Renal Cell Cancer (cont.)
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Surgery for Renal Cell Carcinoma
Removal of the diseased kidney (nephrectomy) is the standard treatment of renal cell carcinoma. People can live normally with one kidney if that kidney is healthy. The 3 main types of nephrectomy are as follows:
Nephrectomy may be performed with a large incision or via laparoscopy. Laparoscopy is a technique that removes the kidney through a very small incision. Laparoscopy leaves a smaller scar and requires less time in the hospital. It is used for people with small kidney cancers.
Nephrectomy may cure the disease if it has not spread to other parts of the body. Sometimes people with metastatic disease undergo a nephrectomy to relieve symptoms such as bleeding, pain, high blood pressure, high levels of calcium in the blood. Nephrectomy alone cannot cure metastatic renal cell carcinoma, but recent studies suggest that selected patients who receive immunotherapy after a nephrectomy for metastatic disease are more likely to respond and have a longer survival rate than those who do not undergo nephrectomy. In some cases, a solitary metastatic tumor can be removed, increasing chances of a more prolonged remission.
Another procedure called arterial embolization (plugging up the artery) is sometimes used for people who cannot undergo surgery. Different methods have been used to embolize kidneys, including injection of small pieces of a special gelatin sponge, plastic microspheres, ethanol, or chemotherapy. The injected agent can block the artery and prevent blood from getting through to the kidney and the tumor. The tumor cannot live without blood, and it dies. The procedure can be painful and cause fevers. The use of arterial embolization prior to radical nephrectomy has been shown to have survival benefit and is not recommended in operable kidney cancers.
Medically Reviewed by a Doctor on 12/14/2015
Kush Sachdeva, MD
Brendan Curti, MD
Winston W Tan, MD
Mary L Windle, PharmD
Koyamangalath Krishnan, MD, FRCP
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