Kidney Cancer

Kidney Cancer

 

The University of Chicago Kidney Cancer Program
The University of Chicago is a world leader in the treatment of kidney cancer. Urologists at the University of Chicago specialize in the latest open and laparoscopic surgical techniques to treat kidney tumors. In combination with colleagues in Medical Oncology and the Cancer Research Center, we offer a comprehensive and diverse option of therapies.

 

An Overview of Kidney Cancer
Most kidney masses (or tumors) are discovered incidentally – meaning that they are found by chance during radiologic studies obtained for an unrelated medical condition.

 

Most solid kidney masses (or tumors) are cancerous. Fortunately, many can be cured with surgery. Some kidney masses (or tumors) are not cancerous. For example, simple cysts, a type of renal mass, are often benign, meaning that they require no additional treatment.


The most common type of kidney cancer is renal cell carcinoma. Each year in the United States, approximately 30,000 new cases of renal cell carcinoma are identified. Many of these are found early in their course, when they are small and very treatable. CT or MRI scans demonstrating a “solid, contrast-enhancing mass” or a “complex cystic lesion” suggest the presence of kidney cancer. At the University of Chicago, we offer a variety of treatments for renal cell carcinoma, including radical nephrectomy (removing the entire kidney) and partial nephrectomy (removing just the cancerous part of the kidney). Minimally-invasive (or laparoscopic) techniques are used when applicable. However, if feasible, open surgery is preferred. We offer cryotherapy (freezing the tumor) as well as several drug treatments that can be sued in combination (or instead of surgery) depending on the size and extent of the tumor.

 

A second type of kidney cancer is called transitional cell cancer. This type of cancer is very similar to bladder cancer and can involve the kidney or the ureters, the tubes that empty the kidney and drain urine to the bladder. These cancers are relatively rare, affecting approximately 4,000 people in the United States each year. At the University of Chicago, we offer a variety of treatments for transitional cell carcinoma. Most patients undergo a nephroureterectomy – an operation in which the kidney and the adjoining ureters are removed. If the cancer is limited to a specific portion of the ureter, some patients are able to undergo a ureterectomy, an operation in which the kidney is preserved but the ureter is removed. Minimally invasive (laparoscopic) techniques are used when applicable, however, both open surgical and minimally-invasive (or laparoscopic) techniques are avaiable at the University of Chicago for both nephroureterectomy and ureterectomy. In very select cases, a patient may undergo endoscopic surgery, in which the tumor is removed while the kidney and ureter are left intact. This is rarely performed and depends upon the patient’s health as well as the aggressiveness, location, and extent of the cancer.

 

  • For more details on transition cell cancer of the kidney and ureter, click here.
  • For more details on the treatment of transition cell cancer of the kidney and ureter, click here
     

There are other tumors that can affect the kidney. Sarcomas are treated similarly to renal cell carcinoma. Angiomyolipomas (a tumor consisting of fat, muscle, and blood vessels) can be treated in a variety of ways: including surgery, embolization (blocking the blood supply to the tumor) and observation. Lymphomas are treated with drug therapies.

 

At the University of Chicago, we offer the latest and most comprehensive treatment for any type of kidney tumor. For an appointment with one of our kidney cancer specialists, click here.

 

Surgical Treatment Options for Kidney Cancer
Surgery is the main treatment for kidney cancers.

 

Radical Nephrectomy(click here for FAQs about Radical Nephrectomy)

 

  • This involves removal of the entire kidney, the adjoining adrenal gland, and the surrounding fatty tissue (all contained within Gerota’s Fascia). This operation is used for renal cell carcinomas that are larger than 4cm or for smaller tumors if they are located in the center of the kidney.
  • Radical nephrectomies are performed in a laparoscopic (minimally-invasive) manner unless the tumor is too large or invades into surrounding organs.
  • If the tumor invades surrounding organs (such as the liver or spleen) or is involving the inferior vena cava, these structures may be removed in addition to the kidney. Depending upon the location and extent of such locally-advanced disease, open or laparoscopic techniques may be used.
  • Larger kidney tumors may recur even after complete surgical removal. Therefore, drug (medical therapy) may be given after surgery to help prevent recurrence. This treatment usually involves stimulation of the immune system and is called systemic immunotherapy.
     

Partial Nephrectomy and Nephron-sparing Surgery

  • This involves removal of the tumor, leaving the surrounding normal kidney tissue intact. This operation is often used for renal cell carcinomas that are smaller than 4cm or for larger tumors if a patient has or is at risk for kidney failure (such as patients with a single kidney, severe high blood pressure, kidney stones, diabetes).
  • Sometimes, the tumor can be frozen, a process known as cryotherapy. In this case, no tissue is removed and the cancer cells are killed by freezing them.
  • Partial nephrectomies are performed in a laparoscopic (minimally-invasive) manner unless the tumor is centrally located. Cryotherapy is usually performed through a laparoscopic approach.
  • Surgeons at the University of Chicago are trained in the most up-to-date and technologically-advanced methods of treating kidney cancers and saving normal kidney tissue.


Nephroureterectomy

  • This involves removal of the kidney, the ureter, and all of the surrounding tissue. This operation is often used for transitional cell cancers of the kidney and ureters.
  • Nephroureterectomies and ureterectomies are performed in a laparoscopic (minimally-invasive) manner unless the tumor is too large or invades surrounding organs.


Ureterectomy

  • This involves removal of all or part of the ureter, leaving the kidney intact. This operation is infrequently used and applies to patients with small, early cancers and poor kidney function.
  • Reconstruction of the ureter may be necessary, which may involve a direct reconnection of the normal edges, reshaping the bladder to form into a tube, or placing a piece of intestine between the kidney and bladder.
  • Ureterectomies can be performed in an open or laparoscopic (minimally-invasive) manner.


Endoscopic Kidney Surgery

  • This involves removing a transitional cell cancer of the kidney or ureter through a telescope inserted through the urethra and into the bladder.
  • This operation is reserved for ill patients and those with very small, superficial, and non-aggressive tumors.

Surgeons at the University of Chicago are trained in the most up-to-date and technologically-advanced methods of treating kidney cancers. At you appointment, your surgeon will be glad to discuss all of these treatment options with you, as well as any applicable clinical trial or experimental therapy.