Kidney cancer treatment depends on the type and stage of cancer, the size and location of the tumour, whether it has spread, and the patient’s overall health. Treatment may include surgery, active surveillance, ablation, immunotherapy or targeted medicines.
For kidney cancer that has not spread beyond the kidney, surgery is often the main treatment. Advanced kidney cancer may require a combination of medicines designed to control the disease and slow its progression.
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How is Kidney Cancer Treatment Given?
There is no single treatment suitable for everyone. Doctors consider the cancer stage, tumour size and location, kidney function, overall health and whether the cancer has spread.
Treatment may include:
- Partial or radical nephrectomy
- Active surveillance
- Cryotherapy or other ablation techniques
- Immunotherapy
- Targeted therapy
- Radiotherapy in selected cases
- Clinical trials
A specialist team usually reviews these factors before recommending a treatment plan.
Kidney Cancer Treatment by Stage
Stage 1
Stage 1 kidney cancer is generally confined to the kidney, with a tumour measuring 7 cm or less.
Surgery is often the preferred treatment. A partial nephrectomy removes the tumour while preserving healthy kidney tissue. A radical nephrectomy, which removes the entire kidney, may be recommended when partial surgery is not suitable.
For some people with small kidney tumours, particularly those who are older or have other significant health problems, active surveillance may be considered. This involves regular scans to monitor the tumour rather than treating it immediately.
Stage 2 and Stage 3
Surgery remains an important treatment when the cancer can be removed. Depending on the tumour, this may involve partial or radical nephrectomy.
For selected patients with a high risk of recurrence after surgery, adjuvant pembrolizumab may be considered. The decision depends on the cancer’s characteristics and the patient’s individual risk.
Stage 4
Treatment generally focuses on controlling the cancer, slowing its growth, and maintaining quality of life.
Immunotherapy and targeted therapies are now important treatments for advanced renal cell carcinoma. Some patients may receive combinations of immunotherapy drugs or immunotherapy with targeted treatment.
Surgery for Kidney Cancer
Partial nephrectomy and radical nephrectomy are two key surgical approaches.
A partial nephrectomy removes the cancer while leaving the rest of the kidney intact. The 2026 European Association of Urology guidelines recommend partial nephrectomy for suitable T1 tumours because preserving kidney function is important.
A radical nephrectomy removes the entire affected kidney and may be necessary when the tumour is large, complex or cannot be safely removed while preserving enough healthy kidney tissue.
Ablation treatments
For selected small kidney cancers, particularly when surgery is unsuitable, doctors may consider treatments that destroy the tumour without removing the entire kidney.
- Ablation offers another way of treating certain kidney tumours without removing the entire kidney. Depending on the technique, the tumour can be destroyed by freezing it with cryoablation or by applying controlled heat through radiofrequency or microwave energy. These procedures may be considered for selected patients when conventional surgery is not the preferred option.
Immunotherapy and Targeted Treatment
Immunotherapy helps the immune system recognise and attack cancer cells. Medicines such as pembrolizumab, nivolumab and ipilimumab are used in certain kidney cancer treatment plans.
Targeted medicines work on specific pathways that help kidney cancer cells grow. Depending on the situation, treatments may include drugs such as cabozantinib, axitinib, lenvatinib or everolimus.
Treatment can cause side effects, so patients should discuss the expected benefits and risks with their oncology team.
Is Chemotherapy Used for Kidney Cancer?
Traditional chemotherapy is not commonly used for renal cell carcinoma, as these cancers generally respond poorly to standard chemotherapy. However, chemotherapy can have a role in some rarer types of kidney cancer.
Follow-Up After Treatment
Treatment does not necessarily end when surgery or drug therapy is completed. Regular follow-up appointments, blood tests and imaging may be recommended to monitor for recurrence and check kidney function.
The frequency of follow-up depends on the cancer stage, treatment and individual risk.
Conclusion
The best kidney cancer treatment depends on the cancer’s stage, type and the patient’s overall health. Early tumours may be treated with surgery, surveillance or ablation, while advanced cancer may require immunotherapy or targeted treatment. A specialist team can help determine the most suitable approach for each patient.
Key Takeaways
- Surgery is often the main treatment for kidney cancer that has not spread.
- Partial nephrectomy can preserve healthy kidney tissue.
- Active surveillance may be suitable for selected small tumours.
- Advanced kidney cancer may be treated with immunotherapy and targeted medicines.
- Chemotherapy is generally not used for common renal cell carcinoma.
- Regular follow-up is important after treatment.
FAQs
What is the most common treatment for kidney cancer?
Surgery is the main treatment for many kidney cancers that have not spread beyond the kidney. Depending on the tumour, this may involve partial or radical nephrectomy.
Can kidney cancer be cured?
Some early kidney cancers can be cured, particularly when the cancer is confined to the kidney and can be completely removed.
Can kidney cancer be treated without removing the kidney?
Yes. Partial nephrectomy, active surveillance and, in selected cases, tumour ablation can treat kidney cancer without removing the entire kidney.
