Treatment and prognosis of early versus late kidney cancers differ vastly.
Small kidney cancers found incidentally during routine health checks have a high cure rate and chemotherapy and radiotherapy are rarely necessary. Kidney cancers in their late stages, however, may carry a much poorer outcome and its management tends to be centred on palliative measures.
Systemic treatment of kidney cancer
Chemotherapy has little role in kidney cancers. Other systemic treatments likely multi-kinase inhibitors can play a role in managing late-stage kidney disease. Radiotherapy has a role in the local control of kidney cancer spread. 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 pathological fractures caused by cancer destroying the bones.
Removing small tumours
In carefully selected patients, small renal masses can be removed with techniques such 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 attain good long-term cure rates.
Advanced techniques to treat early kidney cancers
Minimally invasive (MIS) partial nephrectomy has revolutionised the way we manage small, early kidney cancers. Traditionally, patients with kidney cancer will have their affected kidney removed through surgery. In MIS partial nephrectomy, the affected kidney is spared with the surgeon removing only the tumour. This procedure can help preserve kidney tissue and reduce the chance of patients with pre-existing kidney failure needing kidney dialysis.
MIS partial nephrectomy typically involves a short hospital stay and reduced post-operative pain as surgical wounds are much smaller than traditional open surgery. Post-operative recovery tends to be faster than traditional open surgery with the patient getting back to normal activities quicker.
Studies have shown that there is no difference in cure rates between MIS partial nephrectomy and radical nephrectomy, in which the entire kidney is removed.
Prevention of kidney cancer
As the causes of kidney cancer remain a mystery, there are no definitive ways to prevent it. Maintaining good control of blood pressure and quitting smoking can help reduce the risk of kidney cancer. A balanced diet, regular exercise and adequate sleep are also steps which can potentially help reduce the risk of major cancers. Information kindly provided by Dr Poh Beow Kiong, Consultant Urologist, Gleneagles Hospital.