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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="PDQ Cancer Information Summaries [Internet]" /><meta name="citation_title" content="Renal Cell Cancer Treatment (PDQ®)" /><meta name="citation_publisher" content="National Cancer Institute (US)" /><meta name="citation_date" content="2004/02/20" /><meta name="citation_author" content="PDQ Adult Treatment Editorial Board" /><meta name="citation_pmid" content="26389448" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK66012/" /><meta name="citation_keywords" content="renal cell carcinoma" /><meta name="citation_keywords" content="renal cell carcinoma" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Renal Cell Cancer Treatment (PDQ®)" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Cancer Institute (US)" /><meta name="DC.Contributor" content="PDQ Adult Treatment Editorial Board" /><meta name="DC.Date" content="2004/02/20" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK66012/" /><meta name="description" content="Renal cell cancer treatment options include surgery, radiation therapy, chemotherapy, biologic therapy, and targeted therapy. Learn more about the treatment of newly diagnosed and recurrent renal cell cancer in this expert-reviewed summary." /><meta name="og:title" content="Renal Cell Cancer Treatment (PDQ®)" /><meta name="og:type" content="book" /><meta name="og:description" content="Renal cell cancer treatment options include surgery, radiation therapy, chemotherapy, biologic therapy, and targeted therapy. Learn more about the treatment of newly diagnosed and recurrent renal cell cancer in this expert-reviewed summary." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK66012/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/pdqcis/CDR0000276462/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK66012/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="NONE" />
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK66012_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK66012_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK66012_"><span class="title" itemprop="name">Renal Cell Cancer Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: October 31, 2019.</p><p class="small">Created: <span itemprop="datePublished">February 20, 2004</span>.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000276462__196">This PDQ cancer information summary has current information about the treatment of renal cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000276462__197">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000276462__1"><h2 id="_CDR0000276462__1_">General Information About Renal Cell Cancer</h2><div id="CDR0000276462__1.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000276462__2">Renal cell cancer is a disease in which malignant (cancer) cells form in
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tubules of the kidney.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__7">Smoking and misuse of certain pain medicines can affect the risk of renal cell cancer. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__15">Signs of renal cell cancer include blood in the urine and a lump in the abdomen.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__19">Tests that examine the abdomen and kidneys are used to detect (find) and diagnose renal cell cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__23">Certain factors affect prognosis (chance of recovery) and treatment options.</a></div></li></ul></div><div id="CDR0000276462__2"><h3>Renal cell cancer is a disease in which malignant (cancer) cells form in
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tubules of the kidney.</h3><p id="CDR0000276462__4"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044988/" class="def">Renal cell cancer</a> (also called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidney</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000661353/" class="def">renal cell adenocarcinoma</a>) is a disease in which <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a> (cancer) <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> are found in the lining of tubules (very small tubes) in the kidney. There are 2 kidneys, one on each side of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415915/" class="def">backbone</a>, above the waist. Tiny tubules in the kidneys filter and clean the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood.</a> They take out waste products and make <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urine</a>. The urine passes from each kidney through a long tube called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046638/" class="def">ureter</a> into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a>. The bladder holds the urine until it passes through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046640/" class="def">urethra</a> and leaves the body. </p><div id="CDR0000276462__195" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Anatomy%20of%20the%20male%20urinary%20system%20(left%20panel)%20and%20female%20urinary%20system%20(right%20panel)%20showing%20the%20kidneys%2C%20ureters%2C%20bladder%2C%20and%20urethra&p=BOOKS&id=549314_CDR0000765031.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66012.13/bin/CDR0000765031.jpg" alt="Anatomy of the male urinary system (left panel) and female urinary system (right panel); two-panel drawing showing the right and left kidneys, the ureters, the bladder filled with urine, and the urethra. The inside of the left kidney shows the renal pelvis. An inset shows the renal tubules and urine. Also shown are the prostate and penis (left panel) and the uterus (right panel)." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Anatomy of the male urinary system (left panel) and female urinary system (right panel) showing the kidneys, ureters, bladder, and urethra. Urine is made in the renal tubules and collects in the renal pelvis of each kidney. The urine flows from the kidneys through the ureters to the bladder. The urine is stored in the bladder until it leaves the body through the urethra.</p></div></div><p id="CDR0000276462__5">Cancer that starts in the ureters or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046562/" class="def">renal pelvis</a> (the part of the kidney that collects urine and drains it to the ureters) is different from renal cell cancer. (See the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summary about <a href="/books/n/pdqcis/CDR0000343585/">Transitional Cell Cancer of the Renal Pelvis and Ureter Treatment</a> for more information).</p></div><div id="CDR0000276462__7"><h3>Smoking and misuse of certain pain medicines can affect the risk of renal cell cancer. </h3><p id="CDR0000276462__9">Anything that increases your risk of getting a disease is called
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a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045873/" class="def">risk factor</a>. Having a risk factor does not mean that you will
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get cancer; not having risk factors doesn't mean that you will
