Monitoring a kidney cancer (active surveillance)

Your doctor may monitor a small kidney cancer for a while before recommending treatment.

You may also hear this called active surveillance. Your doctor may recommend this if you're older or have lots of other health problems.

Small kidney cancers

Most kidney cancers are found by chance when you have a scan for other reasons. Many of these are very small. Doctors call them small renal masses.

If a kidney cancer is less than 4cm across, your doctor may want to check the cancer regularly to see if it grows. They may take a small piece of tissue (biopsy) from the cancer. This helps them decide if you need treatment straight away. Or if they can continue to monitor it. This way you avoid unnecessary treatments that could affect your quality of life.

Some small kidney cancers may not cause any problems for a long time, even without treatment. They are very unlikely to spread into surrounding tissue or elsewhere in your body. If they don't grow, you may not need any treatment.

Scans

If your doctor finds a small kidney cancer on a scan, you may have another scan of your kidney after 3 months. This is to see if the cancer has grown. You might have:

• an ultrasound
• a CT scan
• an MRI scan

You may also have an x-ray of your chest. This is to check the cancer hasn’t spread to your lungs.

If the cancer hasn't grown, your doctor will talk to you about having regular scans. How often you have them depends on the cancer. This may be:

• every 3 months for the first year
• 6 monthly for the next 2 years
• then once every year

If the cancer starts to grow

Your doctor will suggest treatment to destroy or remove the cancer if it starts to grow. Treatment choices can include: 

• surgery to remove part or all of the kidney
• freezing treatment (cryotherapy)
• heat treatment using microwaves or radiofrequency (thermal ablation)

How you may feel

Some people find it very stressful knowing they have cancer that doesn’t need treatment straight away.

You can talk this through with your doctor or specialist nurse. They can:

• reassure you

• explain how often you will have checks

• explain the treatment you may have if the cancer grows

• tell you about support groups

What you can do for yourself

It is important that you have your scans and follow up appointments. Make sure you know who to contact if you need to change the date or need help getting to the hospital.

To keep healthy and feel you are doing something positive you can:

• eat a healthy diet

• try to learn to relax

• be as physically active as you can

• try to stop smoking

• note any new symptoms and report them to your doctor

A diet high in fresh fruit, vegetables, wholegrains and healthy sources of protein such as beans, fish and chicken is good for your health.

Techniques such as meditation, mindfulness or learning a new hobby can help you to relax.