What Is Active Surveillance for Kidney Cancer?

Active surveillance is a treatment approach used for small, slow-growing kidney tumors, where the cancer is closely monitored instead of being treated right away. This method is considered safe in selected patients and helps avoid or delay surgery, especially when the tumor is unlikely to cause harm in the short term.

It is most often recommended for:

  • Tumors smaller than 4 cm (about 1.6 inches)
  • Patients who are elderly, have other health problems, or are unfit for surgery
  • Cases where the tumor is discovered incidentally and is not causing symptoms

During active surveillance, doctors perform:

  • Regular imaging tests (ultrasound, CT, or MRI) to track tumor growth
  • Routine blood tests to monitor kidney function
  • Periodic physical exams and follow-ups

The goal is to observe the tumor's behavior over time. If it stays stable, no treatment may be needed for years. If the tumor grows or starts causing symptoms, treatment—usually surgery or minimally invasive procedures—can be started.

Active surveillance is not the same as doing nothing. It is a structured, careful monitoring plan with a clear schedule. It is also different from "watchful waiting," which is less formal and usually used when no treatment is expected.

This approach can help maintain quality of life and reduce the risks associated with unnecessary surgery, especially in patients with other serious health conditions. It is also a good option for some patients with limited kidney function, where preserving as much kidney tissue as possible is important.

Looking for more questions?

Visit our Kidney Cancer Questions page for all other topics explained in plain language.

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