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not get cancer. Talk with your doctor if you think you may be at risk.</p><p id="CDR0000276462__201">Risk factors for renal cell cancer include the following:</p><ul id="CDR0000276462__10"><li class="half_rhythm"><div>Smoking.</div></li><li class="half_rhythm"><div>Misusing certain pain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">medicines</a>, including <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044696/" class="def">over-the-counter</a> pain medicines, for a long time.</div></li><li class="half_rhythm"><div>Being <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304742/" class="def">overweight</a>.</div></li><li class="half_rhythm"><div>Having <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000458091/" class="def">high blood pressure</a>.</div></li><li class="half_rhythm"><div>Having a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000302456/" class="def">family history</a> of renal cell cancer.</div></li><li class="half_rhythm"><div>Having certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046391/" class="def">genetic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045563/" class="def">von Hippel-Lindau disease</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045983/" class="def">hereditary</a> papillary renal cell <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045963/" class="def">carcinoma</a>.</div></li></ul></div><div id="CDR0000276462__15"><h3>Signs of renal cell cancer include blood in the urine and a lump in the abdomen.</h3><p id="CDR0000276462__17">These and other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> may be caused by renal cell cancer or by other conditions. There may be no signs or symptoms in the early <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stages</a>. Signs and symptoms may appear as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> grows. Check with your doctor if you have any of the following:</p><ul id="CDR0000276462__18"><li class="half_rhythm"><div>Blood in the urine.
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</div></li><li class="half_rhythm"><div>A lump in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>.
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</div></li><li class="half_rhythm"><div>A pain in the side that doesn't go away.
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</div></li><li class="half_rhythm"><div>Loss of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454699/" class="def">appetite</a>.</div></li><li class="half_rhythm"><div>Weight loss for no known reason.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045360/" class="def">Anemia</a>.</div></li></ul></div><div id="CDR0000276462__19"><h3>Tests that examine the abdomen and kidneys are used to detect (find) and diagnose renal cell cancer.</h3><p id="CDR0000276462__21">The following tests and procedures may be used:</p><ul id="CDR0000276462__22"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and health history</b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046157/" class="def">Ultrasound</a> exam</b>: A procedure in which high-energy sound waves (ultrasound) are bounced off internal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> and make echoes. The echoes form a picture of body tissues called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046587/" class="def">sonogram</a>.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304685/" class="def">Blood chemistry studies</a></b>: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046641/" class="def">Urinalysis</a></b>: A test to check the color of urine and its contents, such as sugar, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046124/" class="def">red blood cells</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">white blood cells</a>.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT
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scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a>, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic
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resonance imaging)</b>: A procedure that uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). </div></li><li class="half_rhythm"><div>
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<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">Biopsy</a></b>: The removal of cells or tissues so they can be viewed under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> to check for signs of cancer. To do a biopsy for renal cell cancer, a thin needle is inserted into the tumor and a sample of tissue is withdrawn. </div></li></ul></div><div id="CDR0000276462__23"><h3>Certain factors affect prognosis (chance of recovery) and treatment options.</h3><p id="CDR0000276462__130">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> (chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>) and treatment options depend on the following:</p><ul id="CDR0000276462__133"><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the disease.</div></li><li class="half_rhythm"><div>The patient's age and general health.</div></li></ul></div></div><div id="CDR0000276462__26"><h2 id="_CDR0000276462__26_">Stages of Renal Cell Cancer</h2><div id="CDR0000276462__26.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000276462__27">After renal cell cancer has been diagnosed, tests are done to find out if cancer cells have spread within the kidney or to other parts of the body. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__169">There are three ways that cancer spreads in the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__192">Cancer may spread from where it began to other parts of the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__31">The following stages are used for renal cell cancer:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000276462__36">Stage I</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__39">Stage II</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__42">Stage III</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__45">Stage IV</a></div></li></ul></li></ul></div><div id="CDR0000276462__27"><h3>After renal cell cancer has been diagnosed, tests are done to find out if cancer cells have spread within the kidney or to other parts of the body. </h3><p id="CDR0000276462__29">The process used to find out if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread within the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidney</a> or to other
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parts of the body is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">staging</a>. The information gathered from the
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staging process determines the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the disease. It is important to know
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the stage in order to plan treatment. The following tests and
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procedures may be used in the staging process:
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</p><ul id="CDR0000276462__30"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT
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scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, such as the chest or brain, taken from different angles. The pictures are made by a computer linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> machine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or swallowed to help the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic
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resonance imaging)</b>: A procedure that uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the body, such as the brain. This procedure is also called nuclear magnetic resonance imaging (NMRI). </div></li><li class="half_rhythm"><div>
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<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304687/" class="def">Chest x-ray</a></b>: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046499/" class="def">Bone scan</a></b>: A procedure to check if there are rapidly dividing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>, such as cancer cells, in the bone. A very small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a>.</div></li></ul></div><div id="CDR0000276462__169"><h3>There are three ways that cancer spreads in the body.</h3><p id="CDR0000276462__169_69">Cancer can spread through <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045764/" class="def">lymph system</a>, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>:</p><ul id="CDR0000276462__169_70"><li class="half_rhythm"><div>Tissue. The cancer spreads from where it began by growing into nearby areas.
