• Chemotherapy
• Clinical Trials
• Future Treatments
• Immunotherapy
• Nephrectomy
• Radiation Therapy
• Surgical Treatments
• Treatment Choices by Stage

Stage I or stage II: Patients with stage I and II RCC most often have their cancers surgically removed by either radical or partial nephrectomy. Additional (adjuvant) chemotherapy, radiation therapy, or immunotherapy after surgery for stage I or stage II RCC is not recommended. Patients who are unable to tolerate kidney surgery because of other serious medical problems are often treated by experimental procedures such as cryoablation or arterial embolization. With surgical treatment, the 5-year survival for stage I patients is between 88% and 100% and the 5-year survival for stage II patients is between 63% and 67%.

Stage III: Radical nephrectomy is the most common treatment for stage III RCC. Sometimes, a patient will have an arterial embolization procedure in attempt to reduce the amount of bleeding during nephrectomy. If the cancer extends into nearby veins, the surgeon may need to cut open these veins and to completely remove the cancer. The 5-year survival for stage III patients varies widely and is between 40% and 80%, depending on the local extent of the cancer.

Stage IV: Stage IV RCC has spread too far away from the kidney to be cured by surgery. If the patient's general health is good enough to withstand the side effects of cytokine immunotherapy, this option offers the best opportunity and is now considered standard therapy by many doctors. Clinical trials of new forms of immunotherapy, combined immunotherapy and chemotherapy, new chemotherapy drugs, and other new therapies are other options. For some patients, palliative treatments such as embolization or radiation therapy may be the best treatment. When one or a few metastases are present and the surgeon considers it possible to remove them without serious side effects, an aggressive surgical approach to removing the kidney tumor and these metastases may be beneficial. Unfortunately, most patients who appear to have only 1 or 2 metastases on imaging tests actually may have cancer that cannot be surgically resected. The 5-year survival for stage IV patients is less than 18%.

Recurrent RCC
As with stage IV RCC, cytokine immunotherapy or clinical trials of new treatments are treatment options for patients able and willing to tolerate the side effects. In rare cases, a patient willl have a solitary site of recurrence of RCC detected several years after nephrectomy. In these exceptional cases, surgical removal of the solitary site of recurrence may be possible after extensive imaging tests have shown no other evidence of cancer spread. Radiation therapy can be used to reduce symptoms of some metastases. Appropriate treatment of pain is an important way of maintaining quality of life. It is important to realize that medications to relieve pain do not interfere with other treatments, and that there are new approaches to pain medication that do not prevent a patient from being alert and active. In fact, proper treatment of pain often helps people with cancer to be more active and continue their usual activities.