Surgery For Kidney Cancer: Learn More About A Nephrectomy

The kidney is one of two small, bean-shaped organs in your abdomen. The kidneys work to filter blood and remove waste in the form of urine. The kidneys are also responsible for producing certain hormones that help create red blood cells and control your blood pressure.

Most people are born with two kidneys, but around one in a thousand babies¹ are born with a single kidney.

Kidney cancer is one of the ten most common cancers. Around 80,000² new kidney cancer cases are diagnosed yearly in the United States. You are more at risk of developing kidney cancer as you get older, as most cases occur in people between the ages of 65 and 74.

It's very rare to have a kidney cancer diagnosis under 40³.

For most people, the recommended treatment for kidney cancer⁴ is surgery. The surgical procedure to remove all or part of the affected kidney is called a nephrectomy. Whether you have all or part of a kidney removed depends on the cancer stage and your surgeon's recommendations.

Living a healthy and active life with a single kidney is possible. However, it can increase your risk of kidney failure and high blood pressure.

What are the reasons for kidney removal?

While kidney cancer is a common reason for a nephrectomy, it's not the only one. You may also undergo a nephrectomy if you:

Have a damaged kidney

Your kidneys can become damaged from high blood pressure and diabetes. They may also become damaged from illness, injury, or certain types of medications.

Are donating a kidney

Thousands of people a year donate a kidney. By donating one of their healthy kidneys to a person experiencing kidney failure, both patients have a good chance of going on to live healthy lives with a single kidney.

Types of surgery for kidney cancer

If your doctor recommends surgery to treat kidney cancer, they will let you know the type of procedure you'll have and what methods they'll use. Your medical team will give you clear instructions about preparing for surgery and when to come to the hospital on the day of the procedure. You will need to undergo general anesthesia for a nephrectomy.

You'll need to stop eating and drinking for a short period before the procedure, usually midnight the night before.

Partial nephrectomy

Your doctor may also call this a nephron-sparing or kidney-sparing surgery. Partial nephrectomy involves removing a part of the kidney, usually the part that is damaged or has a tumor, and leaving the rest of the healthy kidney behind.

Partial nephrectomy can help preserve kidney function, but there may be higher risks associated with the procedure⁵, such as urine leaking into the abdomen. Your doctor will monitor you for signs of any complications. Still, you should immediately report any unusual symptoms such as swelling or tenderness in the abdomen to your medical team.

Simple nephrectomy

A simple nephrectomy is the removal of one kidney. Your surgeon will make an incision in your side, about 12 inches long, in the area below your ribs. They will then locate the kidney. Then, the surgeon will sever the ureter, the tube that goes from the kidney to the bladder. They will also sever any blood vessels supplying the kidney.

Once that's complete, they will be able to remove the kidney. The incision will be stitched or stapled, and you'll go to a recovery room for monitoring.

Radical nephrectomy

A surgeon will perform a radical nephrectomy much the same way as a simple nephrectomy. However, along with the kidney, they will also remove the fat surrounding the organ. They may also decide to remove some of the lymph nodes or adrenal glands near the affected kidney if there are signs cancer may be spreading. Your doctor may recommend a radical nephrectomy if you are in the later stages of kidney cancer.

Laparoscopic surgery

Your surgeon may complete your nephrectomy as open surgery, meaning they make an eight to 12-inch incision in your side to access the kidney. They may also do a simple, radical, or partial nephrectomy laparoscopically.

A laparoscopy means that instead of making a large incision, they can create multiple smaller incisions to insert a tiny camera and surgery tools into your abdomen. Using the camera, they can guide the tools to your kidney, then remove it through the smaller incisions. If a laparoscopic nephrectomy is an option for you, there are several benefits to having this procedure versus open surgery:

• You won't have to stay in the hospital as long

• Shorter recovery time at home

• There is a lower risk of complications after surgery, such as infection

Recovery and complications after surgery

You will need to stay in the hospital for up to a week⁶ after surgery. Expect to experience some pain and discomfort after the surgery. Still, many patients can control these symptoms with over-the-counter pain relievers. If the pain becomes unbearable, talk to your doctor about getting a prescription for stronger pain relievers for a short period.

Most people can resume light activity after about two weeks. Avoid strenuous activities for at least six weeks, only then with your doctor's permission.

As with any surgical procedure, complications such as damage to surrounding organs, blood loss, and infection are risks. Additional possible complications after a nephrectomy include: 

• Urine leaking into the abdomen. This complication is more commonly associated with a partial nephrectomy, which only removes part of one kidney.

• Kidney failure. This complication may happen if, for example, cancer develops in the remaining kidney or the remaining kidney is damaged through illness or injury. 

Your doctor will carefully monitor your condition after surgery to ensure you recover well. They will also follow up with you periodically to check your kidney function and monitor your blood pressure.

When to visit a doctor

Most people don't experience any signs or symptoms of kidney cancer until the disease has progressed to the later stages. However, your doctor may detect an issue through routine blood or urine tests. You may also experience symptoms such as: 

• Blood in the urine

• Pain or a lump in your lower back on one side 

• Feeling more tired than normal

• Unexplained weight loss

• A persistent fever

These can be common symptoms of various medical conditions, most of which are very treatable. However, if you are experiencing any of these symptoms, you should make an appointment with your doctor. They can perform a physical examination and request testing to help you determine the cause of your symptoms.

If you've recently had a nephrectomy, you should contact your doctor after the surgery if: 

• Your incisions are showing signs of infection, including redness, swelling, or discharge

• You have  a fever above 100.5°F

• You've been nauseous or vomiting for longer than a day

• Have difficulty breathing, or have a cough

• It isn't easy to pass urine 

• You are experiencing new tenderness or pain in your abdomen

• Your pain isn't going away, even after you take the recommended medication

Your doctor will help you manage these symptoms and ensure they aren't signs of infection or other complications.

The lowdown

The kidney is a bean-shaped organ in your abdomen that helps filter your blood. There are around 80,000 new kidney cancer cases yearly, primarily treated by removing the affected kidney, called a nephrectomy. A doctor may also recommend a nephrectomy if you have kidney damage due to illness or injury or if you choose to donate a kidney.

There are different types of nephrectomies. A partial nephrectomy removes part of the kidney, leaving the remaining healthy part of the kidney behind. Simple nephrectomy removes one of the kidneys, while a radical nephrectomy also includes the surrounding fat and may include nearby adrenal glands and lymph nodes.

A surgeon may opt to perform a nephrectomy as open surgery, or they may opt for a laparoscopic procedure. There are fewer post-surgical complications associated with laparoscopies, and hospital stays and recovery times are typically shorter.

As with all surgical procedures, there is a risk of complications with a nephrectomy, including infection, blood loss, and kidney failure. Most people won't experience any symptoms of kidney cancer until the later stages of the disease.

However, if you are experiencing any symptoms such as fatigue, unexplained weight loss, or blood in your urine, you should make an appointment with your doctor.