Treatment

• Surgery:

A surgical removal of the entire kidney (nephrectomy) and if necessary the surrounding lymph nodes and connective tissue is possible, as the other kidney can compensate the function of both kidneys. At specialized hospitals the operation can be done by minimally invasive surgery, which means the surgery is done through a small incision.

A non-surgery method is the closure of the kidneys blood vessels, preventing the blood flow to the tumour, which leads to a shrinking. For this purpose the artificial embolus is introduced into the vessel by a catheter.

Metastases can be treated with different methods, besides surgical removal:

• Chemotherapy:

A chemotherapy means the employment of anti-cancer (cytotoxic) drugs, through the bloodstream, which target the cancer cells and tries to destroy them. The aim is to stop the cancer cells from multiplying themselves. The setback with this therapy is that the drugs also destroy healthy cells leading to typical side effects such as hair loss and diarrhoea. The chemotherapy is carried out in several sessions, depending on the stage of the tumour (5-Fluorouracil, 5FU).

• Hormonal therapy:

Organs produce hormones, which manage the cell division (endocrine system). The hormonal therapy slows down the growth of the tumour by manipulating this endocrine system. (Gestagens, Androgens, Antiandrogens and Tamoxifen).

• Immunotherapy:

An immunotherapy in combination with a chemotherapy helps the immune system build up a resistance against the tumour cells. This immunization targets at training the immune system in recognizing tumour cells in order to fight explicitly them and not any healthy cells (Interferon-alpha or Interleukin 2). Current studies are looking into specific vaccines which are similar to the surface of renal cell cancer cells (IMA901).

• Biological Therapy:

The biological therapy inhibits messengers, who stimulate the growth of blood vessels (Sorafenib, Sunitinib, Temsirolimus, Bevacizumab) Sorafenib and Sunitinib effect the dermis (palm of hand, sole of foot), mucous membrane (gullet and stomach) and the blood vessels (high blood pressure, engorgement).

• A radiation therapy:

kills tumour cells through selective ionizing rays and is effective in treating metastases in the brain or bone marrow.

A successful therapy does not exclude the possibility of a renal cell carcinoma relapse. Therefore new biological therapies are anticipated that minimize the cases of relaps.