Kidney cancer was once a relatively rare type of cancer compared with others, but it has become much more common in Australia over the past two decades.
It also becomes much more prevalent with age, with kidney cancer rare in people under 45. The average age of those first receiving a kidney cancer diagnosis is 65, with the majority of cases diagnosed in people aged 55 to 74.
The prognosis for kidney cancer is relatively good compared to other cancers, particularly in the early stages. Someone diagnosed with stage 1 kidney cancer has a roughly 90 per cent five-year survival rate, while both stages 2 and 3 have a 75 per cent five-year survival rate.
But at stage 4, five-year survivability drops to just 15 per cent, highlighting the importance of early detection.
Kidney cancer is most commonly picked up by accident when a person has an ultrasound or computed tomography (CT) scan for an unrelated reason. Preventative screening is usually limited to those already at risk of kidney cancer.
One major benefit of early detection is the availability of different – and more palatable – treatment options. One such treatment is cryoablation, which has been found to be particularly effective at treating kidney cancer in its early stages.
Cryoablation is a minimally invasive treatment performed by an interventional radiologist (IR) that uses extreme cold to kill kidney cancer cells. A thin, hollow needle known as a cryoprobe is inserted into the cancer from outside the body.
A very cold gas is then pumped through the needle, forming an ice ball on the tip in order to freeze the cancer tissue.
The procedure works best with early-stage kidney cancer tumours less than four centimetres in diameter and is not effective for later stages, highlighting the urgent need for regular screening.
Cryoablation specialist Dr Will Ormiston is a leading IR based at Perth’s Sir Charles Gairdner Hospital. He says there’s a lack of awareness of cryoablation, which can provide a less invasive treatment option rather than surgery.
“Although surgery is the benchmark for long-term treatment, it can be riskier for older people,” he says.
Surgery at older ages also comes with an increased risk of complications such as bleeding and infection and recovery times, as well as longer hospital stays.
Cryoablation on the other hand usually takes between one and three hours, and requires no hospital stay. Recovery times are also much milder. Some people may be able to return to normal activity almost immediately, but even the worst cases shouldn’t experience any lingering pain for more than a week.
This makes the procedure particularly suited to people at greater risk of surgical complications or those with significant comorbidities that could cause issues in surgery.
“Minimally invasive procedures like cryoablation are a more patient-centred approach to care, which leads to improved outcomes and enhanced patient satisfaction.
Dr Ormiston says that not only is cryoablation kinder on the patient, but could also represent huge savings for the wider healthcare system. But the procedure suffers from a general lack of awareness that it exists and, subsequently, a lack of funding.
Writing for Oncology Republic, Dr Ormiston made the push for cryoablation to be adopted nationally as a first-line treatment for kidney cancer after seeing the benefits it has brought to patients in WA.
“Despite its multifactorial benefits, Western Australia was lacking a cryoablation service for RCC [renal cell carcinoma] until recently,” he said.
“Having been in place successfully for several years now, the state’s successful cryoablation initiative illustrates the potential for broader national adoption.
“Modern IR services … extend beyond single procedures, offering initial consultation and follow-up, resulting in coordinated care that integrates with the patient’s broader treatment team.”
Had you heard of cryoablation before this? Should the option be promoted more among doctors? Let us know in the comments section below.
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