Treatment and prognosis (likely development of the condition) of early and late stage kidney cancers are very different from each other.
Kidney cancers found early during routine health checks have a high cure rate and chemotherapy and radiotherapy are rarely needed. Kidney cancers in their late stages, however, may carry a much poorer outcome and its management is usually focused on providing comfort for the patient.
Systemic Treatment of Kidney Cancer
Chemotherapy has little role in kidney cancers. Other systemic treatments like multi-kinase inhibitors can help with managing late-stage kidney disease. Radiotherapy has a role in preventing the kidney cancer from spreading. In patients with terminal kidney cancer that has spread to the spine or bones, local radiotherapy can reduce the risk of spinal cord compression and fractures caused by the cancer destroying the bones.
Removing Small Tumours
In carefully selected patients, small kidney masses can be removed with techniques like radiofrequency ablation (RFA) and cryoablation. These options use heat and cold respectively to kill cancerous cells while preserving the remaining kidney tissue. When used in carefully selected patients, this can result in good long-term cure rates.
Advanced Techniques to Treat Early Kidney Cancers
Minimally invasive (laparoscopic) partial nephrectomy has changed the way we manage small, early stage kidney cancers. Traditionally, patients with kidney cancer will have their affected kidney removed through surgery (complete nephrectomy). In a partial nephrectomy, part of the affected kidney is spared as the surgeon removes only the tumour. This procedure can help preserve kidney tissue and reduce the chance of patients with pre-existing kidney failure needing kidney dialysis.
Laparoscopic partial nephrectomy typically involves a shorter hospital stay and reduced post-operative pain as surgical wounds are much smaller than a traditional open surgery. Recovery from the operation tends to be faster than traditional open surgery with the patient returning to normal activities quicker.
Studies have shown that there is no difference in cure rates between laparoscopic partial nephrectomy and radical (complete) nephrectomy.
Prevention of Kidney Cancer
As the causes of kidney cancer remain a mystery, there are no proven ways to prevent it. Maintaining good control of blood pressure and quitting a smoking habit can help reduce the risk of kidney cancer. A balanced diet, regular exercise and adequate sleep are also steps that can possibly help reduce the risk of major cancers.
Information kindly provided by Dr Poh Beow Kiong, consultant urologist, Gleneagles Hospital.