Treatment Options

The main types of treatment for bladder kidney cancer are surgery (removing the cancer cells), radiation (using high-dose X-rays to kill cancer cells), chemotherapy (using high-dose anti-cancer medication) and immunotherapy (using the body's immune system to attack cancer).

Surgery
The most common treatment for kidney cancer, there are several different surgical procedures your doctor may use to treat your cancer.

Arterial embolization is a procedure to shrink the tumor by depriving it of oxygen-carrying blood and other substances is sometimes used before surgery to make surgery easier. It may also be used to provide relief from pain or bleeding when removing the tumor is not possible.

For renal-cell carcinoma, the surgery choices range from removing part of the kidney to all of it. Options include the following:

• Radical nephrectomy: The entire kidney is removed along with the nearby adrenal gland, fatty tissue and lymph nodes.
• Simple nephrectomy: The entire kidney is removed.
• Partial nephrectomy: The part of the kidney containing that contains the cancer is removed.

For transitional-cell carcinoma, the options include the following:

• Nephroureterectomy: The kidney, ureter and part of the bladder are removed.
• Segmental resection: The affected part of the kidney or ureter is removed.
• Electrosurgery endoscopic resection: An electric current removes the cancer by burning away the tumor and the areas around it. Laser energy is also used in some cases to remove the cancer cells.
• Laser light: A narrow beam of intense light is used to remove cancer cells.

All of these surgical procedures can be performed laparoscopically - with the aid of a camera so that there are no large incisions.

Radiation/chemotherapy
Renal-cell carcinoma does not respond well to chemotherapy but there are sometimes dramatic responses to newer immunotherapy approaches. Chemotherapy is used to treat patients with advanced kidney cancer and transitional-cell carcinoma. Radiation therapy is often given to patients who are too sick to have surgery but want relief from their symptoms.

Follow-Up After Treatment
As part of the Survivorship Program at SCCA, a clinic has been developed for general medical oncology survivors treated with conventional therapy. This clinic is the Medical Oncology Survivorship Team (MOST).