What are the treatment options?
Treatment differs based on the type and size of tumour, as well as the clinical contexts:
· Surveillance: As a general rule small tumours typically do not grow rapidly and while small, (< 4cm) the risk of spreading is very low (<5% over the period of 3 years). It is not uncommon to simply surveil the tumour with regular scans (every 6-9 months), especially if other medical conditions are present. Definitive treatments can be offered if during the period of surveillance, the tumour grows rapidly. As a general rule in many instances, the tumour can be observed for an extended period without any need for treatment or any harm to the patient.
· Surgery: Complete removal of the cancerous tumour is the treatment of choice for kidney tumours. For tumours less than 4 cm the standard of care is partial nephrectomy. During this process, the kidney lesion is removed but the rest of the kidney is preserved. Depending on the size and location of the lesion, 80-90% of the affected kidney can be preserved. For larger or more complex tumours, the entire kidney may need to be removed (radical nephrectomy). In the majority of instances, kidney surgery can be carried out via the laparoscopic (keyhole) route. Robotic surgery allows the surgeon to carry out more complex surgery using the keyhole approach. This will allow for less pain, less blood loss, shorter hospital stay and earlier return to daily activities. Read more about robotic kidney surgery here.
· Ablation: Depending on the size and location of the tumour, it may be possible to destroy the tumour by passing a probe through the skin into the tumour and ablating it with various forms of energy (heat or cold). This approach has an extremely low risk of complication but the risk of cancer recurrence is somewhat higher than surgery. Furthermore, this approach is not suitable for all tumour locations.
How long will my recovery take?
Generally, after laparoscopic/robotic surgery patients will be required to stay in hospital for 1-2 nights. The pain is minimal and is typically around the incision sites and is well controlled by oral pain medications. Patients can start driving after two weeks and should refrain from strenuous activities for about 4 weeks.
For larger lesions, where open surgery is performed, the length of hospital stay would be longer. Patients treated with ablative therapy usually are discharged the next day.