- Kidney Cancer Diet and Nutrition
- Foods to Avoid After Transplantation
- Will I have to watch my diet after a transplant?
- Why do I need to avoid certain foods?
- What are some of the ‘high-risk’ foods to avoid?
- What is a nephrectomy?
- Types of nephrectomy
- Preparation for living donor nephrectomy
- How is nephrectomy surgery done?
- Aftercare and recovery
- Risks and complications of nephrectomy surgery
- Care of the remaining kidney
- Are dietary changes needed?
- Where can I get more information?
- What to Expect after Surgery
- Our Surgeons
- Kidney removal – discharge
- Living as a Kidney Cancer Survivor
- Ask your doctor for a survivorship care plan
- Follow-up care
- Keeping health insurance and copies of your medical records
- Can I lower my risk of kidney cancer coming back?
- Lifestyle Changes After Cancer of the Kidney
- If the cancer comes back
- Could I get a second cancer after kidney cancer treatment?
- Moving on after kidney cancer
- Kidney cancer
- Taking care of your remaining kidney
- Cancer affecting both kidneys
- 11 Nutrition Dos and Don’ts for People With Kidney Cancer
- Foods That Fight Kidney Cancer
- Supportive care for kidney cancer
- Living with one kidney
- Questions to ask about supportive care
- 7 Kidney-Friendly Superfoods
Kidney Cancer Diet and Nutrition
People receiving treatment for kidney cancer need proper nutrition to help their bodies remain strong. Chemotherapy, radiation therapy, and other treatments take a huge toll on the body, and a healthy, planned cancer diet gives it the fuel to combat the side effects from these therapies.
Unfortunately, these therapies also create unique challenges when it comes to eating a healthy diet. Patients often lose their appetites completely, or find their tastes have changed to the point where it’s hard to eat anything. They are also more vulnerable to infection, which means their food needs to be carefully prepared to prevent further illness.
What You Should Eat
A kidney cancer diet should include many of the things found in any healthy diet, with some nutritional tweaks to combat the specific effects of cancer treatment. A patient’s daily nutrition should include:
- Plenty of fruits and vegetables. “You want to choose lots of plant source products, so make sure you eat 5 to 10 servings of fruits and veggies a day,” says Dee Sandquist, RD, spokeswoman for the American Dietetic Association.
- A good amount of whole grains. “Whole grains are a great source of B vitamins and iron and fiber,” Sandquist says. These include whole wheat, brown rice, oatmeal, and cracked wheat.
- Lots of calories. Here’s where a cancer diet differs from a normal diet. Nutritionists recommend that people eat high-calorie foods to help keep the body from shedding pounds as a result of treatment. “The main thing during treatment is to really maintain weight,” Sandquist says. Cancer patients are often urged to eat high-calorie, high-protein foods such as peanut butter, milkshakes, sauces, gravies, meats, cheeses, and whole milk.
- The right amount of protein. Kidney function may decrease as a result of cancer treatment, particularly if surgeons have to remove one kidney. High-protein diets may cause the kidneys to work harder to remove urea, a waste product created as your body breaks protein down for use. Kidney cancer patients need to keep their weight up, but should discuss their protein intake with medical experts. “How much protein a kidney cancer patient should eat would depend on their kidney function,” Sandquist says. “The physician and registered dietitian would work with the patient and adjust the diet accordingly.”
How You Should Eat
The side effects from your cancer treatment will have a lot to do with how you prepare and enjoy your kidney cancer diet. Here are some problems you may face, along with some potential solutions.
Poor appetite. Cancer treatment can wipe out your appetite, but you still need to eat. To make sure you get the nutrition you need, you should:
- Have five or six small meals during the day instead of three large ones.
- Keep small snacks handy for when you feel like eating.
- Eat as much as you can when your appetite is strongest, usually early in the morning.
- Focus on eating the foods you can eat without difficulty, even if there are only a couple of them.
Nausea. Lots of different things can make a patient nauseated during kidney cancer treatment. To avoid nausea, you might consider:
- Choosing bland foods and avoiding spicy, sour, or acidic foods.
- Eating foods that are cold, rather than hot or warm.
- Staying out of the kitchen. “Sometimes cooking odors might upset their stomachs,” Sandquist says. “Be sure to try and eat in a separate room if possible.”
