Our Approach to Kidney Cancer

James Hsieh, MD, PhD (left), R. Sherburne Figenshau, MD (center), and Eric Kim, MD (right) discuss research in Dr. Hsieh's lab. James Hsieh, MD, PhD (left), R. Sherburne Figenshau, MD (center), and Eric Kim, MD (right) discuss research in Dr. Hsieh's lab.

Patients who come to the Siteman Cancer Center for treatment of kidney cancer are seen by a team of Washington University Physicians — surgical, medical and radiation oncologists — often during the same visit. A health psychologist is also available as needed. Experienced nurses then spend time with you, answering your questions and putting you in touch with resources that may help during this stressful time. These nurses offer patient literature on your condition, chemotherapy, radiation therapy, surgery and other related issues.

Our team of urologic surgeons sees on average 350 cases of kidney cancer a year, and performed the world’s first kidney removal using minimally invasive laparoscopic surgery. Compared to traditional surgery, laparoscopic surgery requires only three or four small punctures, instead of a large incision. This approach substantially reduces the pain and discomfort of patients and hastens recovery.

The team also has developed techniques to perform robotic partial kidney removal — a complex procedure being performed at only a few centers around the country. Siteman specialists pioneered the technique and perform it more than many other cancer treatment facilities around the world. They are often able to remove tumors and save kidneys using methods with expertise that most centers don’t have.

Siteman also offers non-surgical treatment for kidney cancer, especially for patients ineligible for any type of surgery due to their poor health or age. This group of patients may receive percutaneous cryoablation, a procedure that involves inserting probes through the skin to freeze small tumors in the kidney. This procedure currently is appropriate only for small tumors or for patients who have no other alternatives. Because this technique holds the promise for being the least debilitating of all kidney cancer treatments, researchers are focused on expanding its application for the future.

There are two major categories of kidney cancer seen at Siteman:

  • Renal cell cancer (also called renal adenocarcinoma): This disease is characterized by cancer cells found in the lining of tubules in the kidney. This type of cancer accounts for about 80 percent of kidney cancers. Renal cell cancer is generally what is meant by kidney cancer.
  • Transitional cell cancer of the renal pelvis and ureter: In this type of cancer, malignant cells form in the renal pelvis where the ureters connect and in the ureters, the long tubes that connect the kidney to the bladder.

For treatment purposes, types of primary kidney cancer are also divided into clear cell and non-clear cell types of tumors.

Siteman treats all major categories of kidney cancer, and can use laparoscopic and robotic techniques with tiny incisions and shorter recovery time. Types of treatment used for kidney cancer depend on the stage, size and location of the tumor at which it is diagnosed, whether the cancer has spread outside the kidney, the patient’s age and overall health. All surgical and chemotherapy options are available.

Siteman cancer physicians are actively involved in clinical trials that investigate new chemotherapy regimens, and other approaches to cure. Having your cancer treated at Siteman gives you access to new therapies that are as good as – or potentially better than – current standard therapies available elsewhere.