cancer is still confined to the kidney (stage I or II disease), it can usually be treated by removing part or all of the kidney.
However, in cases of cancer that has spread beyond the kidney and invaded nearby lymph nodes and surrounding tissues (stage III) or other parts of the body (stage IV), a cure may not be achievable and treatment will need to focus on slowing progression and alleviating symptoms.
Renal cell carcinoma is one of the few cancers that has a poor response to chemotherapy and the main treatment approaches to this illness include:
- Biological therapies,
The various approaches to treating this condition are described in more detail below:
- Watchful waiting and routine monitoring - In some patients, especially those with small tumors and other complications that make surgery difficult, routine monitoring and watchful waiting may be suggested as the initial management approach.
- Nephrectomy - This is the surgical procedure used to remove some or all of the kidney in order to treat stage I and stage II tumors. Before surgery, the blood supply to the kidney may be cut off using embolization (the deliberate occlusion of a blood vessel), to reduce blood loss during surgery. Surgery may also be recommended for the removal of metastatic lesions that have spread from the kidney to other parts of the body.
- Chemotherapy - Although this cancer does not respond well to chemotherapy, certain new combinations of anticancer medications are being explored in kidney cancer clinical trials.
- Immunotherapy - Immunotherpay is used to trigger an immune response that attacks cancer cells. Examples of typical immunotherapy agents that may be use include interferon alpha and aldesluekin.
- Targeted therapy - These agents target and disrupt the various necessary functions required for cancer to proliferate and spread. Seven examples of recently developed targeted therapies are sunitinib, axitinib, sorafenib, everolimus, pazopanib, bevacizumab and temsirolimus.
- Radiation therapy - Radiotherapy is also largely ineffective at curing renal cell carcinom but can be reduced to slow the disease and alleviate pain symptoms. When used in this way, the side effects of radiotherapy are often mild and include tiredness, nausea and vomiting.
Reviewed by Sally Robertson, BSc