Monitoring Kidney Cancer Growth Is a Safe Alternative to Surgery for Some Older Patients

Genitourinary Cancers Symposium
February 12, 2013

A recent analysis of information from the Surveillance Epidemiology and End Results (SEER) database showed that patients who had surgery to remove small kidney tumors (tumors that are less than 1.5 inches across) have the same risk of dying of kidney cancer over a five-year period as those who received surveillance instead. Surveillance of kidney cancer involves using imaging tests, such as magnetic resonance imaging (MRI), ultrasound, and computed tomography (CT or CAT) scans to watch for signs that the cancer is growing or worsening.

Most of the time, small tumors are discovered when a patient has an ultrasound, CT, or MRI imaging for symptoms unrelated to the tumor. Surgery to remove part or all of the kidney is usually the first treatment option for these small tumors. However, for older patients with other severe health conditions and a lower life expectancy, the risks of surgery may outweigh the benefits. For instance, surgery may cause chronic kidney disease and related complications such as kidney failure and heart problems.  

In this study, researchers analyzed information from 8,317 patients age 66 or older who were diagnosed with small kidney tumors. Of these patients, 5,706 received surgery and 2,611 received surveillance. After about five years, 3% of these patients died from kidney cancer, and the rates were the same among patients who received surgery and those who received surveillance. Researchers also found that the patients who received surveillance were less likely to have heart problems, such as heart failure or stroke, and less likely to die of any cause.

What this means for patients

“This study indicates that doctors can comfortably tell an older patient, especially a patient who is not healthy enough for general anesthesia and surgery, that the likelihood of dying of kidney cancer is low and that kidney surgery is unlikely to lengthen their life,” said lead author William C. Huang, MD, Assistant Professor of Urologic Oncology at New York University Medical Center in New York. “Treatment considerations are different for healthy patients, because they have a long life expectancy and a greater chance of having the disease worsen and spread.” Talk with your doctor about your specific diagnosis to learn more about your treatment options, as well as the risks and benefits of each option.

Questions to Ask Your Doctor

  • What stage of kidney cancer do I have?
  • What is my prognosis (chance of recovery)?
  • What are the treatment options?
  • If surgery is an option, am I healthy enough for anesthesia and surgery?

For More Information

Guide to Kidney Cancer

Cancer in Older Adults

Making Decisions About Cancer Treatment