People with kidney cancer have more treatment options than ever before. Although the most common treatment is still surgery for localized kidney cancer, many new immunotherapies and targeted therapies have been approved by the U.S. Food and Drug Administration (FDA) in recent years to treat metastatic kidney cancer.
Seattle Cancer Care Alliance (SCCA) experts offer comprehensive care for renal cell carcinoma (RCC) and other kidney cancers, including advanced treatments and new options available only through clinical studies.
A diagnosis of cancer can feel overwhelming. We have an experienced, compassionate team ready to help.
- Expertise at SCCA
- Targeted treatment
- Radiation therapy
- Palliative and supportive care
- Clinical studies
- Next steps
Kidney cancer expertise at SCCA
Kidney cancer survival rates
Data collected from cancer centers across the country show that people who begin their kidney cancer treatment at SCCA have higher survival rates on average than those who started treatment at other centers.
Everything you need is here
We have urologic oncologists, medical oncologists, radiation oncologists, pathologists and radiologists who specialize in kidney cancer; the most advanced diagnostic, treatment and recovery programs; and extensive support.
Innovative kidney cancer therapies
SCCA patients have access to advanced therapies being explored in clinical studies for kidney cancer conducted here and at our founding organizations Fred Hutchinson Cancer Research Center and UW Medicine.
Kidney cancer treatment tailored to you
We view treatment as a collaborative effort. Your SCCA doctors will explain all your options and recommend a treatment plan based on the type and stage of your cancer and several other factors, including your health, lifestyle and personal preferences and the probability of extending your life or relieving your symptoms.
Kidney Cancer Multispecialty Clinic
If you have metastatic kidney cancer, you may have your first appointment at our Kidney Cancer Multispecialty Clinic, where you’ll see a full team of UW Medicine kidney cancer specialists in the same day. You will leave with all of your questions answered and a plan of care designed specifically for your needs.
Your personal team includes more than your kidney cancer doctors. Additional experts who specialize in treating people with cancer will be involved if you need them — experts like a palliative care professional, social worker, physical therapist or dietitian.
Ongoing care and support
During and after treatment, your team continues to provide follow-up care on a schedule tailored to you. The SCCA Survivorship Clinic is also here to help you live your healthiest life as a kidney cancer survivor.
Surgery for kidney cancer
Surgery is the most common treatment for kidney cancer that has not spread outside of the kidney. There are several procedures your surgeon may use, depending on:
- The type, size and location of your tumor
- The extent of your cancer
- Your overall health
Whenever possible, we use laparoscopic or robotic surgery techniques, making small keyhole incisions and using telescopic instruments.
Renal cell carcinoma surgery
For renal cell carcinoma, you may need:
- Radical nephrectomy — surgery to remove your entire kidney, including the tumor and a border of healthy tissue and nearby lymph nodes
- Partial nephrectomy — surgery to remove only the part of your kidney that contains the cancer and a small margin of healthy tissue around it
- Regional lymphadenectomy — surgery to remove the nearby lymph nodes to see if they contain cancer
- Ablation — using extreme cold (cryoablation) or heat (radiofrequency ablation) to kill tumor cells, either by inserting a needle through a small puncture in your skin (percutaneously) or reaching the kidney through a laparoscopic incision
Sometimes arterial embolization is used before surgery to shrink the tumor and make surgery easier, especially in people who have a tumor thrombus — a clot of tumor that extends into the renal vein or inferior vena cava (the main vein returning blood back to the heart). Arterial embolization deprives the tumor of oxygen-carrying blood and other substances.
Surgery for urothelial carcinoma of the kidney
If you have urothelial carcinoma, which grows off the lining or renal pelvis of the kidney (where urine goes before it enters the ureter), you may need:
- Nephroureterectomy — to remove your entire kidney, including the tumor and a border of healthy tissue and nearby lymph nodes. The entire ureter is also removed all the way down to the bladder. A small part of the bladder surrounding the ureter is also removed.
- Endoscopic resection — to burn away the tumor and the areas around it using an electric current or a narrow beam of intense laser light. This is done by passing a small telescope up to the ureter and kidney.
Learn more about surgical oncology.
Targeted therapy for kidney cancer
Targeted therapies are relatively new for treating RCC. They work in a more focused way than chemotherapy and are important when chemotherapy is not effective. Often used against advanced RCC, these agents may shrink tumors and control their growth for long periods.
