After kidney cancer surgery: will you need more treatment?

Early-stage kidney cancer refers to kidney cancer that has not spread beyond the kidney. In most cases, surgery is the treatment of choice. The type of surgery used will depend on the number, size, and exact location of the tumors.

• During a radical nephrectomy, the entire kidney is removed.
• During a partial nephrectomy, the tumor and surrounding kidney tissue are removed.
• In some cases, surgeons may remove surrounding lymph nodes (called a regional lymphadenectomy) or the adrenal gland (adrenalectomy).

Surgery may be the only treatment needed. But your healthcare team may recommend follow-up treatments to help prevent kidney cancer from recurring after surgery.

Kidney cancer recurrence

Recurrence is when a cancer comes back after it has been successfully treated. Renal cell carcinoma (RCC) is the most common type of kidney cancer. For RCC that has not spread beyond the kidney, the rate of recurrence after surgery is between 20 and 40 percent.

Kidney cancer can recur in or near the kidney, or where the kidney was removed (called a local recurrence), or in other parts of the body (called a distant recurrence). Treatment may include surgery or systemic therapies such as targeted therapies and immunotherapies.

Certain factors put kidney cancer at a higher risk of recurrence. These can include a person’s overall health and habits, as well as characteristics of the cancer, such as the size of the tumor.

Recurrence risk is something that anyone with kidney cancer should discuss with their healthcare team.

Adjuvant therapy for kidney cancer

Adjuvant therapy is cancer treatment that is prescribed after primary treatment (in this case, surgery). The goal of an adjuvant therapy is to prevent the cancer from recurring.

In the United States, there are multiple medications approved as adjuvant therapies for kidney cancer. One is a targeted therapy, a drug that blocks a specific protein that cancer cells use to multiply. Another is an immunotherapy, a drug that helps the immune system to identify and destroy cancer cells. A third is a combination of one targeted therapy and one immunotherapy.

There are also therapies that are currently in clinical trials and may be available in the future.

The choice of whether to use an adjuvant therapy and what adjuvant therapy to use will be decisions that a person with kidney cancer will make with their healthcare team.

Reducing your risk of kidney cancer recurrence

Once you've completed your initial kidney cancer treatment, it’s important to stay in close contact with your healthcare team.

Talk to your healthcare providers about a survivorship care plan, which can include a suggested schedule for follow-up exams or tests and a list of possible long-term side effects from your treatment. These steps can help you stay healthy after kidney cancer.

If you smoke, quit. Smoking is associated with kidney cancer. While the link between smoking and kidney cancer recurrence isn’t well established, smoking will increase your risk of developing other cancers and other serious illnesses. High blood pressure, obesity, and type 2 diabetes are also associated with a higher cancer risk.

Maintaining an overall healthy lifestyle is important. There is still much we need to learn about kidney cancer, including the role that good nutrition and exercise can play in reducing the risk of recurrence.

It is known that eating a balanced diet, staying active, getting enough rest, avoiding unhealthy habits (like tobacco and alcohol use), reducing stress, and taking care of your mental health will make you feel better overall and improve your quality of life as you recover from cancer.