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39

NCCN Guidelines for Patients

®

:

Kidney Cancer, Version 1.2017

4

Overview of cancer treatments

Supportive care

Supportive care

Supportive care is treatment given to relieve

symptoms of the cancer and side effects of cancer

treatment. It doesn’t treat the cancer itself. The goal

of supportive care is to improve quality of life and

relieve any discomfort you may have.

Supportive care is given at any stage of cancer,

but is often the main type of care when the cancer

is advanced. When used for advanced cancers,

supportive care is often called palliative care.

Supportive care can address many needs. Some

examples include treatment for physical and

emotional symptoms, help with treatment decisions,

and coordination of care between health care

providers. Talk with your treatment team to plan the

best supportive care for you. A few key supportive

care options for patients with kidney cancer are

described next. You will also learn about being a

cancer survivor and advance care planning. It is

helpful to talk with your doctor about your next steps

of care, whether you need physical or emotional

support.

Radiation therapy

Radiation therapy uses a beam of high-energy rays

to kill cancer cells. Radiation therapy is not used as

a standard or primary treatment for kidney cancer.

Instead, it may be used to relieve symptoms caused

by kidney cancer that has spread (metastasized) to

distant sites in the body.

Radiation therapy is often given using a machine

outside the body. This method is called EBRT

(

e

xternal

b

eam

r

adiation

t

herapy). EBRT may be

used to ease pain caused by bone metastases—

cancer that has spread to the bones. It may also be

used for brain metastases—cancer that has spread

to the brain.

Stereotactic radiosurgery is a type of EBRT that may

be used for a small or single metastasis in the brain.

Stereotactic radiosurgery delivers a high dose of

radiation to a very specific, small area of the body.

Whole brain irradiation may be used for large or

many metastases in the brain.

Drugs for bone health

When kidney cancer spreads to distant sites, it

may spread to your bones. Your bones are at an

increased risk for injury and disease when kidney

cancer spreads to them. Such problems include bone

fractures, bone pain, and squeezing (compression)

of the spinal cord. High levels of calcium in the blood,

called hypercalcemia, may also occur.

Drugs such as zoledronic acid (Zometa

®

),

denosumab (Xgeva

®

), and pamidronate (Adredia

®

)

may be given to treat bone problems. These drugs

can help relieve bone pain and reduce the risk

of other bone problems. They work by slowing or

stopping bone breakdown. They also help increase

bone thickness.

However, these drugs may cause damage to the jaw

bone—a condition called osteonecrosis. Be sure to

ask your doctor about this risk and other possible

side effects. It is also recommended that you take

these drugs with calcium and vitamin D.

Surgery

Even if all the cancer can’t be removed, surgery

may be used to help with symptoms caused by the

cancer. This is called palliative surgery. Symptoms

may be from the primary tumor or cancer that has

spread to other body parts.