Strategies to Improve Treatment for Stage I Kidney (Renal Cell) Cancer

This content has been reviewed and approved by

Robert J. Motzer, MD
Attending Physician

Memorial Sloan-Kettering Cancer Center

Progress in treating stage I renal cell cancer is based on improved surgical techniques and the use of improved alternative therapies for patients who are medically unable to have surgery.

Laparoscopic nephrectomy (removal of the kidney through small incisions) is one example of improved surgical technique that can help certain patients. This procedure allows faster healing with less pain than conventional surgery. Another example is partial nephrectomy (removal of only the part of the kidney involved in tumor). When possible and appropriate, this procedure may help preserve kidney function important for a patient's well-being.

Strategies that are under study, but have not been proven for treating kidney cancer, include laparoscopic partial nephrectomy and nonsurgical methods for destroying cancer cells.

Laparoscopic partial nephrectomy is intended to combine the benefits of laparoscopy-directed surgery with those of partial nephrectomy. The goal is to help patients have faster and easier healing while maintaining as much kidney function as possible, and without a high risk of the cancer coming back. However, this procedure is still technically challenging to perform successfully and remains under study.

Nonsurgical methods for destroying small areas of cancer while sparing nearby normal kidney tissue are based on the focused use of energy. The intention is to direct energy to the body so as to kill only the volume of kidney tissue containing cancer cells. Some examples of these techniques include:

• Radiofrequency ablation (destruction of cancer cells using radiowaves, which deliver heat directly to the cells)
• Cryoablation, also known as cryotherapy (destruction of cancer cells using freezing cold)
• Microwave thermotherapy (destruction of cancer cells using microwaves, which deliver heat directly to the cells)
  

Nonsurgical techniques may someday be effective and useful for patients with kidney cancer who have smaller tumors that can be eliminated without surgery, or who are not able to safely undergo surgery. However, these techniques also have the potential to significantly damage normal tissues and are still under study.

Along with improved treatments, new ways are needed to identify which patients would benefit most from less invasive treatment strategies, with the lowest risk that the cancer may come back. Scientists are studying the biologic characteristics of specific types of kidney cancer cells, including the proteins they produce, in an effort to accomplish this and other goals.