May 19, 2009
New Guidelines Point to Kidney Preservation for Cancer Patients
For the first time, the American Urological Association has issued a guideline specifying that complete removal of a kidney, total nephrectomy, is not the best treatment option for small kidney tumors. Total removal puts patients at significant risk for chronic kidney and heart disease. Ithaar Derweesh, MD, urologic oncologist at UC San Diego Medical Center and Moores UCSD Cancer Center is a member of the distinguished panel that developed the new guideline. Derweesh said that treatments that eliminate tumors, while preserving the kidney, offer the best long-term outcomes for patients.
“This new guideline is essential information for both patients and physicians who are making important decisions about their cancer care,” said Derweesh. “In patients with early stage kidney growths, the best approach is to remove the tumor while sparing the healthy surrounding kidney.”
Kidney-sparing treatments, such as partial kidney removal, minimize the risks of future kidney disease while offering a cancer cure rate equivalent to total nephrectomy. Targeted tumor destruction and active monitoring of disease may also be viable options for certain patients with early-stage kidney tumors. Detection of these smaller growths has increased over the previous decade. Of these kidney tumors, 20 percent are benign, 60 percent are slow-growing cancer, and 20 percent are potentially aggressive cancer.
Derweesh is pioneering new minimally invasive techniques to treat kidney cancer.
“It is always the goal to eliminate all tumor from a patient,” said Christopher Kane, MD, FACS, chief of urology at UC San Diego Medical Center. “But it is also critical to save as much of the kidney as possible. Attack the cancer but preserve the kidney. The process requires a combination of advanced technology and exceptional surgical skill —both in abundance at UC San Diego Medical Center.”
Derweesh, a pioneer in single-incision surgery is currently researching the benefits of minimally invasive techniques for partial kidney removal as part of the UC San Diego Center for the Future of Surgery.
“Too often, patients unnecessarily undergo the process of having the entire kidney removed,” said Derweesh, associate professor of surgery for the Division of Urology. “Later, what we see in these patients is an increased rate of metabolic and cardiovascular complications, even in the absence of dialysis. Research at UCSD Medical Center shows that these complications can be dramatically reduced by saving the kidney.”
Kidney cancer is the most lethal of the commonly diagnosed urologic malignancies, diagnosed in more than 50,000 Americans every year. According to the American Cancer Society, kidney cancer is increasing at a rate of two to three percent each year in the United States. Risk factors for developing kidney cancer include smoking, obesity and hypertension.
Established in 1965, the Department of Surgery at UC San Diego Medical Center represents more than 80 leading surgeons with specialties in open, minimally invasive, and scarless surgery techniques. The Department is committed to advancing surgical education by teaching and training the next generation of innovators; researching, testing and developing groundbreaking surgical techniques; providing superior patient care and service; and attracting a world-class faculty.
Every year surgeons at UC San Diego Medical Center and Moores UCSD Cancer Center are recognized locally as San Diego’s Top Doctors and nationally as the physician-scientists who are developing emerging surgical techniques.
The Moores UCSD Cancer Center is one of the nation’s 41 National Cancer Institute-designated Comprehensive Cancer Centers, combining research, clinical care and community outreach to advance the prevention, treatment and cure of cancer.
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