Our Approach & Expertise

Our Publications Visit PubMed for listing of journal articles from our team of kidney cancer experts go

Researchers have found that kidney tumors are a family of tumors with varying degrees of aggressiveness. Our pathologists are experts in examining kidney cells to determine whether cancer is present, and, if so, the specific type of cancer. Over many years of correlating the various types of kidney cancer with specific treatment outcomes, we are now better able to select the most appropriate therapy for each patient.

Renal Cell Carcinoma Nomogram Our nomogram helps physicians and patients decide which treatment approaches will result in the greatest benefit more

If an operation is necessary, our team of specialists will evaluate the patient and, based on the size and location of the tumor, recommend either the removal of the tumor (partial nephrectomy) or removal of the entire kidney (radical nephrectomy). In 2006, Memorial Sloan-Kettering surgeons performed 117 radical nephrectomies and 161 partial nephrectomies. Research (¹) has shown that, when possible, partial nephrectomy is preferable to radical nephrectomy because partial removal allows for preservation of overall kidney function with rates of cure similar to those achieved with removal of the entire kidney.

Sidney Kimmel Center for Prostate & Urologic Cancers Our state-of-the-art outpatient facility offers comprehensive care more

Our team has the capacity to perform kidney operations using either standard open surgical approaches or minimally invasive techniques, depending on the individual patient and his or her disease. Minimally invasive surgery, also known as laparoscopic surgery, is done through small incisions in the abdominal wall using a camera that transmits images to a video monitor. The procedure can, in some cases, reduce post-surgery recovery time, and surgeons at Memorial Sloan-Kettering have considerable experience (²) in the laparoscopic approach to kidney cancer. The removal of certain, more advanced kidney tumors that have invaded adjacent organs or major vascular structures (arteries, veins, and smaller vessels), or that have begun to spread to the lungs, may require the assistance of Memorial Sloan-Kettering's general, vascular, or thoracic (chest) surgeons.

Because our team includes experts in all aspects of the surgical approach to kidney cancer, we can offer our patients a balanced perspective in helping them to make decisions about treatment. Memorial Sloan-Kettering surgeons have been instrumental in pioneering research (³) in kidney-sparing surgery and we make every effort to preserve as much of the healthy kidney as possible. Our team has extensive experience in these technically demanding surgeries, using both open and laparoscopic approaches.

Find a Clinical Trial Find out about new research studies for kidney cancer more

For kidney tumors that may have spread, or metastasized, outside the kidney, our surgeons consult with medical oncologists to determine if systemic (whole-body) treatment is required before or after surgical removal of the kidney.

Recent evidence (⁴) suggests that even patients with metastatic kidney cancer can benefit from surgical removal of the primary tumor before starting systemic therapy. Together with Memorial Sloan-Kettering surgeons, our medical oncologists can help determine the best treatment approach for each individual patient.

For patients who need systemic therapy, Memorial Sloan-Kettering investigators have established an active program of clinical trials designed to explore novel treatment approaches. Kidney cancer does not, in general, respond well to traditional chemotherapy drugs. Until recently, treatment relied upon interleukin-2 (IL-2) and interferon, drugs that boost the immune system while helping the immune system to recognize the kidney cancer as an enemy. Improved understanding of how kidney cancer begins to develop has led to recent advances in what are called "targeted therapies." As a result, over the last few years treatment options have improved dramatically as new inhibitors and antibodies that block growth factors important to kidney cancer growth have shown excellent responses and/or prolonged survival compared to interferon and IL-2.

Since 2005, three drugs have been approved by the US Food and Drug Administration (FDA) for the treatment of advanced kidney cancer: sorafenib (Nexavar®, FDA-approved in December 2005), sunitinib (Sutent®, FDA-approved in January 2006), and temsirolimus (Torisel™, FDA-approved in May 2007). Our clinical investigation program includes strategies to improve upon the responses of kidney cancer to these new drugs, to determine in what order to use them, and to study new agents. Our experience has led to the development of a prediction tool that can help patients determine their individual prognosis and help guide treatment selection.

For kidney tumors that have spread widely to other parts of the body, our medical oncologists have access to the latest treatments available and pursue an active program of clinical research. Among the approaches under evaluation are new antibodies that directly target kidney cancer cells and new drugs that block other kidney cancer growth factors.

Focus on the Patient

Communication with patients and caregivers is an important priority at Memorial Sloan-Kettering. We believe that treating the whole person, not just the disease, is the best for patients and family members. At Memorial Sloan-Kettering, we offer a broad range of emotional support programs designed to help patients and family members cope with the range of issues related to life during and after cancer treatment.

MYMSKCC Patient Portal Learn how you can access information about your care go

Memorial Sloan-Kettering has developed a secure Web site -- called MYMSKCC -- for Memorial Sloan-Kettering Cancer Center patients who receive their treatment at the Kimmel Center to access personalized information about their care. Patients who enroll to use MYMSKCC can view and keep track of appointments; make changes to contact and insurance information; send and receive e-mail messages to and from their nurse; and view hospital bills.

To enroll in or learn more about MYMSKCC, please ask a session assistant in clinic or contact your physician's office.

 

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¹Huang WC, Levey AS, Serio AM, Snyder M, Vickers AJ, Raj GV, Scardino PT, Russo P.Chronic Kidney Disease After Nephrectomy in Patients with Renal Cortical Tumours: a Retrospective Cohort Study.
Lancet Oncology. 2006 Sep;7(9):735-40
[PubMed Abstract]

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²Russo P. Renal Cell Carcinoma: Presentation, Staging, and Surgical Treatment.
Semin Oncol. 2000 Apr;27(2):160-76.
[PubMed Abstract]

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³Russo P. Partial nephrectomy achieves local tumor control and prevents chronic kidney disease.
Expert Rev Anticancer Ther. 2006 Dec;6(12):1745-51.
[PubMed Abstract]

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⁴Flanigan RC, Mickisch G, Sylvester R, Tangen C, Van Poppel H, Crawford ED. Cytoreductive nephrectomy in patients with metastatic renal cancer: a combined analysis.J Urol. 2004 Mar;171(3):1071-6. [PubMed Abstract]