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</div></li><li class="half_rhythm"><div>Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269462/" class="def">lymph vessels</a> to other parts of the body.
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</div></li><li class="half_rhythm"><div>Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> to other parts of the body.
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</div></li></ul></div><div id="CDR0000276462__192"><h3>Cancer may spread from where it began to other parts of the body.</h3><p id="CDR0000276462__192_66">When cancer spreads to another part of the body, it is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a>. Cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> break away from where they began (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>) and travel through the lymph system or blood.</p><ul id="CDR0000276462__192_67"><li class="half_rhythm"><div>Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> tumor) in another part of the body.</div></li><li class="half_rhythm"><div>Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.</div></li></ul><p id="CDR0000276462__194">The metastatic tumor is the same type of cancer as the primary tumor. For example, if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044988/" class="def">renal cell cancer</a> spreads to the bone, the cancer cells in the bone are actually cancerous renal cells. The disease is metastatic renal cell cancer, not bone cancer.</p><div id="CDR0000276462__212" class="box"><h3><span class="title">metastasis: how cancer spreads</span></h3><div class="caption"><p>Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.</p></div><p><a href="https://www.youtube.com/watch?v=fQwar_-QdiQ" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div></div><div id="CDR0000276462__31"><h3>The following stages are used for renal cell cancer:</h3><div id="CDR0000276462__36"><h4>Stage I</h4><div id="CDR0000276462__208" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20I%20kidney%20cancer&p=BOOKS&id=549314_CDR0000789098.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66012.13/bin/CDR0000789098.jpg" alt="Stage I kidney cancer; drawing shows cancer in the left kidney and the tumor is 7 centimeters or smaller. An inset shows 7 centimeters is about the size of a peach. Also shown are fatty tissue and the right kidney." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage I kidney cancer. The tumor is 7 centimeters or smaller and is found in the kidney only.</p></div></div><p id="CDR0000276462__202">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000413916/" class="def">stage I</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is 7 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller and is found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidney</a> only.</p></div><div id="CDR0000276462__39"><h4>Stage II</h4><div id="CDR0000276462__209" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20II%20kidney%20cancer&p=BOOKS&id=549314_CDR0000789101.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66012.13/bin/CDR0000789101.jpg" alt="Stage II kidney cancer; drawing shows cancer in the left kidney and the tumor is larger than 7 centimeters. An inset shows 7 centimeters is about the size of a peach. Also shown are the fatty tissue and right kidney." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage II kidney cancer. The tumor is larger than 7 centimeters and is found in the kidney only.</p></div></div><p id="CDR0000276462__203">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000413917/" class="def">stage II</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is larger than 7 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> and is found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidney</a> only.</p></div><div id="CDR0000276462__42"><h4>Stage III</h4><div id="CDR0000276462__210" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20III%20kidney%20cancer&p=BOOKS&id=549314_CDR0000789104.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66012.13/bin/CDR0000789104.jpg" alt="Stage III kidney cancer; drawing shows cancer in the left kidney and in a) nearby lymph nodes, b) the renal vein, c) the structures in the kidney that collect urine, and d) the layer of fatty tissue around the kidney. Also shown are the right kidney, vena cava, and right and left adrenal glands." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage III kidney cancer. The cancer in the kidney is any size and cancer has spread to a) nearby lymph nodes, b) the blood vessels in or near the kidney (renal vein or vena cava), c) the structures in the kidney that collect urine, or d) the layer of fatty tissue around the kidney.</p></div></div><p id="CDR0000276462__204">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000413918/" class="def">stage III</a>, one of the following is found:</p><ul id="CDR0000276462__205"><li class="half_rhythm"><div>the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidney</a> is any size and cancer has spread to nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>; or </div></li><li class="half_rhythm"><div>cancer has spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> in or near the kidney (renal vein or vena cava), to the fat around the structures in the kidney that collect <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urine</a>, or to the layer of fatty <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> around the kidney. Cancer may have spread to nearby lymph nodes.</div></li></ul></div><div id="CDR0000276462__45"><h4>Stage IV</h4><div id="CDR0000276462__211" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IV%20kidney%20cancer&p=BOOKS&id=549314_CDR0000789107.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66012.13/bin/CDR0000789107.jpg" alt="Stage IV kidney cancer; drawing shows cancer that has spread beyond the layer of fatty tissue around the left kidney to a) the adrenal gland above the left kidney. Also shown are the lymph nodes, right adrenal gland, and right kidney. An inset shows b) other parts of the body where kidney cancer may spread, including the brain, lung, liver, adrenal gland, bone, and distant lymph nodes." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IV kidney cancer. Cancer has spread a) beyond the layer of fatty tissue around the kidney and may have spread into the adrenal gland above the kidney with cancer, or b) to other parts of the body, such as the brain, lung, liver, adrenal gland, bone, or distant lymph nodes.