Kidney cancer treatment focuses on removing all cancer cells so that a person can retain kidney function and survive. The right treatment depends on the stage of cancer. In the early stages of cancer, the goal is to completely cure it.

Kidney cancer is highly treatable with early diagnosis and treatment. Renal cell carcinoma, which makes up more than 90% of all kidney cancer cases, is the most common form of kidney cancer.

The overall survival rate 5 years after diagnosis is 76%. Generally, the survival rate increases if doctors discover and treat the cancer earlier.

The right kidney cancer treatment, as well as the length of time it takes to work, typically depends on:

  • how a person tolerates treatment — for example, whether they experience side effects
  • the stage of cancer
  • the person’s overall health

In most cases, a person will need surgery to remove the cancer. In later stages, a doctor may also recommend chemotherapy or radiation.

Read on to learn more about kidney cancer treatment, side effects, and what to expect.

Kidney cancer usually targets the renal, or kidney, cells.

Renal cell carcinoma makes up about 90% of all kidney cancers. Many renal cell cancers grow slowly. This means a person may live many years even with cancer. Doctors often discover new cancers in the early stages.

A person may have one of several subtypes of renal cell cancer:

  • clear cell
  • chromophilic
  • chromophobic
  • oncocytoma, which is less aggressive than other forms
  • collecting duct, which is a highly aggressive form

Staging of kidney cancer

Doctors divide kidney cancer into four stages. The lower the stage number, the less the cancer has spread:

  • Stage 1: Cancer is localized to just the kidney.
  • Stage 2: Cancer has spread to the tissues around the kidneys.
  • Stage 3: Cancer has spread further to surrounding structures, such as the renal vein or lymph nodes.
  • Stage 4: Cancer has spread to other organs or structures.

Learn more about kidney cancer here.

Early stage kidney cancer is curable. In otherwise healthy people, it is usually possible to cure stage 1 cancer. The overall 5-year survival rate at this stage is 90%. The 5-year survival rate falls to 50% at stage 2. However, with a good surgical outcome, a cure may still be possible.

About two-thirds of people with kidney cancer receive a diagnosis in the early stages, when cancer is still in only the kidneys. This can mean that overall cure rates are relatively high and the prognosis is often good.

However, stage 4 cancer is not curable. Instead, treatment focuses on prolonging survival and providing palliative care.

Several treatment options exist for all stages of kidney cancer.

The ideal treatment for renal cancer is surgery to remove the cancer.

In stage 1, partial nephrectomy or radial nephrectomy may cure the cancer. Partial nephrectomy involves the removal of some kidney cells, while radical nephrectomy involves the removal of the whole kidney. A radial nephrectomy is a viable option for some people, as a person can live with just one kidney.

In stages 2 and 3, removal of the kidney is also the standard of care, but the chances of curing the cancer are lower.

A doctor may also recommend nephrectomy for stage 4 cancer, but this will only prolong survival, not cure the cancer.

People for whom surgery is not an option, such as those who are too frail, may opt for nonsurgical treatments. Risks associated with surgery include:

  • damage to internal organs such as the spleen
  • kidney failure
  • leaking of urine into the abdomen
  • problems with wound healing

Learn more about partial and radical nephrectomy here.

Doctors may use ablation techniques to destroy small tumors — typically those smaller than 4 centimeters. This involves the use of probes.

Cryoablation or cryotherapy uses very cold gases that pass through a probe. An ice ball created at the probe’s tip can infiltrate the tumor and destroy it.

Alternatively, an electric current can pass through a probe and directly act on the tumor. This is called radiofrequency ablation.

Risks associated with ablation include:

  • pain
  • bleeding
  • damage to tissues near the tumor

A doctor may recommend chemotherapy to prolong survival in people who have advanced cancer or cannot have surgery.

Typically, a doctor may prescribe chemotherapy alongside other therapies. This may be because the response rates of kidney cancer to chemotherapy are traditionally low and chemotherapy will not cure the cancer.

