Alternatives to surgery for kidney cancer

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If your cancer is small or you are not suitable for surgery your doctor may recommend one of the treatments below.

Thermal ablation

Thermal ablation  uses heat to destroy the cancer cells. It takes about 20 minutes and is often done in the X-ray department.

A needle-type instrument is placed in the kidney tumour through your skin. A CT scan guides your doctor to the right place. A machine generates heat in the needle, which kills the cancer cells. You may have some discomfort for a few days afterwards. You will be given painkillers for this. You may also feel tired.

This treatment is easier on the body than surgery, but there is a slightly higher risk that some cancer cells may remain after treatment, so it would only be recommended if surgery isn’t an option for you.

This treatment is only used in specific situations and can depend on the exact location of the cancer.

Drug treatments: targeted therapies and immunotherapy 

You doctor may recommend a drug treatment for you:

• If the cancer has spread 
• If the cancer returns after surgery

Targeted therapies

Targeted therapies are drugs that work by targeting certain parts of cancer cells that make them different from other cells. They help to kill cancer cells or stop them from growing and spreading. Immunotherapy boosts your body’s immune system to fight cancer. 

The main type of targeted therapies used to treat kidney cancer are:

• Growth inhibitors
• Angiogenesis inhibitors

Cancer growth inhibitors interrupt the communication process and prevent the cancer from developing. These are usually the first type of drug treatment used for kidney cancer. They are also known as tyrosine kinase inhibitors (TKIs). Examples are: sunitinib (Sutent®), axitinib (Inlyta®), pazopanib (Votrient®) and sorafenib (Nexavar®). These are taken as tablets.

Angiogenesis inhibitors interfere with the growth of blood vessels. This means the cancer doesn't receive the oxygen it needs to survive. This treatment is usually given by injection into a vein. Examples include: bevacizumab (Avastin®), everolimus (Afinitor®) or temsirolimus (Torisel®) may be used. 

Read more about targeted therapies.

Immunotherapy

Immunotherapy drugs boost your immune system to attack the cancer cells and stop them growing. There are different types of immunotherapy drugs including monoclonal antibodies, checkpoint inhibitors and cytokines.

Read more about immunotherapy.

Stereotactic radiotherapy

Stereotactic radiotherapy uses smaller, more precise radiation beams than standard radiotherapy. These beams are targeted at your tumour from several different angles, which combine to give a high dose of radiation. It may be used for small tumours that are not suitable for surgery.

Arterial embolisation 

Arterial embolisation reduces the blood supply to the kidney to shrink the tumour. It is not a cure for kidney cancer, but it can stop it growing bigger.  It is very occasionally used before an open surgery procedure. 

You will be given some medicine to make you sleepy. A narrow tube is put into the main blood vessel that flows to your kidney through a small cut in your groin.

Your surgeon injects small pieces of a special gelatin sponge through the tube into the blood vessel. The sponges block the blood flow to your kidney or to the part of the kidney that contains the cancer.