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KIDNEY CANCER
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.
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.
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.
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