- Avoiding your most-loved foods while you are nauseated. If you try to eat favorite foods when you are sick, you may develop an aversion to them.
Weakness. Kidney cancer treatment can rob you of energy. To make sure you eat enough despite feeling fatigue and weakness, you should:
- Stock up on foods that are easily prepared, such as canned soups (your doctor may prefer that you purchase low-sodium varieties), frozen dinners, and pre-cooked meals.
- Cook meals ahead of time when you’re feeling well and freeze them for later.
- Prior to treatment, ask friends to help you shop and cook when you’re not feeling well later on.
- Plan for foods that come in thick liquid (milkshakes) or semi-solid (mashed potatoes) form for when you are too weak to chew properly.
Increased risk of infection. Cancer treatment can ravage the immune system and leave you open to infection. You must take great care preparing your meals:
- Thoroughly wash fruits and vegetables.
- Carefully cook meats, poultry, and eggs. Meat should have no pink. Eggs should not be runny.
- Store leftovers in the refrigerator immediately after eating.
- Drink only pasteurized milk or fruit juice.
- Avoid uncooked shellfish or raw fish.
- Don’t eat foods that show signs of mold, including moldy cheeses like blue cheese.
- Pay attention to freshness dates and don’t eat expired foods.
With some planning, your diet during kidney cancer treatment can be varied and healthy at the same time.
Only a few foods and other substances are completely off limits after a kidney transplant, but avoiding them is really important. Some foods, drinks and over-the-counter drugs can hurt your kidney function and put you at risk for complications.
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Remember that some dietary restrictions often depend on your progress. They can sometimes be necessary after a kidney transplant, on a short- or long-term basis, says Richard Fatica, MD, Vice Chair of Nephrology and Hypertension at Cleveland Clinic.
If your transplant is functioning well, you’ll have few dietary restrictions, but you’ll need to learn about possible interactions with transplant-sustaining drugs. If your new kidney is not doing well, dietary recommendations are likely similar to those for chronic kidney disease (CKD).
8 things to do after a kidney transplant
1. Avoid infections. In the first 90 days after surgery, your immune system is highly suppressed. Having a weakened immune system puts you at high risk for infectious diseases.
Your doctor will likely advise you to avoid close crowds (church, public transportation, fairs and festivals) where contact with an infected person is more likely.
When you do go out, be sure to wash your hands frequently — either with soap and water or with sanitizer — and stay away from people who are ill. Make sure you practice basic good hygiene in general.
2. Stay hydrated. One of the keys to a successful recovery is staying well-hydrated. Drink plenty of water — typically 2 liters (about 68 ounces) — per day. It’s also a good idea to limit caffeine. It’s a weak diuretic and contributes to dehydration.
3. Don’t eat raw or under-cooked foods. With your weakened immune system, eating raw or under-cooked foods — specifically undercooked meat or undercooked eggs — at any time after a transplant puts you at risk for severe intestinal illness.
4. Focus on protein. Eat a well-balanced diet with a few special dietary considerations. Protein is especially important to help build muscle and recover lost weight. Your doctor or a dietitian can help you figure out how much protein you need. It is possible to overdo it, however. “In order to avoid excess protein consumption, we do not typically advise you to take protein supplements,” Dr. Fatica says.
5. Avoid grapefruit and grapefruit juice. Anyone taking drugs which suppress the immune system should avoid these fruits because they can cause a strong reaction, says Dr. Fatica.
6. Don’t take nonsteroidal anti-inflammatory drugs (NSAIDS). Some very common over-the-counter (OTC) drugs, including ibuprofen and naproxen, can cause kidney dysfunction.
7. Skip on antihistamines and antacids. Other common OTC drugs sometimes affect other drugs or change absorption, so you should discuss possible alternatives with your doctor.
8. Avoid certain vitamins and herbal supplements. St. Johns’ wort, schisandra, and some herbal teas and other natural supplements interact with transplant medications. Using them can put you at risk, Dr. Fatica says. It’s always a good idea to ask your doctor about known interactions before taking any herbal product or OTC drugs. Check with your doctor about any other restrictions for your specific case or stage of disease.
