Palliative Care for Renal Cell Carcinoma

Renal cell carcinoma is the most common form of kidney cancer, according to MayoClinic.com. It targets the cells that line the kidney's tubules, the small tubes that help to filter blood and remove wastes. Palliative care for cancer patients involves easing the symptoms and slowing the disease's spread to preserve quality of life for as long as possible. For renal cell carcinoma patients, biological therapy, in combination with pain medication, seems to be the most promising avenue of palliative care.

Incidence, Metastasis & Surgery

• The National Cancer Institute (NCI) estimated that roughly 49,000 cases of renal cell carcinoma would be diagnosed in 2009 and that the cancer would cause about 11,000 deaths. According to MedlinePlus, the cancer is diagnosed most often in men between the ages of 50 and 70 and has already metastasized to other organs in one-third of all diagnoses. If you are diagnosed with this cancer before it has spread elsewhere in the body, your oncologist probably will recommend a complete or partial nephrectomy---the removal of all or part of the kidney in which the malignancy is found. The latter option is usually successful if only a small tumor is found and in those cases is as effective as complete removal, according to the NCI.

Chemotherapy & Radiation

• Neither chemotherapy nor radiation has proved particularly successful in treating renal cell carcinoma, according to MedlinePlus. However, these therapies may be used to treat secondary cancers that have metastasized from the original malignancy in the kidney. Once renal cell carcinoma has spread beyond your kidneys, the prognosis is relatively poor, although measures to slow the cancer's spread can reduce symptoms and extend survival time.

Biological Therapy

• The primary avenue of palliative care is biological therapy, also known as immunotherapy, according to the NCI. This form of therapy uses your "body's immune system, either directly or indirectly, to fight cancer or to lessen the side effects that may be caused by some cancer treatments."

  Biological therapy may utilize one or more biological response modifiers (BRMs) designed to promote your body's immune response to renal cell carcinoma. According to the NCI, BRMs include colony-stimulating factors, monoclonal antibodies, interferons, interleukins and nonspecific immunomodulating agents. Interferons have shown some promise in treating this cancer, but interleukin-2 has been even more effective. However, the latter is unlikely to be used unless you are relatively fit, as it can have strong side effects, including possible renal failure, heart attack and bleeding in the digestive tract.

  Colony-stimulating factors, such as filgrastim, sargramostim, epoetin and oprelvekin stimulate the production of white blood cells, which are often depleted during chemotherapy. Monoclonal antibodies, including rituximab and trastuzumab, can be engineered to retard the growth of cancer cells, while nonspecific immunomodulating agents bolster or stimulate the immune system. Examples of the latter include levamisole and bacillus Calmette-Guerin (BCG). Currently in the experimental stage are cancer vaccines and gene therapy, both of which may prove effective in slowing tumor growth in the future, the NCI says.