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Surgery is the most common treatment for kidney cancer. The goal is to take out the tumor or tumors. You may have radiation or other treatment before or after surgery.
Your health care provider may advise surgery to treat your kidney cancer if any of the following apply to you:
You are healthy enough to have surgery. Your health care provider will only advise surgery if he or she expects you to be able to recover from it.
The tumor is small. In this case, your health care provider may do a partial nephrectomy. This surgery allows you to keep some kidney function. Only the part of the kidney that contains the tumor is taken out. In some cases, your health care provider may advise this surgery if the tumor is larger, but you have cancer in both kidneys or if you have only one kidney. The benefit is that you keep part of the kidney. The risk is that there is a chance some cancer cells will be left behind.
The tumor is larger, but is only in your kidney. Your health care provider will advise the type of surgery you need based on the size and location of the tumor. Your health care provider may advise a simple nephrectomy. This is surgery to take out the entire kidney. Or your health care provider may advise a radical nephrectomy. This is surgery to take out the whole kidney, and the adrenal gland. The adrenal gland is attached to the top of the kidney. Much of the nearby fatty tissue is also taken out. Nearby lymph nodes will also likely be removed. That's because cancer may travel to the nodes first. Taking out the lymph nodes may help prevent the spread of cancer to other parts of your body. And examining these lymph nodes helps determine the stage of the cancer, which is important in deciding whether other treatments are needed after surgery.
You have kidney cancer that has spread to only 1 other area. Your health care provider may suggest a radical nephrectomy and removal of nearby lymph nodes, as well as removal of the tumor or tumors in other parts of the body. Even in cases where surgery won’t cure the cancer, surgery can sometimes help ease symptoms, such as pressure, pain, or bleeding.
You have symptoms. You may have pain, pressure, or bleeding from tumors that have spread. Your health care provider may suggest surgery to remove the tumors. This is done to ease symptoms. Because it doesn't cure the cancer, it is called palliative therapy.
Kidney cancer surgery may be done in several ways:
Open surgery. This is done using a large enough cut (incision). The incision is made in the belly (abdomen). Or it is made in your side. One of the lower ribs may need to be removed to give access to the kidney. The health care provider then uses tools through this incision to do the surgery.
Laparoscopy. This type of surgery uses several small incisions. It’s done with a flexible tube with a light and camera called a laparoscope. The scope is put into 1 incision. Small tools are put into the other incisions. Laparoscopy often leads to less time in the hospital after surgery, with less pain, less scarring, and a faster recovery.
Robotic surgery. This type of surgery uses robot arms guided by a health care provider on a computer. It is only available at certain surgery centers. This type of surgery uses smaller incisions and may lead to less pain and scarring after surgery.
All surgery has risks. The risks of kidney surgery include:
Damage to internal organs
Bulging of organs under the incision (incision hernia)
Air in the chest cavity (pneumothorax)
Kidney failure of the remaining kidney
Your risks depend on your overall health, what type of surgery you need, and other factors. Talk with your health care provider about which risks apply most to you.
Your health care team will talk with you the surgery options that are best for you. You may want to bring a family member or close friend with you to appointments. Write down questions you want to ask about your surgery. Make sure to ask about:
What type of surgery will be done
What will be done during surgery
The risks and possible side effects of the surgery
If you will have kidney function after surgery
When you can return to your normal activities
If the surgery will leave scars and what they will look like
Before surgery, tell your health care team if you are taking any medicines. This includes over-the-counter medicines, vitamins, and other supplements. This is to make sure you’re not taking medicines that could affect the surgery. After you have discussed all the details with the surgeon, you will sign a consent form that says that the health care provider can do the surgery.
You’ll also meet the anesthesiologist and can ask questions about the anesthesia and how it will affect you. Just before your surgery, an anesthesiologist or a nurse anesthetist will give you the anesthesia so that you fall asleep and don’t feel pain.
You may have to stay in the hospital for 2 to 7 days, depending on the type of surgery you had. For the first few days after surgery, you are likely to have pain from the incision. Your pain can be controlled with medicine. Talk with your health care provider or nurse about your options for pain relief. Some people don’t want to take pain medication, but doing so can help your healing. If you don’t control pain well, for example, you may not want to cough or turn over often, which you need to do as you recover from surgery.
You will likely have a urinary catheter for a few days. This a tube put through your urethra and into your bladder so that your urine goes into a bag outside your body. In some cases, you may go home with the catheter still in.
You may have diarrhea. Talk with your health care provider, nurse, or a dietitian about what you can eat to reduce the chance of getting diarrhea. You may have constipation from using some pain medicine, from not moving much, or from not eating much. Talk with your health care provider or nurse about getting more dietary fiber or the use of a stool softener.
You may feel tired or weak for a while. The amount of time it takes to recover from surgery is different for each person.
When you get home, you may get back to light activity, but you should avoid strenuous activity for 6 weeks. Your health care team will tell you what kinds of activities are safe for you while you recover.
You may need radiation treatment after surgery. Your health care provider will talk with you about this type of treatment.
Let your health care provider know right away if you have any of these problems after surgery:
Redness, swelling, or fluid leaking from the incision
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.