When Is Active Surveillance a Safe Option?

Active surveillance is a safe and effective option for managing small kidney tumors in select patients. It involves closely monitoring the tumor over time with imaging and clinical follow-up, rather than removing it immediately. This approach avoids or delays surgery when the tumor is unlikely to grow or cause harm quickly.

It is considered a safe option in the following situations:

Small Tumor Size

Tumors that are 4 cm or smaller (about 1.6 inches) are often slow-growing. Many small kidney tumors are discovered incidentally and don’t change much over time.

Older Adults or Frail Patients

People who are elderly or have serious medical conditions may face higher risks from surgery or anesthesia. For these patients, the potential harm from surgery may outweigh the benefit of immediate tumor removal.

Other Health Conditions

Individuals with heart disease, diabetes, or limited kidney function may benefit from avoiding or postponing surgery. Preserving kidney function is especially important for people with only one kidney or existing chronic kidney disease.

Slow Tumor Growth

If the tumor shows minimal or no growth on repeated scans over months or years, continued surveillance may be preferred over surgery.

Patient Preference

Some patients may choose surveillance after a full discussion of risks and benefits with their doctor. It can be a good fit for those who value avoiding surgery if the cancer appears to be low risk.

Active surveillance is not recommended for:

  • Tumors larger than 4 cm
  • Tumors that are growing rapidly
  • Patients who are otherwise healthy and good surgical candidates

When done under proper medical supervision, active surveillance is not a passive approach. It involves regular imaging, blood tests, and careful planning. If the tumor shows signs of progression, treatment options like surgery or ablation are still available.

Looking for more questions?

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

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