Surgery for early kidney cancer
Surgery is the main treatment for early kidney cancer. Depending on the type of kidney cancer, the grade and stage of the cancer, and your general health, you might have one of the following operations:
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This is the most common operation for tumours 7 cm or smaller that are found only in the kidney. It may also be used for people who have existing kidney disease, cancer in both kidneys or only one working kidney. Only the cancer and a small part of the surrounding kidney are removed. A partial nephrectomy is a more difficult operation than a radical nephrectomy. Whether it is possible depends on where the tumour is in the kidney.
This is the most common operation for large tumours. The whole affected kidney, a small part of the ureter and the surrounding fatty tissue are removed. The adrenal gland and nearby lymph nodes might also be removed. Sometimes the kidney cancer may have spread into the renal vein and even into the vena cava, the large vein that takes blood to the heart. Even if the cancer has spread to the vena cava, it is sometimes possible to remove all the cancer in one operation.
If a whole kidney or part of a kidney is removed, the remaining kidney usually does the work of both kidneys. Your doctor will talk to you about how to keep the remaining kidney healthy, which may include reducing your risk of high blood pressure, heart problems and diabetes.
If you have surgery for kidney cancer, it will be carried out in hospital under a general anaesthetic. Your surgeon will talk to you about the risks of the procedure.
One of the following methods will be used to remove part or all of the kidney (partial or radical nephrectomy). Each method is suitable in particular situations.
- This is usually done with a long cut (incision) at the side of your abdomen where the affected kidney is located.
- In some cases, the incision is made in the front of the abdomen or in another area of the body where the cancer has spread.
- If you are having a radical nephrectomy, the surgeon will clamp off and divide the major blood vessels and tubes to the affected kidney before removing it.
- This is also called minimally invasive surgery or laparoscopic surgery.
- The surgeon will make several small cuts in the skin and insert a tiny instrument with a light and camera (laparoscope) into one of the openings. The laparoscope sends images of your body to a video monitor. The surgeon watches the images on the monitor for guidance during the operation.
- This is a type of keyhole surgery using a robotic device.
- The surgeon sits at a control panel to see a three-dimensional image and moves robotic arms that hold the instruments.
- Robotic surgery has allowed more partial nephrectomies to be performed with keyhole surgery, reducing complications and improving recovery time.
Talk to your surgeon about the types of surgery suitable for you, and ask about the advantages and disadvantages of each method. If your surgeon suggests robot-assisted surgery, check what you have to pay. Unless you are treated as a public patient in a hospital or treatment centre that offers this at no extra cost, it can be a more expensive operation.
Compared to open surgery, both keyhole (laparoscopic) surgery and robot-assisted surgery usually mean a shorter hospital stay, less pain and a faster recovery time. But in some cases, open surgery may be a better option.
See our general section on Surgery for more information about surgery and recovery.
Podcast: Making Treatment Decisions
A/Prof Daniel Moon, Urologic Surgeon, Australian Urology Associates, and Honorary Clinical Associate Professor, The University of Melbourne, VIC; Polly Baldwin, 13 11 20 Consultant, Cancer Council SA; Ian Basey, Consumer; Gregory Bock, Urology Cancer Nurse Coordinator, WA Cancer and Palliative Care Network, North Metropolitan Health Service, WA; Tina Forshaw, Advanced Practice Nurse Urology, Canberra Health Services, ACT; Dr Suki Gill, Radiation Oncologist, Sir Charles Gairdner Hospital, WA; Karen Walsh, Nurse Practitioner, Urology Services, St Vincents Private Hospital Northside, QLD; Dr Alison Zhang, Medical Oncologist, Chris O’Brien Lifehouse and Macquarie University Hospital, NSW.
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