What symptoms should you watch for after a kidney transplant?
For the long term, your team will monitor your progress with regular laboratory work. Your doctors will likely ask you to manage and keep track of your blood pressure and weight.
Watch for any signs of swelling that might signal problems with your transplant. Also pay close attention to early signs of infection, including fever, chills, cough, abnormal pains and diarrhea, and discomfort in the kidney area or while urinating.
Foods to Avoid After Transplantation
Will I have to watch my diet after a transplant?
Yes, your diet still plays a big role after a kidney transplant. It is important to keep a healthy weight and exercise regularly. A healthy, balanced diet will help prevent high blood pressure, high blood sugar, excess weight gain and promote overall wellness and health.
After a kidney transplant, plan to follow a diet low in salt and high in fiber. A balanced diet includes a variety of fresh fruits and vegetables, lean meats, reduced-fat dairy products, whole grains, and plenty of water.
Additionally, you may need to avoid eating certain types of foods. Your healthcare team can help you understand which foods you should avoid – and why. The dietitian at your transplant center can help you find a diet that is right for you.
Why do I need to avoid certain foods?
After your kidney transplant, you will need to take special medicines, called “immunosuppressive drugs” or “anti-rejection medicines.” These medicines help lower the chances of your new kidney being rejected by your body. However, these medicines also weaken your body’s ability to fight infection. Taking these medicines increases your risk for getting sick from germs, such as bacteria.
Some germs cause bacterial infections. Some bacterial infections can be picked up from food. You can help lower your chances of infection from food by:
- Handling foods safely, like washing your hands often, especially after touching raw chicken or eggs.
- Being careful when eating out.
- Avoiding certain ‘high-risk’ foods because they are more likely to have bacteria that can cause an infection.
You may also need to take steroids, which can cause increased:
- Appetite, causing unwanted weight gain
- Increased blood fat levels (cholesterol & triglycerides)
- Increased blood sugar levels
- Salt and fluid retention (too much fluid in the body)
- It can also cause a breakdown in muscle and bone tissue
Due to unwanted weight gain, it’s important to make healthy food choices and stick to appropriate portion sizes. It may be good to avoid fatty foods and foods high in simple sugar. Check with your doctor before exercise. Most often, you may need to exercise 3-4 times a week for 20-30 minutes each time.
What are some of the ‘high-risk’ foods to avoid?
It is recommended to avoid foods that are spoiled, moldy or past its “use by” date, as well as avoid the foods listed below. If you have any questions, talk to your healthcare team.
Meat, fish and poultry
Raw or undercooked:
- Meat, poultry and fish
- Prawns or shrimp
- Clams, oysters, and mussels
- Unpasteurized milk, cheese or yogurt
- Uncooked or undercooked eggs and any products containing them
Fruits and vegetables
- Grapefruit or grapefruit juice and pomegranate or pomegranate juice; especially if you are taking cyclosporine or prograf (specific immunosuppressive medicines)
- Unwashed raw fruits and damaged fruits
- Unwashed raw vegetables and unwashed salads
- Unpasteurized juices or ciders
- Salad from salad bars or delicatessens
- Sprouts (like alfalfa or bean sprouts)
If you have questions or need more information about a healthy eating plan after your kidney transplant, ask your transplant team to refer you to a registered dietitian nutritionist.
Acknowledgment: Reviewed by the Council on Renal Nutrition (04/2019)
What is a nephrectomy?
Nephrectomy (nephro = kidney, ectomy = removal) is the surgical removal of a kidney. The procedure is done to treat kidney cancer as well as other kidney diseases and injuries. Nephrectomy is also done to remove a healthy kidney from a donor (either living or deceased) for transplantation. Thousands of nephrectomies are performed every year in the U.S.
Types of nephrectomy
There are two types of nephrectomy for a diseased kidney: partial and radical. In partial nephrectomy, only the diseased or injured portion of the kidney is removed. Radical nephrectomy involves removing the entire kidney, along with a section of the tube leading to the bladder (ureter), the gland that sits atop the kidney (adrenal gland), and the fatty tissue surrounding the kidney. When both kidneys are removed at the same time, the procedure is called bilateral nephrectomy.
The procedure used to remove a healthy kidney from a donor for the purpose of transplantation is called donor nephrectomy.
