What You Can Expect After A Diagnosis of Kidney Cancer

Usually, biopsies and radiation are not part of the plan

kidneys

A diagnosis of kidney cancer comes with a flood of questions regarding treatment, outcomes and lifestyle changes. And on top of all that come the common worries: Will the cancer spread and what happens if it does?

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Luckily, for most patients, the cancer is not likely to spread to the other kidney and you may not lose a kidney at all, says urologist Rajan Ramanathan, MD. 

How does cancer typically spread?

There are three main ways cancer spreads through the body:

  • Through the lymphatic system to nearby lymph nodes
  • Through the bloodstream, most often ending up in the adrenal glands, liver, lungs, brain and sometimes bone
  • By locality, moving to nearby organs

Because the kidneys aren’t next to each other, there is little chance that your cancer will move from one to the other.

The likelihood, however, that cancer may spread to another organ depends on size and growth rate. Tumors that are larger or fast-growing are more apt to spread to other parts of the body, Dr. Ramanathan says. Early diagnosis also is a key factor in preventing cancer in the kidney from spreading.

Kidney cancer management

Kidney cancer management falls into two categories:

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  • Active surveillance — If your doctor thinks the tumor is benign or if surgery is risky because of advanced age or other health conditions, he or she may follow this course. During surveillance, your doctors will take a look at your tumor with imaging — most likely a CAT scan — every six to nine months. They will track the tumor to see whether it remains the same size or grows.
  •  Surgery —  The typical treatment is surgery for younger, healthier patients.

Dr. Ramanathan says he treats more than 90 percent of his patients today with the minimally invasive partial nephrectomy, in which he removes the tumor and a small portion of the surrounding kidney.

If the tumor is very large or if it looks like it will be difficult to reconstruct the kidney, your doctor may treat you with a radical nephrectomy. In this procedure, the surgeon removes the tumor, kidney and surrounding structures.

Dr. Ramanathan says he uses a radical nephrectomy for fewer patients mainly because it is more likely to damage long-term renal function and increases the risk that the patient will need dialysis.

What won’t happen

Two treatments that patients might expect when diagnosed with cancer — radiation and biopsies — are not usually part of kidney care.

Radiation doesn’t work well with most kidney cancers, Dr. Ramanathan says. Instead, surgery is the gold standard, which provides excellent results.

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He says he rarely biopsies kidney tumors. He removes most tumors successfully with minimally invasive surgery, so a biopsy isn’t necessary.

Risks are higher in rare cases

Tumors aren’t likely to spread between kidneys. But in certain rare cases, you may get cancer in both.

Dr. Ramanathan says cancer can appear for the first time in a second kidney. This also happens if you are at high risk because you have one of the following conditions:

  • Von Hippel-Lindau syndrome
  • Birt-Hogg-Dubé syndrome

Both are genetic conditions that increase the risk of tumors growing in both kidneys at some point.

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