Active Surveillance

Robert Uzzo MD
10th Annual International Kidney Cancer Symposium
Kidney Cancer Association
October 14-15, 2011 

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Tumor Growth Rate in conjunction with the status of patient health and comorbidities are important factors in determining appropriate care.  Most RCC Tumors grow exponentially initially and then at a slow rate and never metastasize.[X]  Because of these complexities, Active Surveillance of Tumor Growth Rate has become an important and very effective method of treatment in recent years.  While some patients consider it unsettling to live with Kidney Cancer, many patients, especially the elderly, can live out their years without much hinderance from the disease.  This is especially true if the Tumor is small and localized, its Growth Rate is slow, and if the patient may not be considered healthy enough for surgery.
The surgical team at Columbia University, for example, found that 93% of their patients that were involved in a program of regular, Active Surveillance, ultimately needed no surgical intervention

Guidelines for Active Surveillance

Source: Castle Surgical, Inc.

at all.[X]  Importantly, the patients in the study had a median age of 71 years and were considered unfit for surgery.  Furthermore, the key to Active Surveillance is regular check-ups, keeping track of Tumor Growth Rate, and urinalysis of eGFR and UACR.