General information on the treatment used for kidney cancer

Surgery is the main treatment for cancer of the kidney. In some people, hormonal treatment or biological treatment can be used either after surgery or when a cancer cannot be removed surgically. Occasionally radiotherapy is used. In rare cases, cancer of the kidney will spontaneously improve without any treatment, but this is not usual.

If you have any questions about your treatment, don’t be afraid to ask your doctor or the nurse looking after you. It often helps to make a list of questions you want to ask and take a close friend or relative with you to help you remember the discussion more fully.

How treatment is planned

In most hospitals a team of specialists will discuss with you the treatment that they feel is best for your situation. This multidisciplinary team (MDT) will include a surgeon who specialises in kidney cancers, an oncologist (specialist in giving chemotherapy, radiotherapy and biological therapy) and may include a number of other healthcare professionals such as a:

• nurse specialist
• dietitian
• physiotherapist
• occupational therapist
• psychologist or counsellor.

Your doctors will be able to advise you on the best course of action and plan of treatment taking into account a number of factors. These include your age, general health, the type and size of the tumour, and whether it has begun to spread.

Occasionally your doctors may offer you a choice of treatments. Sometimes people find it very hard to make a decision. If you are asked to make a choice, make sure that you have enough information about the different treatment options, what is involved and the side effects you might have, so that you can decide what is the right treatment for you.

Remember to ask questions about any aspects that you do not understand or feel worried about. You may find it helpful to discuss the benefits and disadvantages of each option with your cancer specialist, nurse specialist or with the nurses at CancerBACUP.

Second opinion

Even though a number of cancer specialists work together as part of a team to decide on the most suitable treatment, you may want to have another medical opinion. Most doctors will be willing to refer you to another specialist for a second opinion if you feel that it will be helpful. The second opinion may take some time to organise and may cause a delay in the start of your treatment, so you and your doctor need to be confident that it will give useful information.

If you go for a second opinion, it may be a good idea to take a friend or relative with you, and to have a list of questions ready so that you can make sure your concerns are covered during the discussion.

Giving your consent

Before you have any treatment, your doctor will explain the aims of the treatment to you. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should have been given full information about:

• the type and extent of the treatment you are advised to have
• the advantages and disadvantages of the treatment
• any possible other treatments that may be available
• any significant risks or side effects of the treatment.

If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it is not unusual for people to need repeated explanations.

It is often a good idea to have a friend or relative with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write down a list of questions before you go to your appointment.

Patients often feel that the hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.

You can always ask for more time to decide about the treatment if you feel that you can’t make a decision when it is first explained to you.

You are also free to choose not to have the treatment. If you are considering not having treatment it is essential to discuss this fully with your cancer specialist. The staff can explain what may happen if you do not have it. It is essential to tell a doctor, or the nurse in charge, so that they can record your decision in your medical notes. You do not have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice.

Benefits and disadvantages of treatment

Many people are frightened at the thought of having cancer treatments, particularly because of the potential side effects that can occur. Some people ask what would happen if they do not have any treatment.

Although many of the treatments can cause side effects, these can often be well controlled with medicines.

Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation.

Early-stage kidney cancer

In people with early-stage kidney cancer, surgery is often done with the aim of curing the cancer. Occasionally additional treatments are given to help reduce the risks of it coming back.

Advanced-stage kidney cancer

If the cancer is at a more advanced stage, treatment may only be able to control it, leading to an improvement in symptoms and a better quality of life. However, for some people the treatment will have no effect upon the cancer and they will get the side effects without any of the benefit.

Treatment decisions

If you have been offered treatment with the aim of curing your cancer, the decision whether to accept the treatment may not be a difficult one. However, if a cure is not possible and the treatment is being given to control the cancer for a period of time, it may be more difficult to decide whether to go ahead with treatment or not.

Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your doctor whether you wish to have treatment. If you choose not to, you can still be given medicines to control any symptoms that you have. Medicines given in this situation are known as supportive care (or palliative care).

If you want to stop your treatment, it is important to tell a doctor, or the nurse in charge, so that they can record your decision in your medical notes and can give you the best advice.