Preparation for living donor nephrectomy
In order to be evaluated as a kidney donor you must be healthy and without diseases that may lead to kidney failure. These include diabetes and high blood pressure (hypertension). A potential donor is first tested for blood type compatibility with the potential recipient. After blood type compatibility is confirmed the health care team will perform several other tests. These tests are done to look for complications that could possibly cause the recipient’s body to reject the new kidney. Also, to identify any health problems in the potential donor that would make him or her unsuitable as a donor.
A couple of weeks before the scheduled transplant surgery, a kidney donor is given a complete physical examination and advised of any other instructions before the hospital admission. An evaluation from a social worker is done to make sure the donation is being done willingly and without pressure.
Before the operation, the surgical procedure will be explained to you in great detail, along with the possible risks and complications.
How is nephrectomy surgery done?
Some people who require a nephrectomy are suitable for laparoscopic surgery (also called minimally invasive surgery) to remove the kidney. Laparoscopic surgery involves the use of a laparoscope (wand-like camera) that is passed through a series of small incisions or “ports” in the abdominal wall. It is used to view the abdominal cavity and remove the kidney through a small incision. The procedure is done under general anesthesia (you are asleep and do not feel any pain). You will require a bladder catheter that is placed once you are asleep and is removed several hours after surgery.
Laparoscopy achieves the same things as traditional surgical techniques and can be used for both radical and partial surgery. It is also the preferred method for kidney transplant donor nephrectomy.
The advantages of laparoscopic surgery include:
- Shorter recovery time
- Shorter hospital stay
- Smaller incisions
- Fewer post-operative complications
Laparoscopic nephrectomy takes special skills to perform and is not available at all hospitals. Also, whether you can have laparoscopic surgery depends on your medical condition and overall health. Speak to your doctor about your options for laparoscopic nephrectomy.
Open nephrectomy is rarely required but is also done under general anesthesia. The surgeon makes a cut (incision) in the abdomen or in the side of the abdomen (flank area). A rib may need to be removed to perform the procedure. The ureter (the tube that carries urine from the kidney to the bladder) and the blood vessels are cut away from the kidney and the kidney is removed. The incision is then closed with stitches.
Aftercare and recovery
Immediately after surgery, your health care team will carefully watch your blood pressure, electrolytes and fluid balance. These body functions are controlled in part by the kidneys. You will most likely have a urinary catheter (tube to drain urine) in your bladder for a short time during your recovery.
You may have discomfort and numbness (caused by severed nerves) near the incision area. Pain relievers are given after the surgical procedure and during the recovery period as needed. Although deep breathing and coughing may be painful because the incision is close to the diaphragm, breathing exercises are important to prevent pneumonia.
You will probably remain in the hospital for 1 to 7 days, depending on the method of surgery used. You will be encouraged to return to light activities as soon as you feel up to it. Strenuous activity and heavy lifting should be avoided for 6 weeks following the procedure.
Your doctor will give you more detailed instructions about your post-operative activities, restrictions and diet.
Risks and complications of nephrectomy surgery
All surgery has certain risks and complications. Possible complications of nephrectomy surgery include:
- Bleeding (hemorrhage) requiring blood transfusion
- Post-operative pneumonia
- Rare allergic reactions to anesthesia
There is also the small risk of kidney failure in a patient with lowered function or disease in the remaining kidney.
Quick Fact: You are born with two kidneys, but you really only need one. A single healthy kidney can work as well as two kidneys, but if both kidneys are removed, dialysis or a transplant is necessary to maintain life.
The risks of donor nephrectomy for kidney transplantation are very small. This is likely because almost all living donors undergo careful pre-op testing and evaluation to make sure they are healthy enough for surgery. Most studies report death rates for donor nephrectomy in the range of 1 or 2 per 10,000 donor surgeries. About 1 or 2 per 100 patients may experience a post-operative wound infection or complication and about half of these patients may require re-operation for a complication.
The vast majority of kidney donors live long and healthy lives with one kidney.
Care of the remaining kidney
Tests will be done on a regular basis to check how well the remaining kidney is working. A urinalysis (urine test) and blood pressure check should be done every year, and kidney function tests (creatinine, glomerular filtration rate ) should be checked every few years (or more often if abnormal results are found). Regular urine tests for protein should be performed as well. The presence of protein in the urine may mean that the kidney has some damage.