</p></div></div><p id="CDR0000276462__206">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000413919/" class="def">stage IV</a>, one of the following is found:</p><ul id="CDR0000276462__207"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread beyond the layer of fatty <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> around the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidney</a> and may have spread into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046678/" class="def">adrenal gland</a> above the kidney with cancer or to nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>; or</div></li><li class="half_rhythm"><div>cancer has spread to other parts of the body, such as the bones, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a>, brain, adrenal glands, or distant lymph nodes.</div></li></ul></div></div></div><div id="CDR0000276462__48"><h2 id="_CDR0000276462__48_">Recurrent Renal Cell Cancer</h2><p id="CDR0000276462__49"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">Recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044988/" class="def">renal cell cancer</a> is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> that has recurred (come back) after it has been treated. The cancer may come back many years after initial treatment, in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidney</a> or in other parts of the body. </p></div><div id="CDR0000276462__50"><h2 id="_CDR0000276462__50_">Treatment Option Overview</h2><div id="CDR0000276462__50.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000276462__51">There are different types of treatment for patients with renal cell cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__59"> Five types of standard treatment are used:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000276462__61">Surgery</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__65">Radiation therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__68">Chemotherapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__1346">Immunotherapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__158">Targeted therapy</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000276462__83">New types of treatment are being tested in clinical trials.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__213">Treatment for renal cell cancer may cause side effects.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__171">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__173">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000276462__175">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000276462__51"><h3>There are different types of treatment for patients with renal cell cancer.</h3><p id="CDR0000276462__53">Different types of treatments are available for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044988/" class="def">renal cell cancer</a>. Some treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some are being tested in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. A treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve current treatments or obtain information on new treatments for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.</p></div><div id="CDR0000276462__59"><h3> Five types of standard treatment are used:</h3><div id="CDR0000276462__61"><h4>Surgery</h4><p id="CDR0000276462__63"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove part or all of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidney</a> is often used to treat renal cell cancer. The following types of surgery may be used:
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</p><ul id="CDR0000276462__119"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000344353/" class="def">Partial nephrectomy</a>: A surgical procedure to remove the cancer within the kidney and some of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> around it. A partial nephrectomy may be done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439419/" class="def">prevent</a> loss of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000725230/" class="def">kidney function</a> when the other kidney is damaged or has already been removed.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000344357/" class="def">Simple nephrectomy</a>: A surgical procedure to remove the kidney only.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000344355/" class="def">Radical nephrectomy</a>: A surgical procedure to remove the kidney, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046678/" class="def">adrenal gland</a>, surrounding tissue, and, usually, nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.</div></li></ul><p id="CDR0000276462__150">A person can live with part of 1 working kidney, but if both kidneys are removed or not working, the person will need <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045485/" class="def">dialysis</a> (a procedure to clean the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> using a machine outside of the body) or a kidney <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046631/" class="def">transplant</a> (replacement with a healthy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000643010/" class="def">donated</a> kidney). A kidney transplant may be done when the disease is in the kidney only and a donated kidney can be found. If the patient has to wait for a donated kidney, other treatment is given as needed.</p><p id="CDR0000276462__120">When surgery to remove the cancer is not possible, a treatment called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043968/" class="def">arterial embolization</a> may be used to shrink the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>. A small <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046353/" class="def">incision</a> is made and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheter</a> (thin tube) is inserted into the main <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessel</a> that flows to the kidney. Small pieces of a special gelatin sponge are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> through the catheter into the blood vessel. The sponges block the blood flow to the kidney and prevent the cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> from getting <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538149/" class="def">oxygen</a> and other substances they need to grow.</p><p id="CDR0000276462__64">After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045587/" class="def">adjuvant therapy</a>.</p></div><div id="CDR0000276462__65"><h4>Radiation therapy</h4><p id="CDR0000276462__67">Radiation therapy is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. There are two types of radiation therapy:</p><ul id="CDR0000276462__199"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the cancer.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or catheters that are placed directly into or near the cancer.</div></li></ul><p id="CDR0000276462__200">The way the radiation therapy is given depends on the type and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer being treated. External radiation therapy is used to treat renal cell cancer, and may also be used as