Targeted therapies used for kidney cancer include:
- Sunitinib (Sutent) — a tyrosine kinase inhibitor (TKI) that works by preventing the growth of new blood vessels that tumors need to grow (anti-angiogenesis effect) and blocking cells from dividing and multiplying
- Bevacizumab (Avastin) — an anti-angiogenesis medicine usually used in combination with interferon-alpha for RCC that has spread to another part of the body
- Pazopanib (Votrient) — a TKI and anti-angiogenesis medicine
- Temsirolimus (Torisel) — which blocks the mTOR signaling molecule, resulting in the death of tumor cells and anti-angiogenic effects
- Sorafenib (Nexavar) — a TKI and anti-angiogenesis medicine
- Everolimus (Afinitor) — which blocks mTOR and is typically used after other medicines, such as sorafenib or sunitinib, have been tried
- Axitinib (Inlyta) — which inhibits tyrosine kinases and is used for people who have not responded to other medicines
- Cabozantinib (Cabometyx) — a TKI and anti-angiogenesis medicine that blocks MET oncogene signaling
- Lenvatenib (Lenvima) — a TKI and anti-angiogenesis medicine that blocks signaling through FGFR (fibroblast growth factor receptor)
Your SCCA team will talk with you about the specific drugs we recommend for you, how you’ll receive them, your treatment schedule and what to expect. We’ll also explain how to take the best possible care of yourself during treatment and after, and we’ll connect you with medical and support resources throughout SCCA.
Learn more about targeted therapies in our medical oncology section.
Immunotherapy for kidney cancer
The goal of immunotherapy is to use your body's immune system to fight and destroy cancer cells more effectively.
The main immunotherapy medicines used in RCC are:
- Checkpoint inhibitors — These medicines include nivolumab (Opdivo) and ipilimumab (Yervoy), already FDA-approved for kidney cancer. Additional options are being tested in research studies. SCCA has clinical trials open that use checkpoint inhibitors to treat kidney cancer.
- Interleukin-2, or IL-2 (Proleukin) — IL-2 is a growth factor for two types of white blood cells that may have potent anti-tumor effects. Some people with clear cell RCC (5 to 7 percent) can achieve long-lasting complete remission after IL-2 therapy. However, high dose IL-2 is linked with severe side effects and is not right for everyone. If you are interested in IL-2, seek out a cancer center, like SCCA, that is familiar with this style of therapy.
Learn more about immunotherapy.
Chemotherapy for kidney cancer
Renal cell carcinoma does not respond well to chemotherapy, but chemo may be used to treat certain patients with advanced RCC and transitional cell carcinoma.
Radiation therapy for kidney cancer
Radiation therapy is typically used for kidney cancer that has spread to other parts of the body, especially the brain or bones. Radiation therapy is painless and noninvasive, and each treatment lasts only minutes.
Radiation may be used:
- To relieve symptoms of advanced kidney cancer, such as pain or bleeding
- To prevent symptoms from tumors growing in critical areas, such as the brain or spinal cord
Different types of radiation treatments are used for different situations. Two examples are:
- Intensity-modulated image-guided radiotherapy (IMRT/IGRT)
Radiosurgery is an advanced form of highly focused, high-dose radiation therapy that can kill tumors in fewer treatments than conventional radiation treatment — typically one to five sessions rather than daily sessions for several weeks. It has a greater than 95 percent chance of killing small tumors.
There are many names for this type of treatment, including:
- Stereotactic body radiation therapy (SBRT)
- Stereotactic ablative body radiotherapy (SABR)
- CyberKnife or Gamma Knife, brand names
Gamma Knife is specifically designed for treating tumors in the brain. It is not a knife or scalpel in the usual sense of the word (neither is Cyberknife), and it doesn't require opening the skull. Instead, it uses precisely focused beams of radiation. Patients are usually treated in one session.
In this form of radiation treatment, doctors use computed tomography (CT) to scan your tumor and create beams of radiation that closely conform to the tumor's shape. The beams vary in shape and intensity to deliver a higher dose of radiation to the tumor and lower doses to nearby healthy tissue.
Learn more about IMRT/IGRT and other forms of external-beam radiation therapy (EBRT).
Palliative and supportive care
Support and care to reduce any symptoms you have and to enhance your quality of life (palliative care) are important for everyone with cancer, regardless of the stage of your disease, and are provided by SCCA experts alongside your cancer treatment.
Your surgeon, medical oncologist and others on your cancer team will also help you with the effects of your disease and your treatment. If you ever need them, we have a team of specialists in our Pain Clinic.
Clinical trials for kidney cancer
For some people, taking part in a clinical study may be the best treatment choice. Access to clinical studies by researchers at SCCA and our founding organizations Fred Hutch and UW Medicine is one reason many patients come to SCCA.