Kidney Cancer Treatment
Michael A. Palese, MD, Director of Minimally Invasive Surgery at Mount Sinai, along with Matthew Galsky, MD, Director of Genitourinary Medical Oncology at Mount Sinai’s Tisch Cancer Institute, are advancing Mount Sinai’s leadership in the treatment and management of kidney cancer. Integrating the latest surgical and medical advances in kidney cancer treatment, they work closely to create a personalized treatment plan for you to ensure the optimal treatment for your particular needs.
Surgery for Kidney Cancer
Surgery is a critical therapeutic avenue in the management of kidney cancer, as it may be curative in patients with early stage disease and may play an important diagnostic and therapeutic role for those with more advanced kidney cancer. We are trained in traditional open surgery, as well as minimally invasive laparoscopic and robotic surgery for kidney cancer. This combination of expertise makes us uniquely qualified to recommend the optimal approach for each patient, and our outcomes are among the best anywhere.
Surgery is generally the primary treatment for kidney cancer. This holds true for both early and late stage kidney cancers. In kidney cancer (renal cancer), radical nephrectomy (total removal of the kidney has been increasingly displaced by partial nephrectomy, or kidney sparing surgery (surgery to remove only that part of the kidney containing cancer). Partial nephrectomy, which can be done by traditional or laparoscopic robotic surgery methods, has been shown to achieve excellent outcomes while saving the kidney and maintaining adequate kidney function. Mount Sinai has long been a leader in minimally invasive surgery and pioneered robotic surgery for kidney cancer.
Experts in Minimally Invasive Techniques
We have performed thousands of full and partial nephrectomies utilizing minimally invasive techniques, such as laparoscopic and robotic partial nephrectomy (kidney-sparring surgery to remove only the tumor), we can remove cancer while preserving healthy tissue and maintaining kidney function. Other advantages of robotic surgery include smaller incisions, quicker recovery, and less pain.
The focus of Dr. Palese’s practice is kidney cancer and reconstructive surgery for kidney abnormalities in adults. He is one of only a handful of surgeons in the United States trained in robotic, laparoscopic, endoscopic, and open surgery, and he is a leading expert on the use of robotic surgery for kidney cancer. Dr. Palese established the robotic surgery program for kidney disease at Mount Sinai, and he has performed more than 4,000 surgeries to treat the full spectrum of kidney disorders.
Other Minimally Invasive Therapies
Mount Sinai surgeons also utilize other minimally invasive techniques for select patient populations. Percutaneous cryoablation (freezing the tumor without making an incision) is a procedure performed in partnership with specialists from Mount Sinai’s Division of Interventional Radiology, which is recognized as one of the country’s most advanced facilities for image-guided procedures. Percutaneous cryoablation is most appropriate for patients for whom surgery would be too risky or for patients with very small tumors.
New Drug Therapies for Advanced Kidney Cancer
In some cases, Drs. Palese and Galsky determine that medical intervention should be implemented in conjunction with, or instead of, surgery. The treatment of metastatic kidney cancer (cancer that has spread from the kidney to other parts of the body) has changed dramatically in recent years as scientists have discovered more about the genetic and molecular basis of kidney cancer. There have been seven new drugs approved for the treatment of metastatic kidney cancer since 2005, many of which target the blood vessels which supply cancer cells with oxygen and nutrients.
Dr. Galsky has been involved in clinical trials studying many of these drugs prior to approval by the U.S. Food and Drug Administration. He is currently leading a clinical trial assessing the value of adding a new drug, known as BNC105P, to everolimus (Afinitor®), previously approved for kidney cancer. While there are multiple surgical and medical treatments available for kidney cancer, the choice of treatment is always individualized by Drs. Palese and Galsky based on a given patient’s tumor characteristics, his or her medical profile, and his or her preferences regarding care.
For other patients, Drs. Palese and Galsky may determine that neither medical intervention nor surgery is the recommended first-line treatment. Rather, active surveillance with oversight by a team of professionals can offer the option to avoid or delay surgery for small growths.
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