People with one kidney should avoid sports that involve higher risks of heavy contact or collision. This includes, but is not limited to, boxing, field hockey, football, ice hockey, lacrosse, martial arts, rodeo, soccer and wrestling. This may also include extreme activities such as skydiving. Anyone with a single kidney who decides to participate in these sports should be extra careful and wear protective padding. He or she should understand that losing the remaining kidney is a very serious situation.
Are dietary changes needed?
In general, special diets are not needed by individuals who have one healthy kidney. Speak to your doctor or a registered dietitian if you have questions about the basic makeup of a healthy diet.
Where can I get more information?
Contact the National Kidney Foundation for information at 800.622.9010. If you have Internet access, you can find more information at www.kidney.org/transplanttion/livingdonors or at NKF’s Kidney Learning System (KLS)® Web site at www.kidney.org/KLS
You can also get more information from the following organizations:
Date Reviewed: July 2009
If you would like more information, please contact us.
- Prior to Surgery
- What to Expect after Surgery
- Our Surgeons
Prior to the Surgery
What to Expect during Your Preoperative Consultation
During your initial consultation with your surgeon, he or she will review your medical history as well as any outside reports, records and X-ray films (e.g., CT scan, MRI, sonogram). A brief physical examination will also be performed at the time of your visit. If your surgeon determines that you are a candidate for surgery, you will then meet with a patient service surgery coordinator to arrange for the date of your operation.
Note: It is very important that you bring all of your X-ray films and reports to the initial consultation with your surgeon.
What to Expect prior to Surgery
Since insurance companies will not permit patients to be admitted to the hospital the day before surgery to have tests completed, you must make an appointment to have preoperative testing done at your family doctor or primary care physician’s office within one month prior to the date of surgery.
For The Johns Hopkins Hospital patients: These results need to be faxed by your doctor’s office to the Preoperative Evaluation Center at 443-287-9358 two weeks prior to your surgery. Please call the Documentation Center at 410-955-9453 two weeks before your surgery date to confirm that this information was received.
For Johns Hopkins Bayview Medical Center patients: These results need to be faxed by your doctor’s office to the Preoperative Evaluation Center at 410-550-1391 one week prior to your surgery. Please call the Documentation Center at 410-550-2495 before your surgery date to confirm that this information was received.
Once your surgical date is secured, you will receive a form along with a letter of explanation to take to your primary care physician or family doctor in order to have the following preoperative testing done prior to your surgery:
- Physical exam
- Electrocardiogram (EKG)
- Complete blood count (CBC)
- Blood coagulation profile (PT/PTT)
- Comprehensive metabolic panel (blood chemistry profile)
Preparation for Surgery
Medications to avoid prior to surgery
Aspirin, Motrin, ibuprofen, Advil, Alka-Seltzer, vitamin E, Ticlid, Coumadin, Lovenox, Celebrex, Voltaren, Vioxx, Plavix and some other arthritis medications can cause bleeding and should be avoided one week prior to the date of surgery. (Please contact your surgeon’s office if you are unsure about which medications to stop prior to surgery. Do not stop any medication without contacting the prescribing doctor to get their approval.)
Bowel preparation and clear liquid diet
Drink one bottle of magnesium citrate, which you can purchase at your local pharmacy, the evening before your surgery. Do not eat or drink anything after midnight.
Drink only clear fluids for a 24-hour period prior to the date of your surgery. Clear liquids are liquids that you are able to see through. Please follow the diet below.
Clear liquid diet
Remember not to eat or drink anything after midnight the evening before your surgery.
Clear liquids are liquids that you are able to see through. Please follow the diet below.
- Clear broths (no cream soups, meat, noodles, etc.)
- Chicken broth
- Beef broth
- Juices (no orange juice or tomato juice)
- Apple juice or apple cider
- Grape juice
- Cranberry juice
- Hawaiian punch
- Tea (you may add sweetener but no cream or milk)
- Coffee (you may add sweetener but no cream or milk)
- Clear Jell-O (without fruit)
- Popsicles (without fruit or cream)
- Italian ices or snowballs (not marshmallow)
What to Expect after Surgery
During Your Hospitalization
Immediately after the surgery you will be taken to the recovery room, then transferred to your hospital room once you are fully awake and your vital signs are stable.
