When looking to discuss kidney cancer treatment options you should refer to your specialist team. Ideally, a team of specialists, called a multi-disciplinary team (MDT), will be responsible for your care and treatment in the cancer unit. The team will include an urologist (a doctor who specialises in diagnosing and surgically treating urinary, bladder and kidney problems) and, if your cancer has spread, a medical oncologist who specialises in the medical treatment of cancer. Preferably, both will have experience of treating kidney cancer. The urologist and, if appropriate, the medical oncologist will be responsible for your treatment and will discuss your treatment plan with you.
Other members of the team may include a clinical nurse specialist (specialist nurse), a radiologist (for interpreting scans), a pathologist (for assessing biopsies), a dietitian, a physiotherapist (for post-operative complications), an occupational therapist, a psychologist or counsellor. The team might also include a clinical oncologist (a doctor specialising in radiotherapy treatment for cancer) if you are scheduled to have radiotherapy for cancer that has spread.
The multi-disciplinary team (MDT):
- Medical oncologist (for medical therapy)
- Clinical oncologist (for radiotherapy)
- Clinical Nurse Specialist
- Occupational Therapist
Your doctors will tell you which treatment they think would be best for you. Sometimes they may offer you a choice of treatments. In any case, you should be sure you have been given enough information, and understood it, before you give permission for the treatment to start. Don’t be embarrassed about asking people to explain things again. And remember to ask about any aspects that are worrying you.
You should be told:
- What type of treatment the doctors are advising
- How and when this would be carried out
- The advantages and disadvantages of this type of treatment
- Any possible other treatments that might be available
- Any significant risks or side-effects of the treatment.
It may be useful to write down a list of questions to take with you to the appointment. It is also a good idea to have a relative or friend with you when you are discussing your treatment options. They will be able to take notes or help you remember what was said. If you feel you can’t make a decision straightaway, ask for more time to decide.
You may want a second opinion; especially if you feel your doctor does not have enough experience in treating kidney cancer or if you are told little treatment is available. Most doctors will be willing to refer you to another specialist but it may take a little while to organise. As this may delay the start of your treatment you need to feel sure it will be worthwhile. There is more information about how to get a second opinion on the NHS Choices website.
You may find the decision to go ahead relatively easy, especially if the treatment you are being offered aims to cure your cancer. But if, instead, the aim of the treatment is to control the cancer for a period of time, it may be more difficult to decide.
You might want to think about your quality of life while you are having treatment. Will you have to travel back and forth to hospital? What are the side-effects of treatment? Can the side-effects be treated?
As well as talking things over with the people who mean most to you, you may find it helpful to talk to a counsellor or a specialist nurse. If you choose not to have treatment you can still be given help to control any symptoms you have. This is called palliative care and can be offered to help patients through their entire cancer journey. Palliative care also gives people support with social, spiritual and psychological issues. Carers and family may also be offered emotional and spiritual support (see the Living with Kidney Cancer fact sheet for more information).