Kidney Cancer: New Treatments Offer Improved Quality of Life

Kidney cancer is among the 10 most common cancers in both men and women, so awareness about the disease is key. Here, Dr. Waltzer and Dr. Spaliviero, who treat patients within Stony Brook Urology and Stony Brook Cancer Center, discuss the facts about kidney cancer, its treatment and how our multidisciplinary team can assist with that treatment.

Does kidney cancer affect a certain age group and are there risk factors?
People diagnosed with kidney cancer tend to be age 55 and older, the most common age being between 60 and 70 years, with a higher incidence in men. What people may not realize is that smoking is a major risk factor for kidney cancer. One of the most significant prevention tools is for non-smokers to never start and for smokers to stop.
Other risk factors include:
• Hypertension (high blood pressure)
• Obesity
• Chronic renal failure treated with dialysis
• Presence of certain genetic syndromes associated with kidney cancer, such as Von Hippel-Lindau syndrome or Tuberous sclerosis complex
• An inheritable component and/or family history of the disease
• Environment — exposure to toxins, chemicals and pollution

How is kidney cancer detected?
Like many cancers in the early stages, there are often few visible symptoms. However, if you find blood in your urine or experience a pain in your side that is consistent and will not go away, you should see your primary care physician as soon as possible. Your provider may refer you to get further testing, which may include an ultrasound, CT scan or MRI — all of which can be performed by imaging technicians and analyzed by expert radiologists at Stony Brook Medicine. If a tumor is detected on your scans, you would then be referred to a urologic oncologist and our urology team specializing in kidney cancers.

What new treatment options exist for kidney cancer?
We’ve made great strides in treatment for kidney cancer. Surgery to remove a cancerous tumor in the kidney is typically the first line of treatment. There are three surgical approaches available: open (or traditional), laparoscopic and robotic laparoscopic. In the past three decades, partial nephrectomy has become the standard of care. During this procedure, we remove the tumor but can spare the remaining healthy part of the kidney. More recently, robotic-assisted surgery has become a viable option to remove small- and intermediate-size renal masses and kidney lesions, which may be cancerous.

What are the benefits of robotic-assisted surgery?
The da Vinci® robotic system allows us to perform what we call nephron-sparing minimally invasive surgery. In short, we remove the tumor, not the entire kidney.
This does three things:
1. It provides surgeons with superior vision through 3D magnification, and enhanced dexterity using the robotic arm.
2. It preserves the healthy part of the same kidney, which is key because the odds of developing cancer in the other kidney are higher than those of the  general population for patients who have had one tumor already.
3. It often results in a shorter hospital stay and a faster recovery due to the minimally invasive approach.
In addition, this kidney-sparing approach offers other benefits, including improved cardiovascular health, which in turn, lowers the rates of heart and cardiovascular disease that can be associated with loss of a kidney. As a result, the American Urological Association has identified nephron-sparing surgery as the preferred treatment for small or medium-sized kidney tumors.

To schedule an appointment with one of our team members at Stony Brook Cancer Center, call (631) SB-CANCER (722-2623).