Treatment for advanced kidney cancer

Some treatments can control advanced kidney cancer for a time and reduce symptoms. 

Local treatment such as surgery or radiotherapy may be best if you have only one area of cancer spread. Targeted or immunotherapy cancer drugs might be a better option if the cancer is in more than one area, or the cancer has spread quickly.

You may have more than one treatment type to control the cancer. Your doctor will talk to you about the different options for your situation. They can also answer any questions you may have.

Targeted and immunotherapy cancer drugs

Doctors use different types of cancer drugs to control advanced kidney cancer. These are:

• targeted cancer drugs that interfere with the way cancer cells survive and grow
• immunotherapy drugs that help the immune system recognise and attack cancer cells

They can both stop or slow the growth of the cancer for months and sometimes years. You might have a targeted cancer drug or an immunotherapy drug, or both together.

These treatments may be helpful if the cancer:

• has come back soon after surgery
• is growing or spreading quickly

Surgery

Your doctor might suggest surgery if your cancer has come back in or near your kidney. They might do this if:

• you haven't had your whole kidney removed already, and
• the cancer has come back in another part of the kidney

Your doctor takes into account how healthy and fit you are when deciding if surgery is right for you. You must be in reasonable health to recover from a big operation.

If the cancer has spread to one other part of the body (a secondary cancer or metastasis) such as the lung or liver, your doctor may recommend surgery to remove the secondary cancer. They may refer you to a specialist surgeon for your operation. Taking out the secondary cancer can slow down the growth of cancer in the body. This may help you stay well for longer.

If all the cancer is removed by surgery, your doctor may recommend you have immunotherapy to lower the chance of the cancer coming back.

Unfortunately, not everyone with advanced kidney cancer can have surgery. This may be because the cancer:

• has come back soon after an earlier operation to remove it
• has spread to more than one part of the body
• is likely to spread quickly

In this case, your doctor may recommend you have targeted cancer drugs and immunotherapy, or other types of treatment.

Radiotherapy

Radiotherapy isn't used very often to treat kidney cancer. But it can help shrink a larger cancer to control symptoms such as pain and blood in the urine. Your doctor may recommend this if you can't have surgery to remove the cancer in the kidney.

Radiotherapy can also be used to treat symptoms from cancer that has spread to other parts of the body. It can:

• shrink secondary kidney cancer in the lungs to help relieve breathlessness
• help with pain if the cancer has spread to your bones
• treat kidney cancer that has spread to the brain

Cryotherapy

Cryotherapy kills cancer cells by freezing them. It can shrink the cancer and help to control your symptoms.

Having cryotherapy depends on the size of the cancer. Your doctor might recommend cryotherapy if you can't have surgery. They might also recommend it for secondary cancer in the liver or the lungs.

You might be able to have this treatment more than once.

Microwave and radiofrequency ablation

Microwave and radiofrequency ablation uses heat to kill cancer cells. It can help to shrink a cancer and control your symptoms. Your doctor may suggest it if you have a small cancer in the kidney or a small secondary cancer in the liver.

Blocking the blood supply to kidney cancer (renal artery embolisation)

Your doctor may suggest blocking the blood supply to the kidney cancer. This is called renal artery embolisation. It can help to shrink the cancer and control symptoms such as pain or blood in the urine.

Arterial embolisation can also treat secondary cancer in the liver.

Your doctor injects small metal coils or a special liquid into the main blood vessel (artery) to the cancer. This blocks the blood supply and can shrink the cancer. 

You may also have an arterial embolisation before or during surgery. This helps to reduce the risk of bleeding during the operation. For example, you may have it before surgery for secondary cancer in the spinal bones.

Other ways of controlling symptoms of advanced kidney cancer

Symptoms can be caused by many things including the cancer itself. Or they can be a side effect of treatment.

Medicines can help control symptoms such as pain, sickness, diarrhoea and constipation. Let your healthcare team know if you have any symptoms so they can help you manage them.

Some people find complementary therapies can relieve pain or sickness. These include relaxation and massage which also help to reduce anxiety and stress.

Painkillers and pain control

There are many different painkillers and ways of taking them. You should be able to stay pain free most of the time with the help of your doctor or specialist nurse. 

You can also try relaxation or breathing techniques to help you mange pain.

Sickness

There are lots of different anti sickness medicines. Which one you need depends on what's causing your sickness. Tell your doctor or specialist nurse what relieves your sickness and what makes it worse.

If you decide not to have treatment

Some people may decide not to have treatment for advanced kidney cancer. In this situation, you can still have medicines to help control symptoms such as sickness or pain.

Your doctor or nurse will explain what could help you. They can also refer you to a local symptom control team to give you support at home.