Treatment and Trial Options for Kidney Cancer
Your doctors will help you make the plan that is best for you based on a good evaluation of your cancer, your general health and your preferences. Your plan may include surgery, drug therapy or trials.
Making your personalized care plan
Understanding more about the treatment options, both the surgical and drug treatment options that may be discussed, will help you during your initial appointments.
VISIT THE TRANSCRIPTS PAGE FOR PRINTED NOTES FROM THE VIDEO
What are stage, histology and grade of kidney cancer?
After an initial diagnosis, your doctors will use imaging and/or surgical techniques to determine the tumor’s extent of growth (stage), cell type (histology), and how much the cells have mutated from healthy kidney tissue (grade). These features help inform subsequent treatment decisions.
Stages of Kidney Cancer*
STAGE 1

The cancer is only within the kidney and has not spread. The cancer is less than 7 cm in size. If the cancer can be removed it is most likely to be cured with surgery. 9 out of 10 people will be alive and free of the cancer at five years after an operation.
STAGE 2

The cancer is larger than 7 cm but is still confined to the kidney and has not spread outside of the kidney. Surgery is a good treatment option. The five year survival rate is still very high after surgery for stage 2 kidney cancer.
STAGE 3

The kidney cancer has moved nearby outside the kidney, but has not spread to distant organs. For example, the cancer might have spread into the fat around the kidney, into the blood vessel coming out of the kidney, or into lymph nodes near the kidney. Ask your doctor about all treatment options and clinical trials.
STAGE 4

The kidney cancer has spread widely outside the kidney; to the abdominal cavity, to the adrenal glands, to distant lymph nodes or to other organs, such as the lungs, liver, bones, or brain. Ask your doctor about all treatment options and clinical trials.
*This information is reproduced with thanks to the IKCC.
Click to view and download the handout Types of Kidney Cancer from IKCC which gives you the basics on how your testing may guide your care plan.
Kidney cancer substaging:
TNM system
The stage of your disease specifies the tumor size (T), nearby lymph node involvement (N), and spread to distant sites (M). Click on the image to view this video to help you learn the language and better understand what treatment recommendations are being made for you and why.
Understanding your Pathology Report
A pathologist will analyze a tissue sample from your tumor to determine the histological subtype and grade of kidney cancer cells. Learn about the differences between clear cell, chromophobe and papillary subtypes.

Clear Cell Renal Carcinoma
Clear cell renal cell carcinoma is the most common type of kidney cancer in adults.

Papillary renal cell carcinoma
Papillary renal cell carcinoma is the second most common type of kidney cancer in adults.

chromophobe renal cell carcinoma
Chromophobe renal cell carcinoma is the third most common type of kidney cancer in adults.
Active Surveillance: Is it safe to watch small renal masses?
“Active Surveillance” is sometimes an option for patients with a small renal mass. Watching cancer via regular imaging without therapy or surgery is a choice that most patients want more information on.
These two informative videos, one short and a more extensive one covering the research, are provided for patients considering “Active Surveillance”.
Surgery as a treatment option
Your labs, imaging, blood tests and other information will guide the discussion about whether surgery is part of your treatment plan.
A urologic surgeon is the first physician most patients with suspected kidney cancer work with. For some patients surgery alone is the only treatment recommended; for others, surgery is not suggested for the treatment plan.
This short video from the National Kidney Foundation is a great introduction to terminology and topics before your consults with the urologist and urologic surgeon.
Surgery:
Can you explain nephrectomy?
Surgery may be recommended to remove some (partial) or all (radical) of your kidney and the tumor within. Even when not curative, surgery can still help control symptoms of the disease and slow its progression. In this video Eric Kauffman, MD, discusses the difference between partial and radical nephrectomy of kidney cancer.
Questions for your surgeon in the follow-up visit
You will have a follow-up visit with your surgeon a few weeks after the surgery. This visit is a good opportunity to ask about your pathology report, the prognosis, the recovery process, or any other questions that are important to you. Here is a good list to start with.
Questions to ask a health care team from cancer.net

There are many FDA-approved targeted therapies and immunotherapies, as well as combinations that combine both. Your doctor will review your tests, staging and history, and discuss the treatment options that are appropriate for you.
Drug Therapies for Kidney Cancer
Learn about Clinical Trials
Clinical trials are research studies that involve people. Any time you or a loved one need treatment for cancer, clinical trials are an option to think about. Learning all you can about clinical trials can help you talk with your doctor and decide what is right for you.
Reliable Resources for Cancer Information
NATIONAL CANCER INSTITUTE
www.cancer.gov
CANCER.NET
www.cancer.net/cancer-types/kidney-cancer
INTERNATIONAL KIDNEY CANCER COALITION
www.ikcc.org
CANCER AND CAREERS
www.cancerandcareers.org/en/at-work
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