Kidney Cancer
Kidney Cancer Diagnosis and Treatment
Kidney cancer occurs when abnormal cells grow within the kidney. The most common form in adults is renal cell cancer, also known as renal cell carcinoma (RCC).
Many kidney cancers are now discovered at an early stage, sometimes unexpectedly when an ultrasound, CT or MRI scan is performed for another reason. When cancer is confined to the kidney, surgery can be an important treatment option and, depending on the size and position of the tumour, it may be possible to remove the cancer while preserving the remaining healthy kidney.
Mr Neil Oakley's specialist private practice includes robotic surgery for kidney tumours, including robotic partial nephrectomy and removal of the kidney where this is required.
Patients from Sheffield and South Yorkshire can arrange consultation and assessment locally in Sheffield, with robotic kidney surgery undertaken in Manchester where appropriate.
What Is Kidney Cancer?
The kidneys are two organs situated towards the back of the abdomen. Their principal functions include filtering the blood, removing waste products and excess fluid, and producing urine.
Kidney cancer can develop when cells within the kidney begin to grow abnormally and form a tumour.
Renal cell carcinoma is the most common type of kidney cancer in adults. There are different subtypes of renal cell carcinoma, and the behaviour of an individual tumour can vary considerably.
There are also cancers that can arise from the lining of the urinary drainage system within the kidney and ureter. These are different from renal cell cancers and may require a different approach to investigation and treatment.
What Are the Symptoms of Kidney Cancer?
Kidney cancer does not always cause symptoms during its early stages. Increasingly, small kidney tumours are discovered incidentally when patients undergo abdominal imaging for an unrelated problem.
Where symptoms do occur, they can include:
- Blood in the urine
- Persistent pain in the side or back
- A lump or swelling in the kidney area
- Unexplained weight loss
- Persistent tiredness
- Loss of appetite
- Other unexplained changes in general health
These symptoms can have many causes and do not necessarily mean that kidney cancer is present. However, symptoms such as blood in the urine should always be appropriately investigated.
How Is Kidney Cancer Diagnosed?
Kidney tumours are frequently first identified on an ultrasound or other abdominal scan.
If an abnormality is found, further investigations are usually required to understand the nature, size and location of the tumour and whether there is any evidence that it has spread beyond the kidney.
Investigations may include:
- Ultrasound scanning
- CT scanning
- MRI scanning in selected circumstances
- Blood tests to assess general health and kidney function
- Urine tests
- Kidney biopsy in selected patients
- Additional imaging where required
The results help establish the characteristics and stage of the tumour and guide discussion about the most appropriate treatment.
Does Every Kidney Tumour Need Surgery?
Not every kidney mass is cancerous and not every small kidney tumour requires immediate surgery.
Small renal masses are increasingly detected incidentally through modern imaging. Depending on the appearance and size of the tumour, its growth over time, the patient's age, general health and other factors, careful surveillance may sometimes be appropriate.
For other patients, treatment may be recommended.
The important consideration is therefore not simply whether a mass has been found, but what the investigations suggest about its likely nature and behaviour and which management option is most appropriate for the individual patient.
Treatment Options for Kidney Cancer
Treatment depends on factors including the type of kidney cancer, its size and location, whether it has spread and the patient's general health.
Depending on the individual circumstances, options can include:
- Active surveillance for selected small renal masses
- Partial nephrectomy to remove the tumour while preserving the kidney
- Nephrectomy to remove the affected kidney
- Ablation treatments for selected tumours
- Drug treatments for some patients with advanced kidney cancer
- Other specialist cancer treatments where appropriate
When kidney cancer is detected at an early stage and has not spread, surgery is an important treatment option.
Can the Kidney Be Preserved?
One of the most important questions for a patient diagnosed with a kidney tumour is whether the cancer can be removed without removing the entire kidney.
Where technically and oncologically appropriate, a partial nephrectomy removes the tumour together with an appropriate margin of surrounding tissue while preserving the remainder of the kidney.
This is sometimes referred to as nephron-sparing surgery because the objective is to treat the tumour while retaining as much functioning kidney tissue as possible.
Whether partial nephrectomy is appropriate depends on factors including the size and position of the tumour, its relationship to the kidney's blood vessels and drainage system, the condition of the remaining kidney tissue and the patient's overall circumstances.
Mr Oakley has extensive experience in minimally invasive kidney-preserving surgery and performs robotic partial nephrectomy for suitable kidney tumours.
