Approaches to Treating Kidney Cancer
Clinical staging is a way for physicians to evaluate how a tumor is progressing. For kidney cancer this is commonly from the results of CT scan or MRI.
Stage I: The tumor is 7 centimeters or smaller and limited to the kidney. There is no spread to lymph nodes or distant organs.
Stage II: The tumor is larger than 7 centimeters but still limited to the kidney.
Stage III: Encompasses varying tumor sizes, and the tumor has spread to one nearby lymph node but not to distant lymph nodes or other organs. Also includes tumors that have spread to the fatty tissue around the kidney and/or spread into the large veins leading from the kidney to the heart but not spread to any lymph nodes or other organs.
Stage IV: Tumors have spread directly through the fatty tissue and the tissue that surrounds the kidney. Also includes any cancer that has spread to more than one lymph node near the kidney, to any lymph node not near the kidney, or to any other organs.
If the tumor is to be removed, pathologic staging is performed and more accurate information can be given to patients regarding chance for progression and recurrence. In addition, a follow-up plan can be designed to evaluate patients who have had tumor removed based on the stage.
Active Surveillance of Renal Masses
In select patients, observation may be the appropriate course of treatment. With "active" observation, we recommend using CT scan or MRI to monitor the mass for a period of time.
Recent research has suggested that renal masses grow slowly and the risk of spreading throughout the body is low in small tumors. In these cases, a biopsy is often recommended.
Modern techniques are very accurate to diagnose kidney cancer using percutaneous biopsy. UW Health kidney cancer physicians work with radiologists to biopsy renal tumors and establish a diagnosis.
Because there is a risk of disease progression, prior to beginning an active surveillance program patients are counseled and follow-up studies will be scheduled to check for tumor growth. Generally, this option is most appropriate for patients with small masses or with other serious medical problems.
Advanced Kidney Cancer Treatment
UW Health urologic oncologists have received additional training to manage urologic cancers and the UW Carbone Cancer Center is the state's only comprehensive cancer center. In some advanced kidney cancer cases, patients may benefit from multimodal treatment (surgery in combination with another therapy). The UW Carbone Cancer Center has an experienced team of medical oncologists, who work closely with the surgeons in the urology department to provide the best care for patients with advanced kidney cancers.
Locally or Regionally Advanced Kidney Cancer
Certain kidney tumors are "advanced" or higher stage at presentation and are at higher risk to spread to the rest of the body (become metastatic). When tumors invade the organs around the kidney or the lymph nodes, the chance for survival with surgery alone is poor. In these cases, close follow-up or consultation with a medical oncologist is often necessary.
Some kidney tumors grow very large or invade the blood vessels and require the expertise of multiple surgical services to remove the tumor. UW Health oncologic surgeons are experienced in removing large, complex tumors and have the resources available to perform more extensive surgery, when necessary.
Metastatic Kidney Cancer
Metastatic kidney cancer - wherein the tumor has spread to another part of the body - affects one in four patients who develop kidney cancer. For some patients, research has demonstrated that removal of the kidney may improve overall survival. Patients with metastatic kidney cancer should receive consultation with medical and urologic oncologists to decide whether this is an appropriate option for them.
UW Health's Urology team puts the patient first when evaluating approaches to kidney cancer treatment. Each week, the medical and urologic oncology teams have a meeting to discuss patients who have advanced kidney cancers. Patients benefit by receiving the most modern approach of the combination of medical and surgical therapies, when appropriate.
The UW Carbone Cancer Center actively participates in clinical trials, so that patients may be given the option of the newest therapies available.