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Robotic Surgery

Kidney Cancer

da Vinci® Partial Nephrectomy

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If you are facing kidney cancer surgery, you may have many questions about the disease, such as:

  • What is the prognosis for kidney cancer?
  • What is the survival or cure rate for kidney cancer patients?
  • What are the early signs and symptoms of kidney cancer?
  • What causes kidney cancer?
  • How is kidney cancer treated?
  • What is thermal ablation or freezing of kidney cancer?

When you visit your doctor, you may want to write down any questions you have about kidney cancer. Fully understanding the disease and treatment options will help you to make the best decisions about your care.

Overview

Each year, kidney cancer is diagnosed in about 190,000 people worldwide.1 Kidney cancer is slightly more common in men and is usually diagnosed between the ages of 50 and 70 years.2 It is important to realize that with early diagnosis and treatment, kidney cancer can be cured. In fact, if found early, the survival rate ranges from 79 to 100 percent.3

A kidney tumor is an abnormal growth in the kidney. The terms "mass," "lesion" and "tumor" are often used interchangeably. Tumors may be benign (non-cancerous) or malignant (cancerous). The most common kidney mass is a fluid-filled area called a cyst. Simple cysts are benign, do not turn into cancer and usually do not require follow-up care. Solid kidney tumors can be benign, but are cancerous more than 90 percent of the time.3

It is possible that kidney cancer can grow into the renal vein and vena cava. The renal vein is the kidney's primary draining vein and the vena cava is the vein that takes blood to the heart. The portion of the cancer that extends into these veins is called "tumor thrombus." Imaging studies, such as an MRI, can help to find out if tumor thrombus is present.

For a tumor to grow and spread, it must stimulate new blood vessels to provide the tumor with nutrients and oxygen. This process is known as angiogenesis. Kidney cancers are considered very angiogenic and are very efficient at travelling through the blood vessels in the body. They do this by secreting a protein called vascular endothelial growth factor (VEGF). VEGF acts on nearby blood vessels and stimulates them to sprout new vessels to supply the tumor.3

Kidney cancer can form in the small tubes inside the kidney. Those tubes are located in the center of the kidney where urine collects and used to filter blood. The most common kidney cancer is called renal cell carcinoma

Symptoms

Unfortunately, kidney cancer does not have early symptoms but you should see your doctor if you notice the following:3

  • Blood in your urine
  • Lump in your abdomen
  • Unexplained weight loss
  • Pain in your side
  • Loss of appetite

If cancer spreads (metastasizes) beyond the kidney, symptoms depend on the organ involved. Shortness of breath or coughing up blood may occur when cancer is in the lung. Bone pain or fractures may occur when cancer is in the bone. When cancer is in the brain, you may have neurologic symptoms.

In some cases, kidney cancer causes related conditions called paraneoplastic syndromes. These syndromes occur in about 20 percent of kidney cancer patients and can occur in any stage, including cancers confined to the kidney. Symptoms from paraneoplastic syndromes include weight loss, loss of appetite, fever, sweats and high blood pressure. In many cases, the paraneoplastic syndrome improves or disappears after the cancer is removed.

Causes & Risk Factors

Researchers have found several risk factors that make you more likely to develop kidney cancer. The following may increase your risk of developing kidney cancer:3

  • Smoking
  • Hypertension
  • Obesity
  • Family history of kidney cancer
  • Chronic kidney failure and/or dialysis
  • Diet with high caloric intake or fried/sautéed meat
  • Von Hippel Lindau disease (rare genetic disorder that causes tumor growths)
  • Tuberous sclerosis (common genetic condition that produces growths in the body from birth throughout adulthood)

Screening and Testing for Kidney Cancer

Unfortunately, there are no blood or urine tests that detect kidney cancer. When kidney cancer is suspected, your doctor will order a kidney imaging study. The initial imaging study is usually an ultrasound or CT scan. In some cases, a combination of imaging studies may be needed to completely evaluate the tumor.3

If cancer is suspected, you should be evaluated to see if it has spread beyond the kidney (metastasized). An evaluation consists of imaging studies such as an ultrasound or CT scan. These tests may be followed by an MRI, X-rays and blood tests. You may also need a bone scan if you have had bone pain, recent fractures, or abnormal blood tests. Additional tests may be ordered if your doctor feels they are needed to completely evaluate the tumor.

Treatment

The primary treatment option for kidney cancer is surgery to remove all or part of the kidney and the tumor; studies have found that kidney cancer does not respond well to radiation and chemotherapy treatments.4

Surgery to remove your entire kidney is known as nephrectomy. Surgery to remove only part of your kidney that contains the cancerous tumor is called a partial nephrectomy.

da Vinci Nephrectomy: Overview Video

PN 1002149 Rev A 04/2013


  1. World Health Organization; Global cancer rates could increase by 50% to 15 million by 2020; URL: http://www.who.int/mediacentre/news/releases/2003/pr27/en/
  2. "Cancer Facts & Figures 2008", American Cancer Society, www.cancer.org , URL: http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf
  3. 'Kidney Cancer', American Urological Association Foundation, www.urologyhealth.org , URL: http://www.urologyhealth.org/adult/index.cfm?cat=04&topic=124
  4. American Urological Association; Guideline for Management of the Clinical Stage I Renal Mass; 2009; URL: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/renalmass09.pdf

Serious complications may occur in any surgery, including da Vinci® Surgery, up to and including death. Examples of serious or life-threatening complications, which may require prolonged and/or unexpected hospitalization and/or reoperation, include but are not limited to, one or more of the following: injury to tissues/organs, bleeding, infection and internal scarring that can cause long-lasting dysfunction/pain. Risks of surgery also include the potential for equipment failure and/or human error. Individual surgical results may vary.

Risks specific to minimally invasive surgery, including da Vinci Surgery, include but are not limited to, one or more of the following: temporary pain/nerve injury associated with positioning; temporary pain/discomfort from the use of air or gas in the procedure; a longer operation and time under anesthesia and conversion to another surgical technique. If your doctor needs to convert the surgery to another surgical technique, this could result in a longer operative time, additional time under anesthesia, additional or larger incisions and/or increased complications.

Patients who are not candidates for non-robotic minimally invasive surgery are also not candidates for da Vinci® Surgery. Patients should talk to their doctor to decide if da Vinci Surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options in order to make an informed decision. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer to www.davincisurgery.com/safety and www.intuitivesurgical.com/safety. Unless otherwise noted, all people depicted are models.

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