Urologic Oncology Team photo

Update on Kidney Cancer: New Treatments Offer Improved Quality of Life

Kidney cancer is among the 10 most common cancers in both men and women, so awareness is key. The urologic oncologists from Stony Brook Cancer Center discuss the facts about kidney cancer and its treatment — and how Stony Brook Medicine can help.

First, what do we need to know about kidney cancer?

Kidney cancer is a good news/bad news scenario. There are more than 65,000 new cases annually, and rates have risen steadily since the 1990s. We believe this is due to new imaging technologies that can detect cancers that would not have been found otherwise. The good news, however, is that treatment has improved, which has resulted in higher survival rates and better quality of life for patients.  

Who gets kidney cancer - and what are the signs and symptoms?

People diagnosed with kidney cancer tend to be age 55 and older, with a higher incidence in men. What people may not realize is that smoking is a major risk factor for kidney cancer, and one of the most significant prevention tools is for non-smokers to never start and for smokers to stop. Other risk factors include:

  • Smoking
  • Obesity
  • Environment — exposure to chemicals and pollution
  • Presence of certain syndromes associated with kidney cancer, such as Von Hippel-Lindau syndrome or Tuberous Sclerosis
  • An inheritable component and/or family history of the disease

How is kidney cancer detected?

Like so many cancers in the early stages, there are few visible symptoms. If you find blood in your urine, or experience a pain in your side that is consistent and will not go away, you should see your primary care physician. He or she may then refer you to further testing, such as a CT scan or an MRI — both of which we can perform at Stony Brook Medicine. If a tumor is detected during a scan, you would then be referred to a urologist or urology team specializing in kidney cancers.

What are the treatment options?

Surgery to remove the tumor is typically the first line of treatment, and there are three options available today: open, laparoscopic and robotic- assisted. Twenty years ago, the best practice was to remove the entire kidney through open surgery. And while that did eliminate the tumor, it also involved a large open incision, removal of a rib, a long recovery period and the loss of a kidney. In the last ten to fifteen years, surgeons have also used laparoscopic surgery. This avoids the large open incision, but unless the surgeon is an expert in laparoscopic surgery, removing complex tumors with this method can be difficult, so this option is not available to everyone. However, more recently, robotic-assisted surgery has become a viable option for removing small renal masses and kidney lesions. 

What are the benefits of robotic-assisted surgery for kidney cancer - and where is this option available in Suffolk County ?

Currently, in Suffolk County Stony Brook Medicine is the only medical center with physicians fellowship-trained in urologic oncology and robotics. We are so pleased to be able to provide this option to our patients because the robotic platform allows us to perform what we call nephron sparing minimally invasive surgery. In short, removing the tumor, not the entire kidney. This does three things: 

  • It offers cancer control because the robotics give physicians greater accuracy through 3D magnification and more flexible instrumentation 
  • It preserves the kidney, which is key because the odds of developing cancer in the other kidney are elevated for patients who have had one tumor already
  • It takes a minimally invasive approach, which means a much shorter hospital stay and recovery period versus the open incision with a prolonged recovery.

In addition, this kidney-sparing approach offers other benefits, including improved cardiovascular health, which in turn, lowers the rates of heart and cardiovascular disease that can be associated with loss of a kidney. As a result, the American Urological Association has identified nephron-sparing surgery as the preferred treatment for smaller kidney tumors. In the big picture, we see the robotic-assisted option as a game changer because it optimizes both the short-term results and the long-term quality of life for patients with kidney cancer. In the smaller picture, it may not be appropriate for every person and every diagnosis. However, robotic-assisted surgery for kidney cancer offers the people of Suffolk County something very important: another choice. 

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