Advanced Kidney Cancer: Know Your Treatment Options

This article is for people who have advanced kidney cancer and their caregivers, or anyone who wants to learn more about advanced kidney cancer. The goal of this activity is to help people engage in shared decision-making with their doctor about treatment.

You will learn about:

• What advanced kidney cancer is

• Making a treatment plan with your doctor

• Treatment options for advanced kidney cancer

• Possible side effects of treatment

• Questions to ask your doctor

Medicines listed in this activity may not be approved by the US Food and Drug Administration (FDA) for locally advanced or metastatic kidney cancer but are recommended by the National Comprehensive Cancer Network (NCCN).

Kidney cancer is cancer that starts in the kidneys. In adults, the most common type is renal cell carcinoma (RCC), which starts in the cells lining the small tubes (tubules) in the kidneys.

Advanced kidney cancer can be locally advanced or metastatic. Locally advanced means cancer cells have spread to tissues near the original tumor (group of cancer cells). This can include fat, blood vessels, nearby lymph nodes, adrenal glands, and the outer layer of tissue around the kidney.

With metastatic kidney cancer, cancer cells have traveled through the blood or lymph and spread, or metastasized, to other parts of the body far from the original tumor. This can include the lungs, farther lymph nodes, bones, liver, and brain.

The goals of treatment are to remove as much of the cancer as possible, shrink tumors, slow cancer growth and spread, and help you have the best quality of life you can.

There is more than one treatment available for advanced kidney cancer, and no one treatment is for everyone. Which treatment -- or combination of treatments -- your doctor recommends will depend on the cancer's size and location, stage, and where it has spread. Your doctor will also take into account your overall health and wishes.

Sometimes cancer can come back after treatment. This is called a recurrence, or relapsed kidney cancer. If this happens, your doctor will also consider any treatment you had before and how well it worked when recommending a next treatment.

Treatment options that may be used alone or in combination for advanced kidney cancer can include:

• Surgery to remove as much of the cancer as possible or tumors that have spread to other parts of the body

• Radiation therapy that uses high-energy waves (such as x-rays) to lessen symptoms and improve your quality of life

• Ablation, a procedure where a special needle inserted into the tumor uses cold, heat, radio waves, microwaves, or chemicals to destroy cancer cells

• Supportive or palliative care to help relieve symptoms

• Joining a clinical trial

Other treatment options that may be used alone or in combination for advanced kidney cancer can include medicines such as:

• Targeted therapy to help stop cancer cells from growing and kill them. Monoclonal antibodies and kinase inhibitors are the 2 main types used

• Immunotherapy to help your immune system -- your body's natural defense system -- find and kill cancer cells. Types of immunotherapy that may be used include immune checkpoint inhibitors and cytokine therapy

Talk to your doctor about how the different treatments they're recommending may be given.

All treatments can have side effects. Some that may happen with treatments used for advanced kidney cancer can include:

• Fatigue (tiredness)

• Nausea, vomiting, diarrhea, constipation, loss of appetite

• High blood pressure, headache

• Muscle or bone pain 

• Cough

• Fever, infections

• Itching, skin rash or dryness, hair loss

• Changes in certain lab tests

Not all side effects are listed in this activity. Ask your doctor, pharmacist, or healthcare team for a complete list.

Before starting any treatment, ask your doctor about which side effects can happen with each treatment. The same side effect can mean something different, happen to a different degree, and be managed differently depending on which treatment caused it.

Some side effects can go away on their own over time, but others may last longer. You may need to contact your doctor right away when certain side effects happen with certain treatments, so be sure to ask when you should call them or go to the emergency room.

Talk to your doctor about any side effects that you have -- even if they don't seem severe or bothersome -- and when you have them. Together, you can find ways to manage them.

Talk to your doctor and healthcare team about your personal preferences for your treatment plan. This way, you can make a plan together that best fits your goals and individual needs.

During treatment, your doctor will check, or monitor, how well your treatment is working and look for any side effects. Be sure to tell them about your quality of life and share any concerns you may have around your treatment.

Recording how you're feeling, along with your symptoms and any side effects, in a journal or diary can be helpful for when you talk with your doctor and healthcare team.

Questions you can ask your doctor about advanced kidney cancer can include:

• What treatments are available, and what are the treatment goals?

• How will I know if treatment is working?

• What side effects can happen with what treatments, and how can we manage them?

• Is there a clinical trial I might be eligible for?

• How can I have the best quality of life possible?

• What should I do if I feel stressed or depressed?

• Where can I find more information and resources?

Congratulations!

You have successfully completed the program Advanced Kidney Cancer: Know Your Treatment Options.

View Additional Materials on this topic that you may find useful:

Kidney Cancer

Kidney (Renal Cell) Cancer

Renal Cell Cancer Treatment