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Questions to ask your doctor before a partial nephrectomy

Am I a candidate for a partial nephrectomy?

A partial nephrectomy is a surgical procedure that involves removing your kidney tumour and a small amount of normal tissue surrounding your tumour. Your urologist performs this surgery through an open incision or through a laparoscopic approach.

The joint decision between you and your urologist to perform a partial nephrectomy considers several factors and always includes an analysis of the benefits versus the risks to you. These factors include:

  • The size of the tumour
  • The presence of tumours in both kidneys
  • Whether you have only one functioning kidney
  • Whether you have other diseases (co-morbidities) that affect your kidney function, now or in the future

 


The following questions are designed with the help of the Kidney Cancer Canada Medical Advisory Board to help you understand the options available to you. We recommend you print this page and discuss the questions with your doctor.


 

What size is my kidney tumour?
A partial nephrectomy should be the first surgical option considered for any tumour less than 7 cm. However, larger tumours (between 4 and 7 centimetres) can be a challenge for a partial nephrectomy.

 

Do I have other medical conditions that threaten my long-­‐term kidney function?
It is important to preserve the function of your kidneys. If you have a medical condition that can threaten your future kidney, a partial nephrectomy may be your best surgical option. Examples of these conditions include diabetes, high blood pressure, kidney stone disease, and chronic kidney disease.

 

Does my history of past surgical operations prevent the use of a partial nephrectomy in my case?
If you had previous abdominal surgery for any reason, it may increase the complexity of a partial nephrectomy to the point it is not a suitable option.

 

What is my urologist’s experience with partial nephrectomies?
A partial nephrectomy is a more complex surgery than a radical nephrectomy. The surgery is best performed by a surgeon with partial nephrectomy experience. If your urologist is not comfortable with the procedure, ask whether they willing to refer you to another urologist for a second opinion.

 

Do I have tumours present in both of my kidneys?
If you have tumours present in both of your kidneys (either at the same time or at subsequent times) a partial nephrectomy may be the best surgical option for one, or all your kidney tumours.

 

Do I have multiple tumours in my kidneys?
Having multiple tumours in the kidneys may indicate a hereditary form of kidney cancer.

 

Do I have only one functioning kidney?
If you only have one kidney, a partial nephrectomy must be considered as a surgical option; otherwise, you will need dialysis to perform the function of your kidneys. You should discuss with your urologist other options such as ablation or SBRT.

 

Does my own diagnosis or a family history suggest a genetic predisposition to kidney cancer?
If your doctor suspects that you may have a genetic tendency for kidney cancer, then you may have another tumour(s) at some time in the future. In these cases, it is best to consider a partial nephrectomy as your surgical option to conserve as much kidney function as possible.

More questions and answers from kidney cancer experts are the Kidney Cancer Video Knowledge Library

2019-8-5

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