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to relieve
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</p></div><div id="CDR0000276462__68"><h4>Chemotherapy</h4><p id="CDR0000276462__70">Chemotherapy is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). When chemotherapy is placed directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a>, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a>, or a body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, the drugs mainly affect cancer cells in those areas (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046559/" class="def">regional chemotherapy</a>). The way the chemotherapy is given depends on the type and stage of the cancer being treated. </p><p id="CDR0000276462__186">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/kidney" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Kidney (Renal Cell) Cancer</a> for more information.</p></div><div id="CDR0000276462__1346"><h4>Immunotherapy</h4><p id="CDR0000276462__1348"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> is a treatment that uses the patient's <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or biologic therapy.</p><p id="CDR0000276462__1349">The following types of immunotherapy are being used in the treatment of renal cell cancer:</p><ul id="CDR0000276462__1350"><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000772606/" class="def">Immune checkpoint inhibitor</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a>: Some types of immune cells, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044928/" class="def">T cells</a>, and some cancer cells have certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">proteins</a>, called checkpoint proteins, on their surface that keep <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045722/" class="def">immune responses</a> in check. When cancer cells have large amounts of these proteins, they will not be attacked and killed by T cells. Immune checkpoint inhibitors block these proteins and the ability of T cells to kill cancer cells is increased. They are used to treat some patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478743/" class="def">advanced</a> renal cell cancer that cannot be removed by surgery.</div><div class="half_rhythm">There are two types of immune checkpoint inhibitor therapy:<ul id="CDR0000276462__1355"><li class="half_rhythm"><div>CTLA-4 inhibitor: CTLA-4 is a protein on the surface of T cells that helps keep the body’s immune responses in check. When CTLA-4 attaches to another protein called B7 on a cancer cell, it stops the T cell from killing the cancer cell. CTLA-4 inhibitors attach to CTLA-4 and allow the T cells to kill cancer cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000535555/" class="def">Ipilimumab</a> is a type of CTLA-4 inhibitor.<div id="CDR0000276462__1361" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Immune%20checkpoint%20inhibitor&p=BOOKS&id=549314_CDR0000776560.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66012.13/bin/CDR0000776560.jpg" alt="Immune checkpoint inhibitor; the panel on the left shows the binding of the T-cell receptor (TCR) to antigen and MHC proteins on the antigen-presenting cell (APC) and the binding of CD28 on the T cell to B7-1/B7-2 on the APC. It also shows the binding of B7-1/B7-2 to CTLA-4 on the T cell, which keeps the T cells in the inactive state. The panel on the right shows immune checkpoint inhibitor (anti-CTLA antibody) blocking the binding of B7-1/B7-2 to CTLA-4, which allows the T cells to be active and to kill tumor cells." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Immune checkpoint inhibitor. Checkpoint proteins, such as B7-1/B7-2 on antigen-presenting cells (APC) and CTLA-4 on T cells, help keep the body’s immune responses in check. When the T-cell receptor (TCR) binds to antigen and major histocompatibility complex (MHC) proteins on the APC and CD28 binds to B7-1/B7-2 on the APC, the T cell can be activated. However, the binding of B7-1/B7-2 to CTLA-4 keeps the T cells in the inactive state so they are not able to kill tumor cells in the body (left panel). Blocking the binding of B7-1/B7-2 to CTLA-4 with an immune checkpoint inhibitor (anti-CTLA-4 antibody) allows the T cells to be active and to kill tumor cells (right panel).</p></div></div></div></li><li class="half_rhythm"><div>PD-1 inhibitor: PD-1 is a protein on the surface of T cells that helps keep the body’s immune responses in check. When PD-1 attaches to another protein called PDL-1 on a cancer cell, it stops the T cell from killing the cancer cell. PD-1 inhibitors attach to PDL-1 and allow the T cells to kill cancer cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000767747/" class="def">Nivolumab</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">pembrolizumab</a>, and avelumab are types of PD-1 inhibitors.</div></li></ul></div></li></ul><div id="CDR0000276462__1351" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Immune%20checkpoint%20inhibitor&p=BOOKS&id=549314_CDR0000774646.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66012.13/bin/CDR0000774646.jpg" alt="Immune checkpoint inhibitor; the panel on the left shows the binding of proteins PD-L1 (on the tumor cell) to PD-1 (on the T cell), which keeps T cells from killing tumor cells in the body. Also shown are a tumor cell antigen and T cell receptor. The panel on the right shows immune checkpoint inhibitors (anti-PD-L1 and anti-PD-1) blocking the binding of PD-L1 to PD-1, which allows the T cells to kill tumor cells." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Immune checkpoint inhibitor. Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, help keep immune responses in check. The binding of PD-L1 to PD-1 keeps T cells from killing tumor cells in the body (left panel). Blocking the binding of PD-L1 to PD-1 with an immune checkpoint inhibitor (anti-PD-L1 or anti-PD-1) allows the T cells to kill tumor cells (right panel).