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Surgery is the initial procedure in the treatment of many cancers. Surgery and other invasive procedures work by removing cancerous tissues.
Surgical removal of the kidney offers the best option for a cure for patients able to physically tolerate the procedure. Surgery also may be used to remove cancerous lesions that have spread to other organs. This is usually done to control symptoms and not to cure the disease.
Nephrectomy is the removal of the whole kidney. Doctors may be able to remove part of the affected kidney (partial nephrectomy) in certain cases, such as:
Nephrectomy is recommended for Stage I and II kidney cancer. Nephrectomy plus removal of regional lymph nodes is common for Stage III. If the cancer has spread to the renal vein, the doctor may remove the tumor and repair the vein.
The doctor may recommend an arterial embolization prior to surgery to decrease blood flow to the affected kidney. For this procedure, a catheter is inserted through the groin and threaded up to the renal artery. The doctor injects a substance into the artery to block blood flow.
The surgeon makes an incision under the ribs or in the back just behind the kidney. Then the surgeon removes the whole malignant kidney (radical nephrectomy) or a portion of the cancerous kidney (partial nephrectomy). He or she may also remove the adrenal gland; one adrenal gland sits above each kidney. Nearby lymph nodes may also be taken out. The incision is closed with stitches or staples, and bandaged to prevent infection.
Generally, this has been an open procedure. But the laparoscopic approach has become the preferred method to treat kidney cancer if suitable. With this method, small incisions are made in the skin through which a camera, light source, and surgical instruments are inserted. The surgeon performs the surgery using these tools, without cutting open the abdomen or back. With the laparoscopic approach you should have a faster recovery and spend only a couple of days in the hospital. Open surgery is still performed, usually for larger tumors that require more extensive surgery. You will stay in the hospital for four to seven days.
Nephrectomy is very successful. It has a five-year survival rate of 94% for patients with Stage I disease. For Stage II, it offers a five-year survival rate of 79%. The survival rate varies for Stage III, depending on where and how extensively the cancer has spread.
After surgery, you may need certain interventions:
In the hospital and after you leave:
References:
American Cancer Society website. Available at: http://www.cancer.org/docroot/home/index.asp?level=0 .
Bast R, Kufe D, Pollock R, et al, eds. Cancer Medicine. 5th ed. Hamilton, Ontario: BC Decker Inc; 2000.
Kidney Cancer Association website. Available at: http://www.kidneycancerassociation.org/ .
National Cancer Institute website. Available at: http://www.cancer.gov/ .
Last reviewed November 2008 by Mohei Abouzied, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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