Biological therapy is a type of systemic therapy. It uses substances that travel through the bloodstream, reaching and affecting cells all over the body. Biological therapy uses the body's natural ability (immune system) to fight cancer.
For patients with metastatic kidney cancer, the doctor may suggest interferon alpha or interleukin-2 (also called IL-2 or aldesleukin). The body normally produces these substances in small amounts in response to infections and other diseases. For cancer treatment, they are made in the laboratory in large amounts.
Chemotherapy is also a type of systemic therapy. Anticancer drugs enter the bloodstream and travel throughout the body. Although useful for many other cancers, anticancer drugs have shown limited use against kidney cancer. However, many doctors are studying new drugs and new combinations that may prove more helpful. The section on "The Promise of Cancer Research" has more information about these studies.
Arterial embolization is a type of local therapy that shrinks the tumor. Sometimes it is done before an operation to make surgery easier. When surgery is not possible, embolization may be used to help relieve the symptoms of kidney cancer.
The doctor inserts a narrow tube (catheter) into a blood vessel in the leg. The tube is passed up to the main blood vessel (renal artery) that supplies blood to the kidney. The doctor injects a substance into the blood vessel to block the flow of blood into the kidney. The blockage prevents the tumor from getting oxygen and other substances it needs to grow.
The two main approaches for treating kidney cancer are surgery and immunotherapy. However, the specialists Roswell Park Cancer Institute can offer certain patients, particularly those who cannot tolerate surgery, another treatment option. Called Stereotactic Body Radiation Therapy (SBRT), radiologists are able to direct higher and more effective radiation doses over a shorter time period than conventional radiation treatment. “Instead of giving a patient two units of radiation twenty-five times,” says Anurag K. Singh, MD, director of clinical radiation research at RPCI, “with stereotactic body radiation therapy, we can give a patient 15 units of radiation just once.”
A key part of delivering such high radiation doses is the ability to pinpoint just the tumor with unprecedented precision. A cone-beam CT scan is conducted while the patient is on the treatment table, which ensures the high-dose radiation is delivered only to the tumor and not surrounding healthy tissues. Because the radiation is precise within millimeters and normal tissues get very low doses, the treatment’s effectiveness is possibly higher and certainly side effects are lessened. The radiation targets only the renal mass, potentially making SBRT a nephron-sparing treatment that would help protect and preserve kidney function.
The potential promise of this novel treatment is two-fold. When a large number of cells die at once from radiation, they cause the blood vessels feeding the tumor to collapse, thus helping to kill the tumor. In addition, a massive die-off of cells by radiation seems to present molecules on the surface of these cells and in the bloodstream which then invokes the immune system to respond, triggering another mechanism for immunotherapy, at least in theory. “We know about the tumor-killing part,” says Dr. Singh. “We’re hoping our ongoing studies in the lab will show us the immune response, too.” Researchers at RPCI hope to begin patient trials within a year.
Roswell Park Cancer Institute is the only treatment facility in WNY to offer, and an international leader in, Stereotactic Body Radiation Therapy.