</p></div></div><div id="CDR0000276462__1352" class="box"><h3><span class="title">immune checkpoint inhibitors</span></h3><div class="caption"><p>Immunotherapy uses the body’s immune system to fight cancer. This animation explains one type of immunotherapy that uses immune checkpoint inhibitors to treat cancer.</p></div><p><a href="https://www.youtube.com/watch?v=GIUu239FWMg" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div><ul id="CDR0000276462__1356"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045324/" class="def">Interferon</a>: Interferon affects the division of cancer cells and can slow tumor growth.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045256/" class="def">Interleukin-2</a> (IL-2): IL-2 boosts the growth and activity of many immune cells, especially <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045765/" class="def">lymphocytes</a> (a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">white blood cell</a>). Lymphocytes can attack and kill cancer cells.</div></li></ul><p id="CDR0000276462__1353">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/kidney" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Kidney (Renal Cell) Cancer</a> for more information.</p></div><div id="CDR0000276462__158"><h4>Targeted therapy</h4><p id="CDR0000276462__182"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Targeted therapy with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044186/" class="def">antiangiogenic</a> agents are used to treat advanced renal cell cancer. Antiangiogenic agents keep blood vessels from forming in a tumor, causing the tumor to starve and stop growing or to shrink.</p><p id="CDR0000276462__1357"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">Monoclonal antibodies</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750798/" class="def">kinase inhibitors</a> are two types of antiangiogenic agents used to treat renal cell cancer. </p><ul id="CDR0000276462__1358"><li class="half_rhythm"><div class="half_rhythm">Monoclonal antibody therapy uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> made in the laboratory, from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infusion</a>. They may be used alone or to carry drugs, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046622/" class="def">toxins</a>, or radioactive material directly to cancer cells. Monoclonal antibodies used to treat renal cell cancer attach to and block substances that cause new blood vessels to form in tumors. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046115/" class="def">Bevacizumab</a> is a monoclonal antibody.</div></li><li class="half_rhythm"><div class="half_rhythm">Kinase inhibitors stop cells from dividing and may prevent the growth of new blood vessels that tumors need to grow. </div><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044222/" class="def">Vascular endothelial growth factor</a> (VEGF) inhibitors and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000753869/" class="def">mTOR inhibitors</a> are kinase inhibitors used to treat renal cell cancer.<ul id="CDR0000276462__1360"><li class="half_rhythm"><div>VEGF inhibitors: Cancer cells make a substance called VEGF, which causes new blood vessels to form (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046529/" class="def">angiogenesis</a>) and helps the cancer grow. VEGF inhibitors block VEGF and stop new blood vessels from forming. This may kill cancer cells because they need new blood vessels to grow. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000468779/" class="def">Sunitinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000527219/" class="def">pazopanib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000743915/" class="def">cabozantinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538635/" class="def">axitinib</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000509041/" class="def">sorafenib</a> are VEGF inhibitors.</div></li><li class="half_rhythm"><div>mTOR inhibitors: <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000653126/" class="def">mTOR</a> is a protein that helps cells divide and survive. mTOR inhibitors block mTOR and may keep cancer cells from growing and prevent the growth of new blood vessels that tumors need to grow. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386203/" class="def">Everolimus</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000434624/" class="def">temsirolimus</a> are mTOR inhibitors.</div></li></ul></div></li></ul><p id="CDR0000276462__188">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/kidney" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Kidney (Renal Cell) Cancer</a> for more information.</p></div></div><div id="CDR0000276462__83"><h3>New types of treatment are being tested in clinical trials.</h3><p id="CDR0000276462__168">Information about clinical trials is available from the <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000276462__213"><h3>Treatment for renal cell cancer may cause side effects.</h3><p id="CDR0000276462__213_73">For information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> caused by treatment for cancer, see our <a href="https://www.cancer.gov/about-cancer/treatment/side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Side Effects</a> page.</p></div><div id="CDR0000276462__171"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000276462__171_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000276462__171_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000276462__171_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000276462__173"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000276462__173_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurring</a> (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000276462__173_30">Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trials search</a> webpage. Clinical trials supported by other organizations can be found on the <a href="https://clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov</a> website.</p></div><div id="CDR0000276462__175"><h3>Follow-up tests may be needed.</h3><p id="CDR0000276462__175_33">Some of the tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> the cancer or to find out the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000276462__175_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> has changed or if the cancer has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back). These tests are sometimes called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044671/" class="def">follow-up</a> tests or check-ups.</p></div></div><div id="CDR0000276462__1362"><h2 id="_CDR0000276462__1362_">Stage I Renal Cell Cancer</h2><p id="CDR0000276462__1363">For information about the treatments listed below, see the <a href="#CDR0000276462__59">Treatment Option Overview</a> section.</p><p id="CDR0000276462__1364">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000413916/" class="def">stage I renal cell cancer</a> may include the following:</p><ul id="CDR0000276462__1365"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000344355/" class="def">radical nephrectomy</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000344357/" class="def">simple nephrectomy</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000344353/" class="def">partial nephrectomy</a>).
