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Treatment and Testing

RMC treatment varies depending on the extent of the cancer. Localized cancer means the tumor is limited to the kidney, while advanced stages of RMC can mean the tumor has spread beyond the kidney and into the tissue surrounding the kidney. Treatments in both cases will largely revolve around surgical removal of cancerous tissue and the use of chemotherapy medications.

Treatment Overview

Surgery to remove the entire affected kidney (total nephrectomy) or part of the kidney (partial nephrectomy) is frequently done in localized RMC. This can often achieve the goal of removing all of the cancer. 

Surgery is often the first and most effective way of treating many kidney cancers. Deciding whether to have surgery will happen after completing initial testing for diagnosis and after discussion with a surgeon. You may also consider getting a second opinion from another kidney cancer specialist before opting for surgery. Second opinions may not change your diagnosis but it may give you useful information and treatment alternatives, such as clinical trials. If surgery is done first, additional treatment may be recommended to delay the cancer’s return or to treat metastatic disease. 

A variety of surgical procedures can be considered depending on the type and size of the tumor, the extent of disease, and the patient’s overall physical condition. You and your doctor should discuss the surgical options that are appropriate for you.

Types of Surgery

The treatment of many kidney cancers begins by removing the primary tumor in an operation called a nephrectomy. The purpose of surgery is to remove the primary tumor and involved tissue in the kidney. 

Though nephrectomy is the most common treatment for kidney cancer, it may not be appropriate in some cases. Your doctor can help explain the factors that influence whether to proceed with a nephrectomy. There are two basic types of nephrectomies for kidney cancer. A partial nephrectomy involves removing just the part of the kidney that contains the tumor. A radical nephrectomy involves removal of the entire kidney and often the removal of the adrenal gland above the kidney, the surrounding fatty tissue, and the lymph nodes adjacent to the kidney.


Cytotoxic combination chemotherapy (particularly platinum-based cytotoxic regimens) is the only systemic treatment approach that has consistently shown to produce partial or complete responses in approximately 29% of cases. Therefore, outside of clinical trials, platinum-based cytotoxic combination chemotherapy remains the mainstay of systemic treatment for RMC. Unfortunately, responses are not durable in most cases and there are no direct comparisons between the different chemotherapy regimens. 

Minimally invasive surgeries involve the use of a laparoscope, an instrument that is passed through a series of small incisions or “ports” in the abdominal wall to reach the internal organs. Laparoscopy can be used for both radical and partial nephrectomies and can obtain the same results as previous traditional surgical techniques that required larger openings in the abdominal wall. Laparoscopic radical or partial nephrectomy can result in decreased blood loss, shorter hospital stays, less need for narcotic pain medication, and shorter recovery time when compared with open radical nephrectomies.

Laparoscopy and Other Minimally Invasive Procedures

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