How is kidney cancer treated?

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Active surveillance

If you have a small tumour that has not spread (stage 1), and you are elderly, or have significant medical problems, it may be safer to carefully monitor the cancer with scans and visits to see the doctor. This is called active surveillance, and it can be used for people where the risk of dying during an operation outweighs the benefits of surgery. Kidney cancers that are smaller than 4 cm are very unlikely to spread elsewhere; however, these tumours still need to be followed up in case the cancer starts to grow.


Surgery is usually the first treatment for kidney cancer, and may be all that is required if the cancer is at an early stage. Surgery to remove kidney cancer is carried out by a specialist surgeon called a urologist.

  • Radical nephrectomy – surgery to remove the entire kidney along with the primary tumour, surrounding fatty tissue, and sometimes the adrenal gland. Local lymph nodes can also be removed to help determine if the cancer has spread. Radical nephrectomy can be done with a large cut (open surgery) or by keyhole surgery (laparoscopic surgery).
  • Partial nephrectomy – surgery to remove only the part of the kidney containing the cancer, and sparing the remaining healthy kidney tissue. Partial nephrectomy can be done with a large cut (open surgery) or by keyhole surgery (laparoscopic surgery).
  • Robot-assisted surgery – a type of laparoscopic surgery in which a special machine or robot is used by the surgeon to help carry out the surgery. The surgeon has a 3D view of the inside of your tummy and the area can be magnified 10-12 times. Robotic surgery is only available at a few specialist centres in the UK.


For some people an operation is not possible due to their age or other serious medical problems. And some people decide against having surgery. It may still be possible to treat small, early stage kidney cancer without using surgery:

  • Cryotherapy/cryoablation – a non-invasive treatment where a number of small probes are inserted through the skin (percutaneous) into the tumour, and then cooled with liquid nitrogen to freeze the cancer cells and kill them. Cryotherapy is usually carried out under general anaesthetic.
  • Radiofrequency ablation (RFA) – a non-invasive treatment where heat from an electric probe inserted through the skin into the tumour is used to destroy the cancer cells. RFA is usually carried out out under general anaesthetic.
  • Microwave ablation – is like radiofrequency ablation and uses heat to kill the cancer.
  • Laser ablation uses laser light treatment to kill the cancer. It can be used to treat brain metastases or remove abnormal tissue from the bladder in a procedure called transurethral laser ablation (TULA).


Radiotherapy uses high energy X-rays to destroy cancer cells. For patients who are unable to have surgery, it can be used to destroy or shrink tumours and control symptoms. It can also be used if the cancer has spread to other areas of the body, such as the brain, lungs, liver or bone, or for the treatment of cancer that has come back.

  • Stereotactic radiotherapy – a type of radiotherapy that directs a high dose of radiation into the tumour, but avoids damaging surrounding tissues and organs. This is often used to treat cancer that has spread. It is particularly used for the treatment of cancer that has spread to the brain.
  • Stereotactic ablative radiotherapy (SABR) – sometimes called stereotactic body radiotherapy (SBRT) can also be used to treat metastases found in the liver, lung and pancreas, as well as the brain.

Cancer Research UK: Kidney cancer

Macmillan: Kidney cancer

NHS: Kidney cancer

European Association of Urology (EAU) Renal Cell Carcinoma guidelines: 7. Disease management

Further reading: Action Kidney Cancer Essential guide: Surgery for kidney cancer

Updated: October 2023                                                                                                                      Next review: October 2025

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