The Duke Cancer Institute's experienced physicians focus on diagnosing and treating kidney and renal cancers while preserving normal function.
We combine quality patient care with innovative research to offer kidney cancer patients a wider range of treatment options than most medical centers.
Our caregivers provide information and consultation at the time of diagnosis, providing state-of-the-art treatment options in urology, radiation oncology, and medical oncology, and new treatments based on basic, translational, and clinical research.
Novel treatments are available through a robust clinical trials program.
Duke surgeons offer the spectrum of surgical treatment for kidney cancer, including:
Our surgeons specialize in minimally invasive kidney surgery, which reduces pain and scarring and allows our patients to recover faster than with traditional surgery.
Depending on tumor size, location, and other factors, minimally invasive surgery can be done using only needles, robotics, or single-port surgery. We often employ image-guided surgery using intraoperative ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) technology.
In cases where the tumor is small, it is our standard attempt to remove only part of the affected kidney (partial nephrectomy). The partial removal of the cancer with a surrounding margin of normal tissue to act as a buffer has been shown in these cases to provide outcomes similar to removal of the entire kidney, while preserving more kidney function.
If the majority of the kidney is affected with cancer, surgery will be performed to remove the kidney and surrounding tissue (nephrectomy). If lymph nodes or the adrenal gland are affected, these may be removed as well (radical nephrectomy).
Partial nephrectomy is also used in cases where the patient already has reduced kidney function or has a genetic syndrome that increases risk for developing cancer in the other kidney in the future.
In a few cases, even though the cancer has spread to other organs, removing the cancer from those places as well as removing the kidney can result in long-term survival. In other cases where the cancer has spread, surgery to remove the distant cancer may still be performed to relieve pain and other symptoms.
Cryosurgery is also offered for treatment of kidney cancer. This innovative technique uses ultra-thin needles to freeze diseased tissue while avoiding damage to surrounding healthy tissue. Cryosurgery can be performed percutaneously under CT-guidance, robotically, or laparoscopically.
Radiofrequency ablation for renal tumors is available for patients who may benefit from this procedure.
Radiation involves using high-energy rays to kill cancer cells. It may be administered externally using a machine, or internally by implanting wires, seeds, or wafers that emit radiation inside the body directly near tumors.
Targeted therapy involves administering medications that block the growth of blood vessels that feed tumors or block other functions of the tumor that enable it to grow.
Targeted therapy is most commonly used against kidney cancer that has spread to other areas of the body or that has come back after treatment.
Targeted therapies used against kidney cancer include bevacizumab (Avastin), pazopanib (Votrient), sorafenib (Nexavar), sunitinib (Sutent), temsirolimus (Torisel), and everolimus (Afinitor).
Immunotherapy uses medications that enhance the body’s own immune system’s ability to fight the cancer. Immunotherapy is not as common as it once was in treatment of kidney cancer, but it can help some patients.
Because of the side effects it causes in many patients, immunotherapy is most commonly used mostly in kidney cancer patients who don’t respond to targeted therapy. Scientists are still studying the most effective ways to use immunotherapy to treat kidney cancer.
The immunotherapy agents most commonly used to treat kidney cancer are cytokines, which are proteins that activate the immune system.
Chemotherapy is not very effective against kidney cancer cells, but some chemotherapy drugs have been shown to help a few kidney cancer patients.
Chemotherapy is most often used to treat kidney cancers that don’t respond to immunotherapy or targeted therapy. Learn more about chemotherapy for urologic cancer.
These treatments are most used in rare cases, such as when people can’t undergo surgery for some reason.
Embolization involves injecting a special solution into the artery that leads to the kidney, blocking the artery and depriving the tumor of oxygen and blood. Embolization may be performed in cases where surgery isn’t possible to relieve pain and bleeding, or it may be performed before surgery to reduce bleeding.
Radiotherapy uses a needle that is guided into the tumor using x-ray guidance. An electrical current runs through the needle, emitting heat that kills the cancer cells.
Learn how to make an appointment at the Duke Cancer Institute.
Physicians offering this service include: