Active Surveillance for Kidney Cancer

One option for some people with small kidney tumors (less than 4 cm[about 1½ inches]), may be to give no treatment at first and watch the tumor carefully to see if it grows. The tumor is removed (or treated another way) if it grows quickly or gets larger than 4 cm.

This approach is most often used for elderly or frail patients as it avoids the risks of treatment, such as surgery or ablation. Often, a biopsy is done before deciding to watch the tumor to see if the growth is really cancer. Some of these small tumors turn out not to be cancers at all. Watching them closely for a time helps doctors decide which tumors are more likely to be cancer based on their growth.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

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Lee SI and  Shauna Duigenan S. UpToDate.  Diagnostic approach, differential diagnosis, and treatment of a small renal mass. This topic last updated: Aug 23, 2016. Accessed at on June 5, 2017. 

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Kidney Cancer. V.2.2017. Accessed at: on June 5, 2017.

Pili R, Kauffman E, Rodriguez R. Ch 82 - Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa: Elsevier: 2014.

Richie JP. UpToDate. Definitive surgical management of renal cell carcinoma. This topic last updated: March 14, 2017. Accessed at on June 5, 2017.

Last Medical Review: August 1, 2017 Last Revised: August 1, 2017

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