What is the first treatment for kidney cancer?

For a kidney tumour that has not spread and can be removed safely, kidney removal surgery may be recommended. Depending on the tumour, surgeons may remove part of the kidney or the whole kidney. Tumour ablation uses heat or cold to destroy selected small tumours and may suit people for whom surgery carries added concerns.

When kidney cancer has spread or cannot be removed with an operation, treatment may begin with medicines. Immunotherapy helps the immune system recognise cancer cells; targeted therapy interferes with signals that help cancer cells grow. Scans, biopsy information when needed, kidney function, and other health conditions shape the plan.

Ask whether the goal is to remove the tumour, control disease elsewhere, or relieve symptoms. Bring a list of medicines and any history of kidney problems. Before surgery or ablation, discuss remaining kidney function and follow-up scans. If medicine is proposed, ask how blood pressure, liver tests, kidney tests, and immune-related symptoms will be monitored.

Read about [Kidney Removal Surgery](/treatments/surgical-oncology/nephrectomy/), [Tumour Ablation](/treatments/surgical-oncology/tumour-ablation/), and [Immunotherapy](/treatments/systemic-therapy/immunotherapy/) for more detail.

Seek urgent help for heavy blood in the urine, inability to pass urine, severe flank pain with fever, sudden breathlessness, chest pain, or marked weakness. During systemic treatment, report severe diarrhoea, a new rash with breathing difficulty, or confusion promptly because these can need rapid assessment.

Can the tumour be removed while preserving kidney tissue? Would ablation be suitable? Has the cancer spread? What tests are needed before treatment? Which side effects should trigger a call? How will kidney function be followed?