How is metastatic kidney cancer treated?

Kidney cancer that has spread is also called advanced or metastatic kidney cancer. Once cancer has spread to other organs in the body, it usually cannot be cured. However, there are a number of treatments that can be used to keep the cancer under control, sometimes for many years.

Different specialists, such as medical oncologists, urologists and medical radiologists, may recommend combinations of different treatments. A team of specialists will work with you and your GP to help control your symptoms and help you to live as normal a life as possible. Treatments for advanced kidney cancer include:

  • Surgery – often the first treatment for advanced kidney cancer. Although surgery cannot cure kidney cancer that has spread, surgery may be recommended to reduce symptoms, especially pain and discomfort. This is called debulking surgery or cytoreductive surgery.
  • Targeted therapies – drugs that target specific biological signals in the cancer cells to stop cell growth and the development of a new blood supply to the tumour (angiogenesis). Treatments that interfere with the development of a blood supply are called anti-angiogenic agents. Targeted therapies used for the treatment of advanced kidney cancer are tyrosine kinase inhibitors, such as sunitinib, pazopanib, sorafenib and axitinib, and mTOR inhibitors, such as everolimus and temsirolimus.
  • Immunotherapies – drugs that boost the body’s immune system to destroy cancer cells. Immunotherapies that are still sometimes used for the treatment of advanced kidney cancer are cytokines, such as interferon and interleukin 2. Another type of immunotherapy that is being tested for use in advanced kidney cancer are checkpoint inhibitors, such as nivolumab, pembrolizumab and ipilimumab.
  • Radiotherapy – although kidney cancer cells are not very sensitive to radiation, radiotherapy can still be used to help control the symptoms of advanced kidney cancer, particularly neuropathic pain. Stereotactic radiotherapy can also be used to treat metastases in the brain, liver, lung and pancreas.
  • Palliative care – includes all the treatments that your medical team recommends to improve your symptoms (especially pain) and your quality of life. You can receive palliative care from when you are diagnosed with cancer and throughout your treatment. Palliative care also includes looking after the spiritual, social and psychological wellbeing of the patient.