Find out more about Robotic Partial Nephrectomy
Robotic Partial Nephrectomy
Robotic partial nephrectomy is a minimally invasive operation designed to remove a kidney tumour while preserving the remainder of the kidney.
The procedure is performed through small incisions using the da Vinci robotic surgical system. The surgeon controls the robotic instruments throughout the operation, using magnified three-dimensional vision and articulated instruments to carefully remove the tumour and reconstruct the remaining kidney.
Partial nephrectomy can be technically demanding because the surgeon must achieve effective removal of the tumour while preserving healthy kidney tissue and controlling the kidney's blood supply.
Robotic technology is particularly useful for this type of precise kidney surgery and has extended the range of renal tumours that can potentially be considered for a minimally invasive kidney-preserving approach.
Read more about Robotic Partial Nephrectomy
When Does the Whole Kidney Need to Be Removed?
Preserving kidney tissue is desirable where it is safe and technically appropriate, but partial nephrectomy is not the correct treatment for every kidney tumour.
For some patients, the size, position or characteristics of the tumour mean that removing the entire affected kidney provides the more appropriate surgical treatment.
The operation to remove a kidney is called a nephrectomy. When performed as a cancer operation it may also be referred to as a radical nephrectomy, depending on the extent of tissue that needs to be removed.
Many people can live normally with one healthy functioning kidney. Kidney function and the condition of the opposite kidney are therefore important considerations when planning treatment.
Where appropriate, nephrectomy can be performed using minimally invasive techniques rather than through a traditional large open incision.
Find out more about Robotic Nephrectomy
Partial Nephrectomy or Full Nephrectomy?
The decision between removing only the tumour and removing the whole kidney is individual to each patient.
Important considerations can include:
- The size of the kidney tumour
- Where the tumour is located within the kidney
- How deeply the tumour extends into the kidney
- Its relationship to major blood vessels and the kidney's drainage system
- The appearance and characteristics of the tumour on imaging
- Function of the affected kidney
- Function of the opposite kidney
- Existing kidney disease or other medical conditions
- The technical feasibility and safety of preserving the kidney
The objective is to provide appropriate cancer treatment while preserving kidney function wherever this can be achieved safely.
A detailed review of the patient's scans is therefore particularly important when planning kidney cancer surgery.
Robotic Surgery for Kidney Cancer
Robotic surgery allows complex kidney operations to be performed using a minimally invasive approach through small incisions.
The da Vinci robotic surgical system provides the surgeon with magnified three-dimensional vision and highly controlled instruments that can articulate within the body.
This can be particularly valuable during partial nephrectomy, where precise removal of the tumour and reconstruction of the remaining kidney are required.
The robotic system does not perform the surgery independently. The instruments are controlled throughout the operation by the surgeon.
Mr Oakley's experience in minimally invasive kidney surgery extends back to the development of laparoscopic urological techniques in the UK, and kidney surgery remains a major part of his specialist robotic practice.
Find out more about Robotic Urological Surgery
What Happens After Kidney Cancer Surgery?
Tissue removed during partial nephrectomy or nephrectomy is sent to a specialist pathologist for examination.
The pathology report provides detailed information about the tumour, including the type of cancer and its characteristics. In the case of partial nephrectomy, the specimen is also assessed to determine whether the tumour has been completely excised at the surgical margin.
The results help determine the appropriate follow-up after surgery.
Follow-up can include clinical review, blood tests to monitor kidney function and scans at intervals appropriate to the type and stage of the kidney cancer.
Kidney Cancer Consultations in Sheffield
Patients diagnosed with a kidney tumour or kidney cancer in Sheffield, South Yorkshire and surrounding areas can arrange a private consultation with Mr Oakley in Sheffield.
This provides an opportunity to review your scans and other investigations and discuss whether surgery is required and, importantly, whether the kidney may be suitable for a kidney-preserving partial nephrectomy.
For patients who proceed with robotic kidney surgery, appropriate consultation and pre-operative assessment can take place locally in Sheffield, with robotic surgery performed by Mr Oakley in Manchester using the da Vinci robotic surgical system.
Find out more about Private Urology Consultations in Sheffield
Robotic Surgery for Sheffield Patients
Diagnosed with a Kidney Tumour or Kidney Cancer?
If you have been diagnosed with a kidney tumour or kidney cancer and would like to discuss your surgical options, including whether robotic kidney-preserving surgery may be appropriate, you can arrange a private consultation with Mr Neil Oakley in Sheffield.