Kidney cancer is among the more common urologic malignancies, and its management has evolved substantially over the past decade. Many kidney tumors are now discovered incidentally on imaging obtained for unrelated reasons, which means they are often found at an early and highly treatable stage. At Urology Associates of Green Bay, all four of our urologists are experienced in the full spectrum of kidney cancer care, from initial evaluation through complex surgical management and long-term surveillance. We tailor our approach to each patient based on tumor size, location, overall health, and individual goals.
Most kidney cancers are detected on CT or MRI imaging performed for another indication, such as abdominal pain or a prior unrelated condition. In some cases, patients present with symptoms including blood in the urine, flank pain, or a palpable abdominal mass, though these findings are less common with modern incidental detection. When a kidney mass is identified, additional imaging is typically obtained to characterize the lesion, assess the opposite kidney, and evaluate for any evidence of spread to lymph nodes or distant organs.
Blood work and urine studies are obtained as part of a standard evaluation. In select cases, a percutaneous biopsy may be recommended to clarify the diagnosis before treatment, particularly when the findings would meaningfully change the management plan. Our team will review all available imaging and clinical information with you to develop the most appropriate next step.
Not every kidney mass requires immediate intervention. For small renal masses, particularly in older patients or those with significant medical comorbidities, active surveillance is a well-supported and widely accepted management strategy. This approach involves periodic cross-sectional imaging at defined intervals to monitor the tumor for growth or change over time. Many small kidney tumors grow slowly or not at all, and the risk of metastatic spread from a small mass is low.
Active surveillance allows patients to avoid the risks of surgery or ablation while remaining under close observation. If a tumor grows beyond a predefined threshold or demonstrates concerning features, treatment can be initiated at that time without compromising outcomes. Our team will help you understand whether surveillance is appropriate for your situation and will coordinate all follow-up imaging and visits throughout the monitoring period.
Cryoablation for Small Kidney Tumors
For patients with small kidney masses who are candidates for treatment but prefer a less invasive approach, cryoablation is an excellent option. Cryoablation uses precisely guided probes to freeze and destroy tumor tissue without removing the kidney or requiring a large incision. The procedure is performed percutaneously, meaning the probes are placed through the skin under CT guidance, and most patients go home the same day with minimal discomfort and a rapid return to normal activity.
Cryoablation is particularly well suited for tumors that are small, peripherally located, and in patients who may not tolerate a more extensive surgical procedure. Oncologic outcomes for appropriately selected small masses are favorable, and the kidney is preserved in its entirety. Our team will review your imaging in detail to determine whether cryoablation is a suitable option for your tumor.
Robotic Partial Nephrectomy
For kidney tumors that require surgical removal, robotic partial nephrectomy is the preferred approach whenever the tumor can be removed while leaving the majority of the kidney intact. This procedure is performed using the da Vinci robotic surgical system, which provides our surgeons with enhanced visualization, precise instrumentation, and the ability to perform complex reconstructive steps through small incisions. Intraoperative ultrasound is used during the procedure to precisely locate the tumor in real time, ensuring complete removal while maximizing the amount of healthy kidney tissue that is preserved.
Nephron-sparing surgery, meaning partial removal of the kidney rather than complete removal, is strongly preferred when technically feasible because it protects long-term kidney function. This is particularly important for patients with a solitary kidney, reduced baseline kidney function, or conditions such as diabetes or hypertension that place the remaining kidney at risk over time. All four of our urologists perform robotic partial nephrectomy, and our team has extensive collective experience with tumors of varying complexity, size, and location.
Radical Nephrectomy When Indicated
In cases where the tumor is large, centrally located, or otherwise not amenable to partial removal, radical nephrectomy, meaning complete removal of the affected kidney, may be the most appropriate option. This procedure is also performed robotically in most cases, allowing for a minimally invasive approach with shorter hospital stay and faster recovery compared to open surgery. Radical nephrectomy may also be necessary when there is evidence of tumor involvement of the renal vein or inferior vena cava, or when the complexity of the tumor makes nephron-sparing surgery unsafe.
Our surgeons will discuss the reasoning behind the recommended approach in detail, and we will always consider whether partial removal is feasible before proceeding with complete nephrectomy.
Radiation Therapy for Kidney Tumors
An emerging area of kidney cancer management that our practice follows closely is the use of stereotactic body radiation therapy (SBRT) for select renal tumors. Historically, kidney cancer was considered resistant to conventional radiation, but data from Mayo Clinic and other leading centers has demonstrated that high-dose, precisely targeted radiation can achieve favorable local control rates in appropriately selected patients, particularly those who are not ideal surgical candidates.
This approach may be especially relevant for patients with significant medical comorbidities, those with a solitary kidney, or those who have declined surgical management. We stay current with the evolving literature in this area and collaborate with our regional radiation oncology colleagues when this option is under consideration. If radiation therapy may be appropriate for your situation, we will facilitate a prompt referral and participate in the multidisciplinary discussion.
Not all kidney cancer presentations are straightforward, and our team has experience managing scenarios that require additional surgical and clinical judgment. Patients with multiple kidney masses, whether sporadic or associated with hereditary conditions such as von Hippel-Lindau disease, require a coordinated strategy that accounts for tumor burden, current kidney function, and long-term functional goals. Similarly, patients who present with a mass in a solitary kidney face unique challenges, as any surgical or ablative intervention carries the potential to affect the only remaining renal unit.
In these situations, our surgeons work carefully to maximize tumor control while preserving as much kidney function as possible. We will discuss the risks and tradeoffs of each available option in detail, and we will take the time necessary to ensure that the recommended approach aligns with your priorities and overall health.
For patients with advanced or metastatic kidney cancer, systemic therapy with immunotherapy or targeted agents is often indicated. Our practice is able to administer immunotherapy infusions in our office for eligible patients, offering a convenient and familiar setting for ongoing treatment. For patients whose systemic therapy needs are better managed through a medical oncology practice, we work closely with regional oncology colleagues to ensure seamless coordination of care.
We remain actively involved in the care of patients receiving systemic therapy, monitoring kidney function, managing urologic complications, and communicating regularly with the oncology team. Our goal is to ensure that patients with advanced disease have continuity and clear communication across all members of their care team.
Following treatment for kidney cancer, ongoing surveillance is an essential component of care. The frequency and type of follow-up imaging and laboratory monitoring depends on tumor stage, histology, and the treatment that was performed. Our team coordinates all post-treatment surveillance, including CT or MRI imaging at appropriate intervals, kidney function monitoring, and clinical evaluation for signs of recurrence.
For patients who remain on active surveillance without intervention, we maintain the same structured follow-up approach with clear criteria for reassessment if the tumor changes. Our goal throughout the surveillance period is to detect recurrence early when it is most treatable, while avoiding unnecessary procedures in patients whose disease remains stable.
Schedule a Consultation
Urology Associates of Green Bay provides comprehensive evaluation and management of kidney cancer from our offices in De Pere and Marinette. Whether you have been referred following an incidental finding on imaging or are seeking a second opinion on a recommended treatment, our team is equipped to provide expert, individualized care. To schedule an appointment, please call our office.