As more patients receive abdominal imaging when they present to emergency rooms for pain or in screening other disease, we continue to find more incidental findings. One of the most common of these is finding a small kidney tumor by a patient presented with belly or abdominal pain. In Louisiana, patients over the age of 65 have among the highest rates of getting CT scans, and therefore the highest rates of detecting kidney cancers. This places both the patient and the physician in the difficult position of discussing a previously asymptomatic possible cancer.

While there are several treatment options for kidney lesions, the most common is the removal of the tumor. This can be accomplished by removing the entire kidney, or just the mass itself. It’s surgically complicated to remove just the mass as the normal kidney tissue needs to be brought back together after the tumor has been removed. However, this spares the normal kidney and helps the patients by keeping their kidneys working normally. This is considered a partial nephrectomy.

Sometimes when the mass is very large or very deep into the kidney, the entire kidney needs to be removed. In doing this, the patient tends to experience a drop in their renal function after the procedure. In addition, removing the kidney in patients who are older or less healthy there are sometimes options for “active surveillance” or watching the renal mass to reduce the risk of surgery while still keeping an eye on the presumed malignancy. Other less common options including freezing or burning the mass, but these tend to be less successful in completely treating the tumor.

At Tulane, we routinely perform nephron sparing or partial nephrectomy in more complex or difficult kidney masses. These are usually performed through a robotic or minimally invasive approach. Most patients leave the hospital the day after the procedure with only minimal changes in the renal function. More importantly, this is the only cancer therapy needed for more than 90% of patients who require therapy. At Tulane, we were the first program in the Gulf South to offer these services to patients, and have the most experience in performing these. If you have questions or concerns about your recently diagnosed kidney cancer, or would like to talk with one of our physicians concerning this please call 504-891-8454 and we’ll see you within 1 week.