How Is Kidney Cancer Recurrence Treated?

When kidney cancer comes back after surgery or initial treatment, it is called recurrence. Treatment depends on where the cancer has returned, how much it has spread, previous treatments, and your overall health. The goal may be curative (if caught early) or palliative (to control the cancer and improve quality of life).

Local Recurrence

If the cancer comes back near the original site, and you are otherwise healthy, surgery may still be an option. In some cases:

• A second surgery is performed to remove new tumors
• Ablation techniques like cryotherapy or radiofrequency ablation may be used if surgery isn't feasible
• Radiation therapy may help control pain or growth, although it's rarely curative in kidney cancer

Distant Recurrence (Metastasis)

If the cancer returns in distant organs like the lungs, bones, liver, or brain, treatment typically includes:

Immunotherapy

• Drugs like nivolumab, pembrolizumab, or combinations with ipilimumab help activate the immune system to attack cancer cells
• Often used as a first-line or second-line treatment

Targeted Therapy

• Includes drugs like cabozantinib, lenvatinib, or belzutifan
• These target specific proteins or pathways the cancer needs to grow

Combination Therapy

• In many cases, immunotherapy is combined with targeted therapy to improve results

Clinical Trials

• New treatments are constantly being tested
• If standard options fail, clinical trials offer access to promising therapies

Individualized Approach

Treatment is tailored to:

• The extent and location of recurrence
• Past treatments and response
• Patient preferences and side effect tolerance

Some recurrences grow slowly and may be monitored with active surveillance, especially if the cancer isn’t causing symptoms or is small in size.

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