Radiation therapy, which uses high energy particles to kill cancer cells, may prolong survival in people with stage 4 cancer and in those who cannot have surgery.

Radiation does not typically cure the cancer but may help shrink tumors in some people.

A number of targeted therapies kill kidney cancer cells without killing other cells in the body. This makes them a good alternative to chemotherapy, especially for people who are sick or older.

Doctors usually recommend targeted therapies to people with advanced cancer or those who cannot have surgery.

Each therapy works slightly differently. For example, certain drugs act on endothelial growth factor (VEGF) and VEGF receptor VEGFR to reduce tumors’ ability to grow. Some drugs that work in this way are:

  • sunitinib (Sutent)
  • sorafenib (Nexavar)
  • bevacizumab (Avastin)
  • axitinib (Inlyta)
  • pazopanib (Votrient)

The side effects that people may experience depend on the specific drug they are taking.

Doctors usually recommend these therapies to people with late stage cancers or those whose cancer is not curable.

While these drugs may prolong survival, long-term survival rates are low.

Similar to targeted therapies, immunotherapy aims to support the immune system to defend the body against cancer. This treatment typically involves inhibitor drugs, which can shrink tumors or slow their growth.

Targeted therapies have mostly replaced immunotherapy, though doctors may still recommend it in some circumstances.

Immunotherapy prolongs survival but does not cure the cancer.

Doctors may choose to monitor people with small tumors or masses that are benign. Nearly 3 out of 4 small kidney cancer are slow-growing.

Healthcare professionals can perform imaging tests every 3–6 months to check whether tumors are growing. These tests may include:

  • CT scans
  • MRI
  • ultrasound

This is a good option for people who are older or frail.

Advanced kidney cancer carries a high death rate and is not usually possible to cure. Instead, treatment focuses on prolonging survival and reducing pain.

In addition to the options mentioned previously, treatment options include:

  • targeted cancer drugs
  • participation in a clinical trial
  • palliative care to ease pain
  • hospice care to stop treatment and reduce pain as death approaches
  • a combination of therapies

Kidney cancer may recur. This means that it can come back after treatment.

A doctor may recommend immunotherapy or targeted therapy to lower the risk of recurrence in people with high risk cancers. A doctor may also prescribe these drugs to people with cancer that recurs, especially if the cancer is in a late stage.

Doctors usually recommend ongoing monitoring to catch recurrent kidney cancer in its early stages.

The main factor that determines a person’s treatment options is the stage of the cancer.

Other factors include:

  • Cancer genetics: The genetics of the cancer may determine which targeted therapies are likely to work best.
  • Age and health: Older people and people in poor health may not be able to have surgery.
  • Type of kidney cancer: Certain types of kidney cancer are more aggressive and more likely to spread than others. Medullary renal cell carcinoma, for example, is highly aggressive and may occur in people with sickle cell disease.
  • Treatment goals and preferences: Some people, especially those who are not in good health or who have more advanced cancer, may prefer to avoid the side effects of treatment and instead pursue palliative options.

According to the American Cancer Society, the 5-year survival rates for kidney cancer are as follows:

  • Overall: 76%
  • Localized cancer in just the kidney: 93%
  • Regional cancer: 71%
  • Distant/metastatic cancer: 14%

As a result of new and emerging treatments, survival rates are improving. Therefore, a person who receives a diagnosis today may have a higher likelihood of long-term survival than these figures indicate.

A person with kidney cancer should find an oncologist who specializes in renal cancer.

Large teaching hospitals often have specific programs. People should ask clear, specific questions about prognosis, treatment options, and clinical trials before choosing an oncologist. People can find additional support through the following organizations:

Early stage kidney cancer has a better prognosis than many other cancers. For this reason, seeking prompt treatment may save a person’s life. However, even in cases of advanced cancer, a cure may be possible with successful surgery.

People with kidney cancer should seek care from an oncologist who has experience with kidney cancer. Large teaching hospitals and cancer care centers often offer innovative care, as well as access to clinical trials, lifestyle support, and palliative care.