When the cancer hasn't spread beyond the kidney, surgically removing the affected kidney and lymph nodes provides a reasonable chance of cure. If the tumor has invaded the renal vein and even the vena cava (the large vein that carries blood to the heat) but hasn't spread (metastasized) to distant sites, surgery may still provide a chance for a cure. However, kidney cancer has a tendency to spread early, especially to the lungs. When it has spread to distant sites, it has a poor prognosis because it can't be cured by radiation, traditional anticancer drugs (chemotherapy), or hormones.

Treating the cancer by enhancing the immune system's ability to destroy it causes some tumors to shrink and prolongs survival in some people. One such treatment, interleukin-2, has been approved for treatment of kidney tumors, and various combinations of interleukin-2 and other biologic agents are being investigated. Rarely (in less than 1 percent of patients), removing the affected kidney causes tumors elsewhere in the body to shrink, but such regression in itself is not sufficient reason to remove a cancerous kidney when the cancer has already spread.

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