Treatment of kidney cancer

Treatment depends on the type of kidney cancer you have. Below, we explain the different types and the treatment options for each. 

This is general information, so be sure to talk to your doctor about what’s right for you. Remember, the treatment options you can get may depend on where you live.

It’s important to be involved in decisions about your treatment, especially for kidney cancer. Research shows that when you talk about your symptoms and help choose your treatment, you may have better results and even live longer.

Ask your doctor how you can take part in making decisions. There are tools to help you and your family work with your healthcare team.

Take an active role in your treatment plan. Working closely with your doctor can lead to better outcomes, so it’s a good idea to stay involved.

When the tumour is only in the kidney and hasn't spread to other parts of the body, it's called localised kidney cancer, also known as Stage 1 or Stage 2 kidney cancer. 

How is localised kidney cancer treated? 

If you are diagnosed with localised kidney cancer, your doctor may suggest different treatment options. These can include:

• Active surveillance
• Partial nephrectomy
• Radical nephrectomy
• Radiofrequency ablation
• Cryotherapy

Each option has its own pros and cons. The treatment that is best for you will depend on your own situation. In this section we will explain what each of these treatments mean.

Active surveillance treatment (no surgery)
If the tumour is smaller than 4 cm, your doctor may recommend active surveillance. This means your doctor will keep a close eye on the tumour without doing surgery right away, often through regular check-ups and scans to see if the tumour is getting bigger.

Active surveillance is usually chosen if surgery isn’t the best option for you. To make sure it's safe, your doctor might take a small sample of the tumour (a biopsy) to check if it's growing quickly. If the tumour is aggressive, surgery or other treatments might be suggested.

A biopsy is a test where a small piece of tissue is taken from the body. This piece of tissue is then looked at under a microscope to check for disease.

Removing the tumour (partial nephrectomy surgery)

In a partial nephrectomy, only the tumour is removed, leaving the healthy part of the kidney untouched. 

Follow this link to find out more about partial nephrectomy.

Removing the kidney and kidney tissue (radical nephrectomy surgery)

If the whole tumour can’t be removed while keeping some of the kidney, then radical nephrectomy is needed. This surgery takes out the whole kidney along with the surrounding tissue where the tumour is. 

Click this link to find out more about radical nephrectomy.

Cool or hot therapy (ablation therapy)

If the tumour keeps growing, ablation therapy might be a good option. Ablation uses heat or cold to destroy the cancer cells. 

Follow this link to find out more about different types of ablation therapy. 

Locally advanced kidney cancer also called Stage 3 or Stage 4 kidney cancer, means the cancer has grown outside the kidney but hasn't spread to other parts of the body.

The renal vein is a blood vessel that carries filtered blood from the kidney to the vena cava. Each kidney has a renal vein that helps remove waste and controls fluid balance in the body.

The vena cava is the major vein that collects blood from the renal veins and carries it back to the heart.

The adrenal glands are small glands on top of each kidney. They make important hormones that help control stress, metabolism, blood pressure, and energy levels.

Lymph nodes are small lumps of tissue that have white blood cells which fight infections.

How is locally advanced kidney cancer treated?

Locally-advanced kidney cancer can be treated with a procedure called radical nephrectomy. This means that the kidney that has the tumour and the surrounding tissue are removed.

Click this link to find out more about radical nephrectomy.

If surgery is impossible or risky, the doctor may recommend embolisation. This works by blocking a blood vessel to cut off the blood supply to the cancer. The doctor puts a thin, flexible tube (called a catheter) into a blood vessel in your groin. They carefully guide it to the blood vessels near the kidney to stop the blood flow to the tumour.

If the cancer has spread to other parts of the body, like faraway lymph nodes or other organs, it is called metastatic kidney cancer. In metastatic kidney cancer, the kidney tumour is called the primary tumour, and tumours in other organs are called metastases.

When kidney cancer spreads (metastasises), it usually goes to the lungs, bones, lymph nodes, or brain. Doctors can spot where the cancer has spread to on a CT scan, either when the cancer is first found, or during follow-up visits after treatment. Sometimes, the spread of the cancer is noticed because it causes symptoms.

Lymph nodes are small lumps of tissue that have white blood cells which fight infections.

How is metastatic kidney cancer treated?

Generally, metastatic disease cannot be cured. The treatment for metastatic kidney cancer focuses on shrinking the tumour in your kidney and the tumours that have spread. This can help you live longer and feel more comfortable.

Your doctor may suggest:

• Surgery
• Drug treatment

It’s important to talk to your doctor about which treatment options are best for you. This is general information, and treatment may vary depending on where you live or your specific situation.

Surgery

If you have metastatic kidney cancer, your doctor might suggest removing the kidney to shrink the tumour and ease symptoms. This surgery is called cytoreductive nephrectomy and can only be done if you're healthy enough for it. If it works, it can help you live longer and with less side effects.

Click this link to find out more about cytoreductive nephrectomy.

If the main tumour is small or your other kidney isn’t working well, your doctor may suggest a partial nephrectomy. In this surgery, the doctor removes the tumour while keeping as much healthy kidney tissue as possible.

Click this link to find out more about partial nephrectomy.

If surgery isn’t an option, embolisation can be used to shrink the main tumour and help with symptoms. It works by blocking a blood vessel to cut off the blood supply to the cancer. The doctor inserts a thin, flexible tube (called a catheter) into a blood vessel in your groin. They carefully guide it to the blood vessels near the kidney to stop the blood flow to the tumour.

Drug treatment

In metastatic kidney cancer, surgery is often combined with medication. There are different types of drug treatments for kidney cancer:

• Immunotherapy-based treatments.
  Click here to learn more about immunotherapy.
• Antiangiogenic therapy, commonly described as targeted therapy.
  Click here to learn more about antiangiogenic therapy.

Your doctor may recommend drug treatment before surgery to shrink the tumour so it can be removed. If it works well, treatment continues after surgery. It is also possible that your doctor recommends drug treatment only after surgery.

If surgery isn’t right for you, you’ll begin treatment with medication right away. These drugs work by stopping tumours from growing. They can help with your symptoms, shrink the main tumour, and also shrink tumours that have spread.

If the metastases still cause symptoms after surgery or while you are on medication, radiotherapy may help to relieve them further.

Click here to learn more about radiotherapy.

This chapter contains general information about treatment options for kidney cancer. If you have any specific questions about your own medical situation you should consult your doctor or other professional healthcare provider. No website or leaflet can replace a personal conversation with your doctor.

Last updated: February 2025