What is the treatment for early-stage kidney cancer?

Each year, more than 80,000 new cases of kidney cancer are diagnosed in the United States. The disease is nearly twice as common in men as it is in women, and most people who develop kidney cancer are over the age of 65.

Kidney cancer is cancer that begins in the kidneys. Approximately 9 out of 10 people with kidney cancer have a type called renal cell carcinoma (RCC), which usually begins as a single tumor in a single kidney. Because RCC is the most common form of the disease, it is sometimes used synonymously with “kidney cancer.”

There are two main subtypes of RCC—roughly 7 out of 10 people have clear cell renal cell carcinoma. A smaller number of people have non-clear cell renal cell carcinoma. There are also additional forms of kidney cancer that are rare.

There are multiple factors that will be considered when a healthcare team recommends treatment for kidney cancer. The type of kidney cancer is one important factor. Another important factor is the stage.

Here, we will be looking at the treatment options that might be considered for early-stage RCC.

What is early-stage RCC?

When determining the stage, healthcare providers will consider the size of the tumor, if the cancer has grown into nearby tissues, if it has spread to nearby lymph nodes, and if it has spread to other areas of the body, such as the bones, lungs, or the brain.

The stages of kidney cancer range from 1 to 4. Early-stage kidney cancer refers to cancer that has not spread beyond the kidneys, meaning it is in stage 1 or 2.

• In stage 1, a tumor is 7 centimeters (cm) across or smaller, and is entirely inside the kidney.
• In stage 2, the tumor is larger than 7 cm across but is still inside the kidney—it has not spread to lymph nodes or other organs.

It’s important to note that staging for other types of cancer—including other forms of kidney cancer and cancers that occur in other areas of the body—will use different staging systems.

Treatment for early-stage RCC

For some people with small kidney tumors, healthcare providers may recommend active surveillance. With this approach, the tumor will be monitored with regularly scheduled ultrasounds. Treatment can begin if the tumor begins to grow.

Surgery is the most common treatment for early-stage RCC. For tumors in stage 1, healthcare providers often recommend a partial nephrectomy. With this procedure, surgeons will remove the part of the kidney where the tumor is located.

For larger tumors in stage 2, it may be necessary to remove the entire kidney. This procedure is called a radical nephrectomy. If lymph nodes near the kidney are enlarged, they will likely be removed as well.

If a person is unable to have surgery, other treatments may be used to destroy the tumor. These can include radiation therapy, cryotherapy, or radiofrequency ablation.

Anti-cancer drugs such as chemotherapy, targeted therapy, and immunotherapy can also be used. Sometimes these therapies are prescribed after surgery, to help prevent cancer from recurring. This is called adjuvant therapy.

Early-stage RCC is highly treatable, with a very favorable prognosis in many cases. According to the American Cancer Society, the 5-year survival rate for localized kidney cancer (localized means it hasn’t spread beyond the kidneys) is 93 percent.