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> in patients who cannot have surgery.</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043968/" class="def">Arterial embolization</a> as palliative therapy.
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</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment.</div></li></ul><p id="CDR0000276462__TrialSearch_1362_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000276462__1366"><h2 id="_CDR0000276462__1366_">Stage II Renal Cell Cancer</h2><p id="CDR0000276462__1367">For information about the treatments listed below, see the <a href="#CDR0000276462__59">Treatment Option Overview</a> section.</p><p id="CDR0000276462__1368">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000413917/" class="def">stage II renal cell cancer</a> may include the following:</p><ul id="CDR0000276462__1369"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000344355/" class="def">radical nephrectomy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000344353/" class="def">partial nephrectomy</a>).
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</div></li><li class="half_rhythm"><div>Surgery (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046265/" class="def">nephrectomy</a>), before or after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>.
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</div></li><li class="half_rhythm"><div>Radiation therapy as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> in patients who cannot have surgery.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043968/" class="def">
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Arterial embolization</a> as palliative therapy.
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</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment.</div></li></ul><p id="CDR0000276462__TrialSearch_1366_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000276462__1370"><h2 id="_CDR0000276462__1370_">Stage III Renal Cell Cancer</h2><p id="CDR0000276462__1371">For information about the treatments listed below, see the <a href="#CDR0000276462__59">Treatment Option Overview</a> section.</p><p id="CDR0000276462__1372">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000413918/" class="def">stage III renal cell cancer</a> may include the following:</p><ul id="CDR0000276462__1373"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000344355/" class="def">radical nephrectomy</a>). <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">Blood vessels</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidney</a> and some <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> may also be removed.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043968/" class="def">Arterial embolization</a> followed by surgery (radical nephrectomy).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.
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</div></li><li class="half_rhythm"><div>Arterial embolization as palliative therapy.
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</div></li><li class="half_rhythm"><div>Surgery (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046265/" class="def">nephrectomy</a>) as palliative therapy.
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</div></li><li class="half_rhythm"><div>Radiation therapy before or after surgery (radical nephrectomy).
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</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">biologic therapy</a> following surgery.</div></li></ul><p id="CDR0000276462__TrialSearch_1370_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000276462__1374"><h2 id="_CDR0000276462__1374_">Stage IV and Recurrent Renal Cell Cancer</h2><p id="CDR0000276462__1375">For information about the treatments listed below, see the <a href="#CDR0000276462__59">Treatment Option Overview</a> section.</p><p id="CDR0000276462__1376">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000413919/" class="def">stage IV</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044988/" class="def">renal cell cancer</a> may include the following:</p><ul id="CDR0000276462__1377"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000344355/" class="def">radical nephrectomy</a>).</div></li><li class="half_rhythm"><div>Surgery (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046265/" class="def">nephrectomy</a>) to reduce the size of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000509041/" class="def">sorafenib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000468779/" class="def">sunitinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000434624/" class="def">temsirolimus</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000527219/" class="def">pazopanib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386203/" class="def">everolimus</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046115/" class="def">bevacizumab</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538635/" class="def">axitinib</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000743915/" class="def">cabozantinib</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045324/" class="def">interferon</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045256/" class="def">interleukin-2</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000767747/" class="def">nivolumab</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000535555/" class="def">ipilimumab</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">pembrolizumab</a>, or avelumab).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.
