The exact sequence of steps in your treatment plan will be decided by your unique needs.
Usually, Stages I to III are initially treated by surgery alone. However, in some cases a clinical trial may be offered for neo-adjuvant treatment (a treatment given as a first step to shrink a tumour before the main treatment) either before surgery, or immediately afterward.
Treatment for Stage IV kidney cancer, also called advanced or metastatic kidney cancer, requires surgery, systemic therapy or a combination of one or more types of medical therapy.
Surgery is conducted to remove the kidney cancer situated within the kidney (requires removal of all or part of the affected kidney) and to remove all metastases (lymph nodes and other organs that have been affected, such as adrenal glands, intestine or part of lung or liver) that can be safely removed.
First-line therapy is the first medication used to treat a cancer. This is also called primary therapy or primary treatment.
Second-line therapy is given when the first-line therapy doesn’t work, stops working, or has to be stopped because side effects are not being tolerated.
Third-line therapy is given when both first- and second-line therapies don’t work, stop working, or have to be stopped due to side effects.
Sequential therapies aren’t taken at the same time, but rather are taken one after the other. In Canada, treatment guidelines for kidney cancer make specific recommendations for first-, second- and third-line therapies for physicians to follow in treating patients with advanced kidney cancer.