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Sunday, May 11, 2008

Treatment for kidney cancer

Surgery is the main treatment for cancer of the kidney. If all of the cancer can’t be removed by surgery, other treatments may be used. These may include biological treatments, or targeted treatments. Occasionally chemotherapy, radiotherapy or hormonal treatment is used. In rare cases, cancer of the kidney will spontaneously improve without any treatment, but this is not usual.

Your doctors will plan your treatment by taking into account a number of factors, including your age and general health, the type and size of the tumour and whether it has spread.

How treatment is planned

In most hospitals, a team of specialists will meet to discuss and agree on the plan of treatment they feel is best for your situation. This multidisciplinary team (MDT) will normally include:

  • a urologist (a surgeon who specialises in treating kidney cancers)
  • an oncologist (a specialist in cancer treatments such as chemotherapy, radiotherapy and biological therapy)
  • a nurse specialist, who gives information and support
  • a radiologist, who helps to analyse scans and x-rays
  • a pathologist, who advises on the type and extent of the cancer.

Other staff are also available to help you if necessary, such as

  • dietitians
  • physiotherapists
  • occupational therapists
  • psychologists and counsellors.

Your doctor will discuss with you what the best treatment is for your particular situation or they may offer you a choice of treatments. If you have to decide between treatments, make sure that you have enough information about each treatment option, so that you can decide which is right for you. You may find it helps to ask questions about what is involved with each treatment and the possible side effects they may cause.

If you have any questions about your treatment, don’t be afraid to ask your doctor or the nurse looking after you. It often helps to make a list of the questions you want to ask and to take a close friend or relative with you to help you remember what is discussed.

Giving your consent

Before you have any treatment, your doctor will explain the aims of the treatment to you. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should have been given full information about:

  • the type and extent of the treatment you are advised to have
  • the advantages and disadvantages of the treatment
  • any possible other treatments that may be available
  • any significant risks or side effects of the treatment.

If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it is not unusual for people to need repeated explanations.

It is often a good idea to have a friend or relative with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write down a list of questions before you go to your appointment.

Patients often feel that the hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.

You can always ask for more time to decide about the treatment if you feel that you can’t make a decision when it is first explained to you.

You are also free to choose not to have the treatment. If you are considering not having treatment it is essential to discuss this fully with your cancer specialist. The staff can explain what may happen if you do not have it. It is essential to tell a doctor, or the nurse in charge, so that they can record your decision in your medical notes. You do not have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice.

Benefits and disadvantages of treatment

You may feel worried at the thought of having cancer treatment, because of the potential side effects that can occur. In this situation it is often helpful to get more information about what can be done to prevent or control side effects. The doctor who will be giving you the treatment will be able to answer your questions about this.

Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation.

Early-stage kidney cancer

In people with early-stage kidney cancer, surgery is usually done with the aim of curing the cancer. Occasionally, additional treatments are given to help reduce the risks of it coming back.

Advanced-stage kidney cancer

If the cancer is at a more advanced stage, treatment may only be able to control it. This may help you to live for longer or it may reduce your symptoms and improve your quality of life. However, for some people the treatment will have very little effect upon the cancer and they will get the side effects without any of the benefits. If you are having treatments you will be monitored closely for signs that it is working. This is so that treatment can be stopped if it isn’t helping you and is only causing side effects.

Treatment decisions

If you have been offered treatment with the aim of curing your cancer, the decision whether to accept it may not be a difficult one. But, if a cure isn’t possible and the treatment is being given to control the cancer for a period of time, it may be more difficult to decide whether to go ahead with treatment or not.

Making decisions about treatment in these circumstances is always difficult, and you may need to discuss things in detail with your doctor. If you choose not to have treatment for the cancer, you can still be given treatment to control any symptoms you may have. Treatment given in this situation is known as supportive care or palliative care.

Second opinion

Even though a number of cancer specialists work together as part of a team to decide on the most suitable treatment for you, you may want to have another medical opinion. Most doctors will be willing to refer you to another specialist for a second opinion if you feel that it will be helpful. This can take time to organise and may cause a delay in the start of your treatment, so you and your doctor need to be confident that it will give useful information.

If you go for a second opinion, it may be a good idea to take someone with you, and to have a list of questions ready so that you can make sure your concerns are covered during the discussion.

Via: http://www.cancerbackup.org.uk

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