Diagnosing and Treating Kidney Cancer

Diagnosis

Cancer of the kidney is most commonly found today when imaging studies of the abdomen are done for other reasons. The least expensive and non-toxic imaging study, the ultrasound, is quite good at detecting kidney tumors, and can be used when symptoms that can occur with kidney cancer are present. These symptoms are highly variable and include vague conditions such as abdominal pain, indigestion, change in bowel habits, fever, malaise, weakness, weight loss, anemia, and even elevated blood pressure. Flank pain, blood in the urine, or a mass that can be felt in the abdomen are clear indications for an imaging study of the kidneys.

Treatment

Surgery: Kidney cancer is relatively resistant to radiation therapy and chemotherapy, which leaves surgery as the best approach. Advances in surgery that are available include removal of the kidney with adjacent lymph nodes, for large tumors, partial nephrectomy for small tumors, and laparoscopic nephrectomy. All of these approaches are available at BCG Oncology.

Immunotherapy: Advanced or metastatic kidney cancer is difficult to treat. Kidney cancer, like bladder cancer, is one of only a few cancers that are often best treated with immunotherapy, the specialty of BCG Oncology. Responses to BCG (Bacillus Calmette-Guerin) immunotherapy have been reported, and IL-2 (Interleukin-2, a cytokine or chemical produced by immune cells that can kill cancer cells) is specifically approved by the FDA for the treatment of advanced kidney cancer. Studies have shown that Interferon (a cytokine that kills virus and stops cancer cells from dividing) is also effective. We have reported remarkably good results using a combination of chemotherapy (5 fluorouracil, 5-FU) and low dose interferon.

Now, the equivalent of 5-FU, Xeloda, can be taken by mouth which makes the treatment much easier. The treatment of kidney cancer is advancing rapidly, and Dr. Lamm attends conferences nearly every week to identify promising new treatments for his patients.

Cryotherapy: The science of cryobiology and cryotherapy continues to evolve at a rapid pace. Studying the effects of low temperatures from hypothermic conditions to cryogenic temperatures on human tissue bears relevance in many areas of medicine, particularly in the field of urology. Typically considered an outpatient procedure, cryotherapy is a relatively new kidney cancer treatment that uses extreme cold to freeze and destroy renal cancer cells. With more research into this rapidly growing field, cryotherapy will likely become one of the dominant clinical procedures in surgical oncology.

Kidney Cancer Cryotherapy is indicated for patients with:
  • A single kidney or compromised renal function
  • Center or peripheral lesions less than 4 cm
  • Complications, making them unfit to undergo major surgery

    • Kidney Cancer Cryotherapy Treatments - Laparoscopic and Pure Percutaneous Renal cryotherapy offers the ability to use minimally invasive approaches, including laparoscopic or purely percutaneous techniques, so treatment can be customized to the patient's individual health. Under both techniques, patients are able to go home the same day and experience significantly less pain and more rapid recoveries when compared to more traditional treatment approaches.

    In laparoscopic cryotherapy of the kidney, general anesthesia is typically administered. A laparoscopic ultrasound probe is inserted to monitor the percutaneous placement of the cryoneedles and thermal sensors into the tumor, the cryoablation needles are inserted through the skin. The ultrasound probe also monitors the tumor and the iceball formation during a double freeze-thaw cycle.

    In pure percutaneous cryotherapy of the kidney, general anesthesia is sometimes administered however, in most cases the procedure is done under light sedation, and patients are positioned in a CT or MRI scanner. No incisions are made as the cryoneedles and thermal sensors are inserted through the skin and guided to the tumor through CT, MRI, or Ultrasound monitoring to perform a double freeze-thaw cycle.

    Advances in Renal Imaging Support the Efficacy of Cryotherapy Treatment As cryotherapy is still considered a new kidney cancer treatment, long-term benefits and risks are very promising. With five-year data now available and outcomes show little to no cancer recurrence or post-procedure complications. Improvements in renal imaging to localize the tumor and define the margins for the freezing process are making cryotherapy an effective kidney cancer treatment option for patients with small tumors located on the outer edge of the kidney. Prior to the advancement of cryotherapy, surgery (in which part or the entire kidney is removed) was the main treatment option for renal cell carcinoma. Today, cryotherapy presents a new kidney-sparring alternative to suitable patients.

    Kidney cancer cryotherapy and other treatment options are available at BCG Oncology. In order to provide the best services for his patients, Dr. Lamm routinely attends conferences to discern the latest developments in the specialty of urology and in the science of cryobiology.

    Patient Brochure: Patient Brochure PDF