For patients with kidney cancer, the first priority of treatment is usually to remove the tumor and stop its spread. Secondary to that is preserving the kidney. In the best scenario, both targets are reached — and at Stony Brook Medicine, patients with kidney cancer have the greatest chance possible to achieve these dual goals.
Thanks to Stony Brook's renowned urology department — ranked among the top 50 in the 2009-2010 "America's Best Hospitals" edition of U.S.News & World Report — patients with kidney cancer have access to a comprehensive range of surgeries and treatments, including a particularly complex, kidney-sparing, and potentially lifesaving surgery available only at a handful of the top academic medical centers nationwide. In essence, the surgery is a kidney transplant — but the kidney is the patient's own.
This unusual procedure is only possible because of Stony Brook's expertise both in cancer care and kidney transplantation. While the "autotransplant" is not appropriate for all patients with kidney cancer, it offers a valuable option to those whose tumor is located in areas of the kidney that are difficult to reach through conventional techniques. In other cancer programs, such patients might be automatically advised to undergo radical nephrectomy, or total removal of the kidney. But in patients with insufficient kidney function — for example, those who may have cancer in both kidneys, or whose noncancerous kidney is damaged — a radical nephrectomy presents a difficult choice because it may leave the patient dependent on dialysis. In these situations, salvage of an otherwise healthy organ becomes paramount — and Stony Brook's autotransplant becomes an optimal choice.
Led by Department of Urology Chairman Wayne Waltzer, MD, the autotransplant borrows in large part from the techniques of kidney transplantation — another special strength at Stony Brook, where more than 1,200 kidney transplants have been performed. In the autotransplant, surgeons takes the kidney from the patient's body and bring it to a specially equipped work table in the operating room. There, just as they would for a kidney transplant, the surgeons bathe the organ with a preservative solution that cools the kidney, flushes out the blood to avoid clotting, and slows the organ's metabolic activity, keeping it viable for up to 24 hours outside the body. Then the surgeon carefully removes the cancerous tumors and closes the blood vessels and urine collection systems affected by the surgery. The final steps involve inserting the kidney back into the patient's body and reconstructing all of its delicate connections. Altogether, the procedure may take up to six hours in the operating room — a heroic effort on the part of Stony Brook surgeons. Postsurgical recovery, however, is like that of any major operation. And unlike a donor transplant, no anti-rejection drugs are needed. Outcomes for the procedure, according to Dr. Waltzer, are excellent.
Our Stellar Kidney Cancer Team
Stony Brook's kidney cancer team consists of physicians who have dedicated their professional lives to restoring health and hope to people with severe kidney problems. Our urologists are leaders in their field who not only treat patients, but as faculty of the Stony Brook University School of Medicine, also conduct research and teach tomorrow's specialists. In total, our teams perform about 250 kidney operations a year including radiofrequency ablation, cryotherapy, robot-assisted surgeries, laparoscopic and open radical and partial nephrectomies, and kidney transplants. Treatment options are different for each patient depending on the extent and location of disease and the individual's overall health.
Patients with advanced disease also can receive immunotherapy with cytokines, such as interleukin-2, everolimus, bevacizumab, and other agents. New oral agents such as sunitinib and sorafenib target vascular endothelial growth factor receptors. We also offer many clinical trials investigating novel therapies and optimizing treatment with new agents currently being used in clinical practice.
For more information on kidney cancer in general, and treatment at Stony Brook Cancer Center, click here.
- Wayne C. Waltzer, MD, Chair, Department of Urology
- Frank S. Darras, MD
Making an Appointment
For an appointment, call the Department of Urology: (631) 444-6280, (631) 444-6270, or (631) 444-1910.