Your oncologist may recommend radiation for kidney cancer if, for example, surgery is too risky. Radiation therapy uses high doses of energy to destroy existing tumors, prevent additional tumors, and ease some cancer symptoms. New techniques have made radiation safer and more effective than ever, but it can still cause some short- and long-term side effects.

Keep reading to learn when and how radiation is used to treat kidney cancer and what to expect.

Types of Radiation Therapy for Kidney Cancer

Radiation therapy (sometimes called radiotherapy) sends powerful energy waves into your cells. The intense energy destroys cells or damages their DNA so they can’t grow and divide.

🗳️ Which side effects of radiation therapy for kidney cancer did you experience?

Skin and hair changes

Nausea, vomiting, or diarrhea

Pain

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When radiation is used to treat cancers, the goal is usually to kill or damage all the cancer cells so that the tumor can’t regrow and the cancer won’t spread. One of the main disadvantages of radiation therapy is that normal, healthy cells around the cancer may also be damaged.

There are two types of radiation therapy used to cure or slow kidney cancer: external-beam radiation therapy (EBRT) and internal radiation therapy.

External-Beam Radiation Therapy

In EBRT, energy waves are sent through the skin to the tumor. The energy comes from X-rays or protons, and it’s a painless procedure similar to getting an X-ray. You lie on a table while a machine above you delivers the energy in a focused beam.

There are several types of EBRT. Stereotactic body radiation therapy (SABR or SBRT) is commonly used to treat stage 1 and stage 2 kidney cancer. SBRT delivers very high doses of radiation in a precise fashion, minimizing damage to healthy cells and reducing treatment time. In a recent clinical trial, SBRT led to a 95 percent five-year survival rate and an 87 percent 10-year survival rate among people with primary renal cell carcinoma (RCC).

EBRT may also be recommended as palliative (symptom-reducing) care in all stages of kidney cancer.

Internal Radiation Therapy

Internal radiation therapy involves placing radiation-emitting material directly into the body. In a process called brachytherapy, a small radioactive “seed” is placed inside or near a cancerous tumor. The seed emits radiation to nearby tissues, but it’s less likely to damage healthy cells because of its precise placement. This allows for faster recovery.

It only takes one to five days to complete a full course of brachytherapy compared to weeks or months of EBRT. The seed can be left inside the body permanently or removed after treatment.

Another option, called systemic radiotherapy, delivers radioactive material through an IV drip line or an oral pill.

Internal radiation therapy is an uncommon treatment option for kidney cancer.

When Is Radiation Therapy Used for Kidney Cancer?

Doctors usually prefer to surgically remove tumors to treat early-stage kidney cancer. But your oncologist may recommend radiation therapy in certain circumstances, which are discussed below.

Surgery Isn’t Possible

Some people face an increased risk of surgery complications. Your oncologist may recommend radiation instead of surgery after reviewing your medical history. They’ll look for risks like:

• Poor tolerance of general anesthesia
• High risk of bleeding or infection
• History of slow healing
• Several previous surgeries in the same area

It takes about two months to fully heal from a nephrectomy (kidney removal surgery). During that time, your body can’t handle additional full-body treatments, like chemotherapy. If your oncologist thinks it’s risky to postpone these treatments, they may opt for radiation instead.

You Only Have One Kidney

A nephrectomy can also be risky for people who only have one kidney. Because parts of the kidney get removed with the tumor, surgery may limit kidney function. Radiation, especially SBRT, is less likely to impact kidney function.

If you lose both kidneys, you need to receive dialysis to filter your blood several times a week for the rest of your life or receive a kidney transplant.

Cancer Has Spread to Other Parts of the Body

When kidney cancer metastasizes (spreads) to other parts of the body, it can cause new symptoms like pain and bleeding. Radiation can help manage these symptoms. This is known as palliative radiation.

In some cases, radiation can also help shrink or destroy the new tumors.

When kidney cancer spreads to the bones, radiation can be part of a treatment plan that stabilizes weak bones to prevent fractures.

The Cancer Comes Back

If your kidney tumor comes back (recurs) after it was surgically removed, your oncologist may hesitate to recommend a second surgery. Repeat kidney surgeries come with an increased risk of complications, including death.

Radiation may also be provided as a palliative treatment if kidney cancer returns. It may delay the need for treatments that affect the whole body, like immunotherapy or targeted therapy.

What Are the Risks and Side Effects of Radiation Therapy?

Although radiation energy is carefully aimed at the cancer, it can reach nearby organs as well. Healthy tissue in the area may be damaged. Sometimes the damage heals quickly, and other times it causes ongoing issues.

The risk of side effects increases with each radiation treatment. It can take a few weeks for side effects to appear, and some long-term effects may not become noticeable for months or years.

Certain kidney cancer radiation side effects are treatable. Tell your care team how you feel so they can recommend medications or supportive therapies.

Short-Term Effects

The following short-term side effects are common with kidney cancer radiation therapy:

• Dry, irritated, discolored, or sensitive skin
• Fatigue
• Hair loss
• Nausea
• Vomiting
• Diarrhea

These side effects typically go away after you finish radiation treatment.

Long-Term Effects

The long-term side effects of kidney cancer radiation therapy may include:

• Decreased kidney function
• High blood pressure
• Bowel obstruction from scarring and narrowing of the intestines
• Intestinal ulcers
• Bleeding in the intestinal tract
• Chronic diarrhea
• Fistula (a passage that forms between two body parts that aren’t meant to be connected)
• Colon cancer
• Liver damage
• Spleen damage
• An increased risk of certain bacterial infections
• Skin and hair changes
• Chronic swelling
• Increased sensitivity to sunlight

Certain radiation techniques may cause less damage to surrounding tissue, making long-term effects less likely. Ask your care team about the pros and cons of each technique that’s available.

Talk to Your Oncologist

Radiation therapy is just one of several kidney cancer treatment options. Your oncologist can explain the potential risks and benefits of each and recommend a treatment plan that meets your treatment goals and preferences.

Make sure you understand the purpose of radiation as part of your treatment plan — whether it’s intended to cure kidney cancer, slow its growth, or help improve symptoms. You can also speak to a radiation oncologist and ask questions about the schedule, what to expect at each session, and safety measures to protect healthy tissues.

Join the Conversation

On MyKidneyCancerTeam, people share their experiences with kidney cancer, get advice, and find support from others who understand.

Did you have radiation for kidney cancer? Let others know about your experiences in the comments below.