Renal cell carcinoma is the most common type of kidney cancer in adults. Kidney cancer usually has no presenting symptoms as the majority of kidney cancer is found by chance on imaging for other health problems.  Only 10% of patients present with the classic triad of flank pain, hematuria, and flank mass.

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Lab studies used for evaluation of suspected renal cell carcinoma include the following:

• Urinalysis (UA)

• Complete blood cell (CBC) count with differential

• Complete metabolic panel (Electrolytes, kidney function tests, liver function tests)

Imaging studies used to evaluate and stage renal masses may include the following:

• CT scan

• Ultrasound

• MRI

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The principal treatment options for renal cell cancer include:

• Surgery

• Molecular-targeted therapy

• Immunotherapy

• Radiation therapy

• Thermal Ablation

• Active surveillance

Surgical resection remains the only known curative treatment for localized renal cell carcinoma, and it is also used improve outcome or for palliation in metastatic disease. Targeted therapy and immunomodulatory agents are considered standard of care in patients with metastatic disease. Chemotherapy is used only occasionally, in certain tumor types. 

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Dr Jeannie Su has extensive training and experience with kidney cancer surgery. She tailors the surgery and treatment based on the individual patient and tumor characteristic.  During your consultation, she will review all images with you and go over all your options in detail. 

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When possible, Dr Jeannie Su strives to save as much of the kidney as possible by only removing the tumor via a partial nephrectomy. Excellent cancer cure rates and preservation of kidney function can be achieved with partial nephrectomy.  In suitable candidates, rather than making a large surgical incision, Dr Jeannie Su can perform the partial nephrectomy by making a few small incisions and using specialized instruments utilizing the daVinci surgical system. Patients who undergo robot-assisted partial nephrectomy are typically in the hospital overnight and are able to return to most of their activities within 1-2 weeks. They are asked not to engage in heavy lifting or strenuous exercise for 4 weeks in order to allow their incisions and the kidney to heal well.

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In rare situations, minimally invasive robotic surgery is not a suitable option for patients who need a kidney tumor removal and an open approach is pursued. Often with the open approach, the surgery is performed by making a flank incision and approaching the kidney by going between the lower ribs. Patients who undergo an open partial nephrectomy are typically in the hospital for 3-5 days and are able to return to most of their normal activities within 2 weeks. They are asked not to engage in heavy lifting or exercise for approximately 4 weeks in order to allow their incision and the kidney to heal well.

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Sometimes the kidney cancer is so large that it has replaced most of the kidney; in other situations, the cancer is located such that preserving the blood supply to the kidney is not possible. In such cases, a partial nephrectomy cannot be performed. Instead, a radical nephrectomy is performed whereby the entire kidney is removed along with the tumor. Typically a radical nephrectomy can be performed through a minimally invasive approach (laparoscopic or robotic nephrectomy), where several small incisions are used to perform the operation. At the end of the operation, one of the incisions is slightly lengthened to allow the removal of the entire kidney from the body. Excellent cancer cure rates can be achieved with a radical nephrectomy. Using a minimally invasive approach, our patients have less pain, shorter hospital stays, and quicker return to their daily activities.

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