Kidney Cancer Treatment Options at  The Kidney Cancer Institute

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Partial Nephrectomy

Open Partial Nephrectomy

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Biotechnology That is Used to Cure Kidney Cancer



Diagnosis of Kidney Cancer

Questions for Dr. Landman

In the past, the majority of kidney cancers were identified due to symptoms. These characteristic symptoms are still seen in a minority of people who present with larger kidney cancers.

However, today, the majority of kidney cancers are “incidental findings.” The term incidental finding simply means that the kidney tumor, which is usually small in diameter, was found during the evaluation of a separate process. Often, a sonogram will be ordered for a non-specific complaint and a kidney mass will be identified.

Today, the reason that the majority of kidney tumors are discovered while still very small in size is the increased use of radiologic tests. These tests have become important in identifying kidney masses as well as in determining if the mass is suspicious for kidney cancer. Unfortunately, with contemporary radiographic technology, it remains impossible to determine if the mass is truly a kidney cancer as opposed to some other non-cancerous growth in the kidney.

Depending on the size of the mass, the probability of kidney cancer can be estimated. Smaller kidney masses can be benign growths 30-40% of the time. In contrast, larger kidney growths are more commonly kidney cancer (over 90%). Naturally, it would seem that a small procedure like a biopsy to take a small sample of the kidney mass tissue would be prudent. However, biopsy is not usually indicated for several reasons.

The most common radiographic tests that are used to identify, characterize and stage kidney cancer are a sonogram IVP, CAT scan, or MRI scan. Each of these tests is discussed briefly below.

  • Kidney sonogram (ultrasound) – Sonography, also know as ultrasonography uses sound waves outside the human hearing range that come from a probe. Typically this probe is placed on the outside of the skin, but probes that are used within body cavities exist to perform ultrasound during surgery as well. These sound waves interact with different structures within the body and bounce back to the probe in different ways.

    The ultrasound probe can then interpret the sound waves that have bounced off of body structures to construct an image. As ultrasound technology relies on sound waves, there is no radiation exposure during ultrasound evaluations. However, current ultrasound technology does not produce the high resolution anatomic images that can be obtained with other imaging tests such as MRI and CT scans. Typically, ultrasound evaluation can identify that there is a problem in the kidney, and another modality such as CT or MRI is used to more precisely characterize the kidney lesion.

  • IVP – An IVP is initials for intravenous pyelogram. This test consists of the injection of dye material into the veins. The dye circulates and is absorbed by the kidney. The kidney then releases the dye into the urine and the dye follows the normal urinary system. Standard X-rays are taken and can be used to look at the kidney as well as the ureters and bladder.

    The IVP was historically the test of choice to identify the majority of kidney problems. Over time, other tests have taken over as they are more versatile and precise. However, there is still a role for IVP in contemporary medicine. Like kidney sonography, the IVP is usually used only to identify that there may be a renal mass. A CT or MRI scan typically will follow to better characterize the kidney lesion and to determine if it may be kidney cancer.

    The IVP has been supplanted by other tests for a number of reasons. Primarily, the IVP is a two dimensional representation of the urinary tract. The IVP also does not characterize the anatomy around the urinary tract. As such, other tests that provide more information (eg. CT or MRI scans) are more commonly used in clinical practice today.

  • CT scan – A CT scan is an acronym for computerized axial tomography. A CAT scan uses standard X-rays, and therefore does expose the patient to a small amount of radiation. CT scans are superior to standard X-ray tests as a computer is used to interpret the X-rays and to reconstruct a three dimensional representation of the patient’s anatomy.

    CT images therefore provide the ability to characterize renal masses to determine if they are potentially cancerous. Additionally, the CT image will provide a surgeon with very clear pictures of the local anatomy to help to determine what type of surgery is indicated and how this surgery might best be performed.

    CT scans can be performed with or without intravenous contrast material. Intravenous contrast material is a dye which, very much like the IVP test, spreads around the body through the arteries and veins. Renal masses, which get a blood supply, are said to "enhance" and are suspicious for kidney cancer. Kidney masses that do not "enhance" are not usually suspicious for kidney cancer and usually do not require surgical intervention.

  • MRI scan – The initials MRI stand for magnetic resonance imaging. An MRI scan is very much like a CT scan in that a computer integrates the signal to construct a three dimensional image of the patient being examined. The MRI scan differs in that there is no radiation. Instead, the MRI uses a magnet to create the signals that later become an image of the patient.

    When comparing an MRI to a CT scan in varying clinical settings, there are different factors to consider. However, both imaging modalities provide excellent images, which can be used to diagnose the nature of a renal mass and to help decide on the best form of clinical management.


Video Showcase

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Cryoablation Patient Interview

Cryoablation Patient Testimonial

Percutaneous Renal Cryoablation

Laparoscopic Partial Nephrectomy

Laparoscopic Radical         Nephrectomy

Robotic Partial Nephrectomy

Complementary Mangement Strategies

More details on metastatic how
kidney cancer spreads

What are the challenges in treating metastatic kidney cancer?

How does metastatic kidney cancer affect my body?

How common is metastatic kidney cancer?

Which organs are most likely to be affected by metastatic kidney cancer?

What is the prognosis of people with metastatic kidney cancer?

As a patient with metastatic kidney cancer, what should I do?

Treatment for Metastatic Kidney Cancer

Why is metastatic cancer worse than localized cancer?

How is metastatic kidney cancer treated?

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