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Treatment Options and Candidacy

Treatment Options and Candidacy

This section is dedicated to a broad overview of various options available for the treatment of kidney cancer/renal cell carcinoma.  Detailed descriptions and candidates most appropriate for these options will be found under each option title.

As with any surgery, these benefits cannot be guaranteed since surgery is specific to each patient, condition and procedure.  It is important to talk to your doctor about all treatment options, including the risks and benefits.  This information can help you make the best decision for your situation.

Radical Nephrectomy: This is a surgical procedure to remove the kidney, the adrenal gland and surrounding tissue, usually in addition to nearby lymph nodes.

  • Candidacy: Patients with localized kidney cancer who can tolerate general anesthesia and have good overall kidney function are generally good candidates for radical nephrectomy.

Partial Nephrectomy (Kidney-sparing): This is a surgical procedure to remove the cancer within the kidney and some of the tissue surrounding it.  A partial nephrectomy is usually performed to prevent loss of kidney function, when the other kidney is damaged or has already been removed.

  • Candidacy: Patients with localized kidney cancer who can tolerate general anesthesia, have good overall kidney function and don't require complete removal of the affected kidney are generally good candidates for a partial nephrectomy.

Laparoscopic Radical/Partial Nephrectomy: In this procedure, a surgeon uses a minimally-invasive approach to perform the same procedure that is done in an open radical nephrectomy or partial nephrectomy procedure.  A laparoscopic approach means that no large incisions are required to perform the procedure.  In the hands of a trained and experienced surgeon (link to Dr.  Ramin's bio/credentials here), the result is typically a shorter hospital stay, less post-operative pain and a faster return to normal living.

  • Candidacy: Patients with localized kidney cancer who can tolerate general anesthesia and have good overall kidney function are generally good candidates for a laparoscopic partial nephrectomy.

Robotic Nephrectomy/Partial Nephrectomy:

Theda Vinci Surgical System uses state-of-the-art technology to help the surgeon perform a more precise operation. da Vinci offers several potential benefits to patients facing kidney cancer surgery, including:

  • Excellent clinical outcomes and cancer control
  • Shorter hospital stay
  • Lower amount of blood loss
  • Precise tumor removal and kidney reconstruction
  • Excellent chance of preserving the kidney, in certain operations
  • Low rate of operative complications

When an experienced and skilled surgeon http://www.roboticcancersurgery.com/Soroush-Adam-Ramin-MD/Curriculum- Vitae.aspx) is able to preserve healthy, functioning kidney tissue, this can help to prevent future kidney disease and even dialysis

  • Candidacy: Most people with localized kidney cancer are candidates for the da Vinci robotic partial nephrectomy, but it may not be right for everyone.  Patients with localized kidney cancer who can tolerate general anesthesia and have good overall kidney function are generally good candidates for this procedure.  Consult with your physician to determine whether this procedure is the best option for you.

Cryotherapy/Radiofrequency Ablation

An alternative therapy for kidney cancer is to treat the cancerous tissue using extreme temperatures.  Cryotherapy freezes the tissue to destroy cancer cells, whereas radiofrequency ablation uses heat to destroy these cells.  Both methods use several tiny probes that are inserted into the kidney tumor either through an open or laparoscopic surgical technique.  Cryotherapy and radiofrequency ablation do not take the cancerous tissue out of the body, but rather use probes to deliver extreme temperatures to the tumors with the goal that all cancerous tissue is destroyed.  Some studies have indicated that patients treated with these types of procedure have had a higher incidence of recurrence (return of the cancer) compared to those patients who underwent surgical removal of tumors.

  • Candidacy: Patients who are slightly older, are exhibiting medical problems associated with their diagnosis and those with localized kidney cancer are candidates for these procedures.

Immunotherapy (Biologic) Treatment

The goal of biologic therapy is to boost a person's own immune system in order to fight off or destroy cancer cells more effectively.  Until recently, this was the most common first-line therapy for advanced kidney cancer, and it may still be helpful for some people.  But because biologic therapy can be hard to give and can cause serious side effects, many doctors now only use it for cancers that aren't responding to targeted therapies.

The main immunotherapy drugs used in kidney cancer are cytokines (proteins that activate the immune system). The two cytokines most often used are interleukin-2 (IL-2) and interferon-alpha.  Both cytokines cause these cancers to shrink to less than half their original size in about 10% to 20% of patients.  Patients who respond to IL-2 tend to have lasting responses.  IL-2 is the only therapy that appears to result in long-lasting responses, although only a small percentage of patients respond.  A cancer has certain characteristics that may help predict if IL-2 will be helpful, and more studies are being done to see which characteristics are most helpful.

  • Candidacy: Patients with advanced kidney cancer or cancers that aren't responding to other targeted therapies may be candidates for this type of treatment.

Tyrosine Kinase Inhibitors (Inhibitor Therapy)

A tyrosine-kinase inhibitor (TKI) is a pharmaceutical drug designed to inhibit cancer growth.  TKI's block chemical messengers which in turn stops cancer cells from growing and dividing.

  • Candidacy: Patients with advanced kidney cancer or cancers that aren't candidates for surgery and/or are not responding to other targeted therapies may be candidates for this type of treatment.

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