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</div></li></ul><p id="CDR0000276462__TrialSearch_1374_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000276462__163"><h2 id="_CDR0000276462__163_">To Learn More About Renal Cell Cancer</h2><p id="CDR0000276462__164">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about renal cell cancer, see the following:</p><ul id="CDR0000276462__189"><li class="half_rhythm"><div><a href="https://www.cancer.gov/types/kidney" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Kidney Cancer Home Page</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/drugs/kidney" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Kidney (Renal Cell) Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/bio-therapies-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Biological Therapies for Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies/targeted-therapies-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Targeted Cancer Therapies</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/angiogenesis-inhibitors-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Angiogenesis Inhibitors</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/causes-prevention/genetics/genetic-testing-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Genetic Testing for Inherited Cancer Susceptibility Syndromes</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Tobacco</a> (includes help with quitting)</div></li></ul><p id="CDR0000276462__163_40">For general <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information and other resources from the National Cancer Institute, see the following:</p><ul id="CDR0000276462__163_41"><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">About Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Staging</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a></div></li><li class="half_rhythm"><div><a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors and Caregivers</a>
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</div></li></ul></div><div id="CDR0000276462__AboutThis_1"><h2 id="_CDR0000276462__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000276462__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000276462__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000276462__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000276462__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000276462__AboutThis_6">This PDQ cancer information summary has current information about the treatment of renal cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000276462__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000276462__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
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</p><p id="CDR0000276462__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000276462__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000276462__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000276462__AboutThis_12">Clinical trials can be found online at <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. For more information, call the <a href="https://www.cancer.gov/contact/contact-center" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Information Service</a> (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000276462__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000276462__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000276462__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000276462__AboutThis_21">PDQ® Adult Treatment Editorial Board. PDQ Renal Cell Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/kidney/patient/kidney-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/kidney/patient/kidney-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389448]</p><p id="CDR0000276462__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 3,000 scientific images.
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</p></div><div id="CDR0000276462__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000276462__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000276462__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000276462__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK66012</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/26389448" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">26389448</a></span></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK66012.13/?report=reader">PubReader</a></li><li><a href="/books/NBK66012.13/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK66012" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK66012" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Renal Cell Cancer Treatment (PDQ®): Patient Version. 2019 Oct 31. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK66012.22/">NBK66012.22</a></span> October 11, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK66012.21/">NBK66012.21</a></span> July 21, 2023</li><li><span class="bk_col_itm"><a 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class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000276462__1" ref="log$=inpage&link_id=inpage">General Information About Renal Cell Cancer</a></li><li><a href="#CDR0000276462__26" ref="log$=inpage&link_id=inpage">Stages of Renal Cell Cancer</a></li><li><a href="#CDR0000276462__48" ref="log$=inpage&link_id=inpage">Recurrent Renal Cell Cancer</a></li><li><a href="#CDR0000276462__50" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000276462__1362" ref="log$=inpage&link_id=inpage">Stage I Renal Cell Cancer</a></li><li><a href="#CDR0000276462__1366" ref="log$=inpage&link_id=inpage">Stage II Renal Cell Cancer</a></li><li><a href="#CDR0000276462__1370" ref="log$=inpage&link_id=inpage">Stage III Renal Cell Cancer</a></li><li><a href="#CDR0000276462__1374" ref="log$=inpage&link_id=inpage">Stage IV and Recurrent Renal Cell Cancer</a></li><li><a href="#CDR0000276462__163" ref="log$=inpage&link_id=inpage">To Learn More About Renal Cell Cancer</a></li><li><a href="#CDR0000276462__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65815/">Health Professional Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389388" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Melanoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Melanoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389225" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Adrenocortical Carcinoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Adrenocortical Carcinoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389197" ref="ordinalpos=1&linkpos=3&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389202" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Merkel Cell Carcinoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Merkel Cell Carcinoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389238" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Carcinoma of Unknown Primary Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Carcinoma of Unknown Primary Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li></ul><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed_reviews&uid=26389448" ref="ordinalpos=1&log$=relatedreviews_seeall&logdbfrom=pubmed">See reviews...</a><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=26389448" ref="ordinalpos=1&log$=relatedarticles_seeall&logdbfrom=pubmed">See all...</a></div></div><div 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<a class="text-white" href="//www.nlm.nih.gov/">NLM</a>
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