Kidney Cancer Treatment-Medical therapy of Renal Cell Cancer.

Gross appearance of the cut surface of a nephrectomy specimen containing a large renal cell carcinoma (the large yellowish tumour in the upper half of the kidney). (Photo credit: Wikipedia)

Non surgical therapy for renal cell carcinoma is offered when the cancer has already spread to other organs or when the cancer has advanced to nearby tissues in the vicinity of the kidney. Under these circumstances treatment of the cancer is not expected to result in a cure.

Chemotherapy
Depending on the type of renal cell carcinoma you have the rate of response to chemotherapy varies. Individuals may also differ in terms of there genetic make up and hence their response to chemotherapy.
On the average the response rate to chemotherapy is low.


Immunomodulatory Therapies

These are therapies aimed at modifying components of the immune system to alter the growth of cancer cells by forcing the body to destroy the cells. There are reports of remissions which may occur spontaneously using these types of therapies.
The include such methods as

• Stem cell transplantation


• Vaccination against tumors.


• Interferon therapy

Interferon is a substance produced by cells of the immune system. Its function is to tell other cells to resist viral infection. A small percentage of a subtype of renal cell cancer will respond to interferon alone.However interferon therapy is associated with significant side effects.

Interferon signalling (Photo credit: AJC1)

Interleukin-2 is considered standard therapy for renal cell carcinoma that is advanced. Patients do very well when there is a complete response to the drug.
Research is ongoing in this area and there is the hope that patients who are likely to have a good response will one day be identified by blood test.

The Future

The identification of the major gene that underlies renal cell cancer has allowed for theoretical constructs with which to drive research.
Research is advanced in the area of exploiting bone marrow transplantation and the use of vaccines. New drug types that inhibit the growth of blood vessels within the tumour are also
in development as adjunctive or "add on" therapy that will further add to the possibility of producing a durable remission.

Until then a combination of therapy surgical and medical may be the best approach to the treatment of Renal cell Carcinoma that is locally advanced or with distant spread. The use of interferon after surgical resection was shown to be superior to interferon alone for this patient group.