Department of Urology

Illnesses We Treat

Kidney Cancer

How a diagnosis of kidney cancer is made
The more frequent general use of CT scans and ultrasound techniques in assessing a variety of symptoms has increased the frequency with which the unsuspected diagnosis of renal (kidney) masses is made. Such tumors would otherwise have remained totally hidden and completely asymptomatic (without symptoms) until they had grown sufficiently large to cause either gross or microscopic blood in the urine, this then leading to studies to establish a diagnosis. Now, kidney cancers are more often diagnosed when they are smaller and blood in the urine may not necessarily be observed.

Treatment options for kidney cancer
Once the diagnosis of kidney tumor is made and additional studies (bone scan, CT scan of the chest) have excluded the possibility of metastases (spreading either to the bone, lungs or regional lymph nodes), surgery is performed. Traditionally, the entire kidney was removed and, depending upon the stage of disease diagnosed, a cure was achieved in a majority of patients. Recent advances in the techniques of laparoscopic surgery have permitted radical nephrectomy (removal of the kidney) to be performed without the need for a large incision. This has led to a decrease in potential morbidity, reduction in pain associated with surgery, reduced time spent in hospital, and enhanced overall recovery.

Recent years have witnessed a growing interest in partial nephrectomy in treating renal cell cancer. With this approach, only the tumor and a surrounding margin of normal kidney tissue are removed. Much of the normal kidney can be preserved. This approach has been extremely successful both in treating the cancer and in preserving as much kidney function as possible.

Occasionally, more complex situations occur in which specialized resources and expertise are needed. For example, the cancer may invade the major vein of the kidney and extend into the vena cava (the major vein in the body). Occasionally, the cancer may even extend into the right side of the heart. Surgery to remove such cancers is generally performed in collaboration with vascular and cardiac surgeons, providing an opportunity for both effective treatment and safety.

In those instances in which metastases have occurred, there are several options that can be pursued. Because neither chemotherapy nor radiation therapy have been found to be effective, approaches using immunotherapy have been exploited. The Department of Urology collaborates with the Department of Medical Oncology to provide these treatment approaches in an attempt to control progressive disease.

For more information or to make an appointment, please contact:
Michael J. Droller, M.D.
Neil H. Grafstein, M.D.
Simon J. Hall, M.D.
Michael A. Palese, MD
Courtney K. Phillips, M.D.
David B. Samadi, M.D.