Whenever possible, surgery is the main treatment for kidney cancers that can be removed. But for people who are too sick to have surgery, other approaches can sometimes be used to destroy kidney tumors. While they may be helpful for some people, there is much less data on their long-term effectiveness than there is for surgery, and some doctors may still consider them to be experimental.

Cryotherapy (cryoablation)

This approach uses extreme cold to destroy the tumor. A hollow probe (needle) is inserted into the tumor either through the skin (percutaneously) or during laparoscopic surgery. Very cold gases are passed through the probe, creating an ice ball that destroys the tumor. To be sure the tumor is destroyed without too much damage to nearby tissues, the doctor carefully watches images of the tumor during the procedure (with ultrasound or other tests).

The type of anesthesia used for cryotherapy depends on how it is being done. Possible side effects include bleeding and damage to the kidneys or other nearby organs.

Radiofrequency ablation

This technique uses high-energy radio waves to heat the tumor. A thin, needle-like probe is placed through the skin and advanced until the end is in the tumor. Placement of the probe is guided by ultrasound or CT scans. Once it is in place, an electric current is passed through the probe, which heats the tumor and destroys the cancer cells.

RFA is usually done as an outpatient procedure, using local anesthesia (numbing medicine) where the probe is inserted. You may be given medicine to help you relax as well. Major complications are uncommon, but they can include bleeding or excessive tissue damage.

Arterial embolization

This technique is used to block the artery that feeds the kidney with the tumor. A small catheter (tube) is placed in an artery in the inner thigh and is advanced until it reaches the artery going from the aorta to the kidney (renal artery). Material is then injected into the artery to block it, cutting off the kidney's blood supply, causing it (and the tumor) to die. Although this procedure is rarely performed, it is sometimes done before nephrectomy to reduce bleeding during the operation.

Radiation therapy

Radiation therapy uses high-energy radiation to kill cancer cells. External beam therapy focuses radiation from outside the body on the cancer. It is like getting an x-ray, but the radiation is much more intense. The procedure itself is painless.

Kidney cancers are not very sensitive to radiation. Radiation therapy can be used to treat kidney cancer if a person's general health is too poor for them to have surgery. For patients who can have surgery, using radiation therapy before or after removing the cancer is not routinely recommended because studies have not shown this improves survival rates.

Radiation therapy is more often used to palliate, or ease, symptoms of kidney cancer such as pain, bleeding, or problems caused by cancer spread (especially to the bones or brain).

A special type of radiation therapy known as stereotactic radiosurgery can sometimes be used for single tumors that have spread to the brain. This procedure does not actually involve surgery. There are two main techniques for stereotactic radiosurgery, but they all use the same principle of pinpoint radiation. In one technique, several beams of high-dose radiation are focused on the tumor from different angles over a few minutes to hours. The second technique uses a movable linear accelerator that is controlled by a computer. Instead of delivering many beams at once, the linear accelerator moves around to deliver radiation to the tumor from different angles. In either approach, the patient's head is kept in the same position by placing it in a rigid frame.

Side effects of radiation therapy may include mild skin changes (similar to sunburn), nausea, diarrhea, or tiredness. Often these go away after a short while. Radiation may also make side effects from some other treatments worse. Radiation therapy to the chest area may damage the lungs and lead to shortness of breath. Side effects of radiation to the brain usually become most serious 1 or 2 years after treatment and can include headaches and trouble thinking.

Last Medical Review: 02/18/2009
Last Revised: 05/14/2009