The standard operation for kidney cancer is to remove the affected kidney. This is called a simple nephrectomy. If the nearby adrenal gland and lymph nodes are also removed, the operation is called a radical nephrectomy.

However, there are times when an operation can be done to remove only part of the affected kidney. This is called a partial nephrectomy or nephron-sparing surgery.

There are three main reasons why your surgeon may suggest a partial nephrectomy:

• You have only one working kidney (doctors call this an absolute indication).
• You have two kidneys but the kidney that isn't affected by cancer is at risk of developing problems in the future. This is usually due to health problems unrelated to the cancer (doctors call this a relative indication).
• You have a small tumour less than 4cm across that has not spread and your surgeon feels this operation is possible in your case (doctors call this an elective indication).

If you have only one kidney, removing it to treat the cancer will mean that you will need to have kidney dialysis for life or have a kidney transplant. If it is possible to remove only part of your kidney, but still take away all of the cancer, this may avoid the need for dialysis or a kidney transplant.

As well as kidney cancer you may have other health problems such as high blood pressure, or kidney cysts that makes it more likely you might develop problems with your other kidney not working so well in the future. Where possible, saving the kidney affected by cancer can help you to avoid needing dialysis in future.

There is also a rare, inherited condition called von-Hippel Lindau syndrome. If you have this you are at higher risk of developing cancer in both kidneys. Sometimes a partial nephrectomy can help to keep both kidneys working.

Even if your unaffected kidney is perfectly healthy and not likely to develop problems in the future, your surgeon may offer you the choice of an operation that lets you keep the kidney with cancer. This is called elective partial nephrectomy. It may be a possible option if there is only one tumour that is no larger than 4cm in size. In this situation this operation is just as effective as taking out all of the kidney.

Reference:

• Ljungberg B et al 2006. Guidelines on renal cell carcinoma. European Association of Urology