Kidney cancer is cancer that starts in the kidneys, the two bean-shaped organs that filter your blood. The American Cancer Society estimates that there will be 79,000 new kidney cancer diagnoses in the United States in 2022.

Surgery is the main treatment for kidney cancer. In fact, there are many times that surgery can result in complete remission of this cancer. Complete remission means that cancer cells can no longer be found and that the signs and symptoms of cancer are no longer present.

We will look at how surgery is used to treat cancer, what the procedure involves, and more.

The type of surgery that’s recommended for kidney cancer depends on factors such as the stage of the cancer and where exactly it’s located. There are two types of surgeries that are used for kidney cancer: radical nephrectomy and partial nephrectomy.

Radical nephrectomy

A radical nephrectomy removes the entire kidney, including the cancer. This surgery is often recommended if the tumor is large or has spread to lymph nodes or other tissues. Many people can function well with only one kidney.

A radical nephrectomy removes the kidneys and the following tissues.

  • The adrenal glands are associated.
  • There are nearby lymph nodes.
  • The tissue surrounding it.

A radical nephrectomy can be done in the abdomen. An open surgery is when one large incision is used. Doctors prefer minimally-invagant procedures where possible.

Minimally invasive procedures involve several smaller incisions instead of one big one and often have a faster recovery time. There are two types of ways this type of surgery may be done:

  • Laparoscopically. This type of surgery is done using a laparoscope, which is a long, thin tube with a camera on the end.
  • Robotically assisted. In this type of surgery, a robot that’s controlled by the surgeon performs the laparoscopic procedure.

Partial nephrectomy

A partial nephrectomy only removes the cancer. This type of surgery is preferred by people with early stage cancer, because the cancer still has not grown beyond the kidneys.

A partial nephrectomy can help you retain some function of the affected kidneys. A partial nephrectomy may not be possible in some situations.

  • The tumor is large.
  • There are tumors in the body.
  • the tumor is located in the middle of the kidney
  • The cancer is spreading into other tissues at a later stage.

Many partial nephrectomies are done using minimally-invasive procedures.

You can expect to get some information from the surgery.

Before your procedure

Prior to your procedure, your medical care team will perform a series of tests to get an idea of your general health. These may include blood tests, an electrocardiogram (ECG), and a chest X-ray.

Your surgeon will give you instructions on how to prepare for the surgery. When to start a fast and which supplements and medications you can take will be included.

It is important to follow the instructions carefully. Before making any changes to your medication, you need to talk to your surgeon.

During your procedure

Kidney cancer surgery is done under general anesthesia. That means that you’ll be in a sleep-like state during your procedure.

The number of surgical interventions will be dependent on the procedure being performed. There may be one larger open surgery or several smaller smaller open surgery.

Typically, kidney cancer surgery takes between 2 and 3 hours. Once the surgery is complete, the incisions will typically be closed with stitches. Doctors may also use surgical staples to close an incision, which will need to be removed when the incision has healed.

After your procedure

You will be taken to a recovery room after your procedure. This can take a long time.

You will be taken to the hospital after you come out of anesthesia.

A hospital stay is usually required for open cancer surgeries. If you experience adverse effects from your surgery, or are in poor health, you may need to stay longer.

You may only need to stay in the hospital for a day or two.

You will be given instructions on what to do at home after you leave the hospital. These can include things.

  • how to care for your incision
  • How to manage pain.
  • When you can return to your daily activities.
  • When to contact a doctor and how to recognize adverse effects.

Recovery times for kidney cancer surgery may range anywhere from 6 to 12 weeks. Your specific recovery time can depend on factors such as your overall health and what type of procedure you had.

The recovery time for minimally-invagant procedures is shorter than for open procedures.

Your surgeon will want to schedule a follow-up appointment with you in the weeks after your procedure. They will check on your recovery during this time.

Your doctor will review the lab analysis of tissue taken from the tumor that was removed during your surgery. You and your doctor can discuss the results of the tissue analysis if additional therapies are needed.

There are risks associated with any procedure. These include:

  • The drug used to induce anesthesia has reactions.
  • excessive bleeding
  • It is an infectious disease
  • serious blood clots
  • There was damage to other nearby organs.
  • There is urine leaking into the abdomen.
  • The kidneys fail.

Minimally invasive surgeries often have a lower risk of adverse effects. For example, a 2020 systematic review of studies noted that, compared with open partial nephrectomy, laparoscopic partial nephrectomy had:

  • shorter hospital stays.
  • The estimated blood loss was less.
  • There are less adverse effects after surgery.

“A doctor will want to use an instrument to make sure that the cancer doesn’t come back after your surgery. This is called active monitoring.”

Some people have a higher risk of recurring cancer after surgery. You may be given additional treatment to help prevent a repeat. This is called therapy.

Adjuvant therapy following kidney cancer surgery typically involves the use of targeted therapy drugs such as sunitinib (Sutent) or immunotherapy drugs such as pembrolizumab (Keytruda).

Your care team can give you a better idea of what treatment you need after your surgery. It is important to discuss the optimal plan for your situation with them.

While surgery is often the preferred treatment for kidney cancer, there are also other options available. These can include:

  • Active surveillance. Active surveillance involves monitoring a tumor through imaging every 3 to 6 months. Treatment is started if the tumor shows signs of growth. This approach is typically used for small tumors.
  • Ablation. Ablation removes cancer cells in the kidney by using either extreme cold or high heat. It can be used for small tumors or those for which surgery isn’t possible.
  • Targeted therapy. Targeted therapy uses drugs that negatively impact specific proteins of kidney cancer cells that are important for growth. It’s often used for more advanced kidney cancers or those that have recurred.
  • Immunotherapy. Immunotherapy drugs help your immune system fight cancer. Like targeted therapy, it’s typically used for advanced kidney cancers or cancers that have recurred.
  • Radiation therapy. Radiation therapy uses high-energy radiation to kill cancer cells. For kidney cancer, it’s used more often to alleviate symptoms such pain than to directly treat the cancer.
  • Chemotherapy. Chemotherapy uses drugs that target rapidly dividing cells. While it’s not effective for most kidney cancers, some rarer types of kidney cancer do respond to chemotherapy.

There are answers to some questions about surgery.

How fast does kidney cancer spread?

Many small kidney cancers are slow-growing. However, research has found that clinically significant tumors that require prompt treatment grow at a faster rate than masses that are under active surveillance.

Kidney cancer may not cause symptoms until a tumor has become large. This means that some people may not receive a diagnosis until their cancer is at a more advanced stage.

Many of the kidneys are found early during the studies.

Should I wait for kidney surgery or do it right away?

A doctor will sometimes recommend active monitoring for a small tumor. Many of the tumors are slow-growing and some are benign.

If you have a large, growing, or already spreading,renal tumors, treatment will be recommended right away. This can involve some form of surgery for the kidneys.

Can kidney cancer be cured with surgery?

Yes. In some cases, kidney cancer can go into complete remission with surgery. Complete remission after surgery is more likely when the tumor is small and has not grown beyond the kidney.

How successful is kidney cancer surgery?

This can depend on things like:

  • The type of cancer you have.
  • The stage of your cancer.
  • Your level of function in the kidneys.
  • Your age and health.

A 2018 study looked at overall survival of people with larger kidney tumors that hadn’t grown beyond the kidney. Overall survival rates at 5 years were 78.7 percent and 76.2 percent for partial and radical nephrectomy, respectively.

The main treatment for cancer is surgery. In some cases, surgery can cure the cancer.

Depending on the stage of the cancer, you can have part of your body removed. Both surgeries can be done in a way that is minimally disruptive.