- Postoperative pain: Pain medication can be controlled and delivered by the patient via an epidural or an intravenous catheter or by injection (pain shot) administered by the nursing staff. You may experience some minor transient shoulder pain (one to two days) related to the carbon dioxide gas used to inflate your abdomen during the laparoscopic surgery.
- Nausea: You may experience some nausea related to the anesthesia. Medication is available to treat persistent nausea.
- Urinary catheter: You can expect to have a urinary catheter draining your bladder (which is placed in the operating room while you are asleep) for approximately one day after the surgery. It is not uncommon to have blood-tinged urine for a few days after your surgery.
- Diet: You can expect to have an intravenous (IV) catheter in for one to two days. (An IV is a small tube placed into your vein so that you can receive necessary fluids and stay well hydrated; it also provides a way to receive medication.) Most patients are able to tolerate ice chips and small sips of liquids the day of the surgery and regular food the next day. Once on a regular diet, pain medication will be taken by mouth instead of by IV or shot.
- Fatigue: Fatigue is common and should start to subside in a few weeks following surgery.
- Incentive spirometry: You will be expected to do some very simple breathing exercises to help prevent respiratory infections by using an incentive spirometry device (these exercises will be explained to you by the nursing staff during your hospital stay). Coughing and deep breathing are an important part of your recuperation and help prevent pneumonia and other pulmonary complications.
- Ambulation: On the day of surgery it is very important to get out of bed and begin walking with the supervision of your nurse or family member to help prevent blood clots from forming in your legs. You can also expect to have sequential compression devices (SCDs) along with tight white stockings to prevent blood clots from forming in your legs.
- Hospital stay: The length of hospital stay for most patients is approximately two days.
- Constipation/gas cramps: You may experience sluggish bowels for several days following surgery as a result of the anesthesia. Suppositories and stool softeners are usually given to help with this problem. Taking a teaspoon of mineral oil daily at home will also help to prevent constipation. Narcotic pain medication can also cause constipation, and therefore patients are encouraged to discontinue any narcotic pain medication as soon after surgery as tolerated.
What to Expect after Discharge from the Hospital
- Pain control: You can expect to have some pain that may require pain medication for a few days after discharge. Afterward, Tylenol should be sufficient to control your pain.
- Showering: You may shower after returning home from the hospital. Your wound sites can get wet but must be padded dry immediately after showering. Tub baths are not recommended in the first two weeks after surgery as this will soak your incisions and increase the risk of infection. You may have adhesive strips across your incision. These are not to be removed. They will fall off in approximately five to seven days. Sutures will dissolve in four to six weeks.
- Activity: Taking daily walks is strongly advised. Prolonged sitting or lying in bed should be avoided. Climbing stairs is possible but should be taken slowly. Driving should be avoided for at least one to two weeks after surgery. Absolutely no heavy lifting (greater than 20 pounds) or exercising (jogging, swimming, treadmill, biking) for six weeks or until instructed by your doctor. Most patients return to full activity on an average of three weeks after surgery. You can expect to return to work in approximately four weeks.
- Diet: You should drink plenty of fluids and discuss with your doctor if you need to be on a salt- or protein-restricted diet.
- Follow-up appointment: If your surgery was performed at The Johns Hopkins Hospital, you will need to call the Johns Hopkins Outpatient Urology Clinic at 410-955-6707 after your surgery date to schedule a follow-up appointment as instructed by your surgeon. If your surgery was performed at Johns Hopkins Bayview Medical Center, please call 410-550-7008 to schedule a follow-up appointment.
- Pathology results: The pathology results from your surgery are usually available in one week following surgery. You may discuss these results with your surgeon by contacting him by phone or in your follow-up appointment in the office.
- Kidney function blood tests and X-rays: Patients are encouraged to have an annual blood test, called serum creatinine, performed by their primary care physician to follow their overall kidney function. Your surgeon will also review these results in the office during follow-up visits. In patients with kidney tumors, follow-up X-ray tests (e.g., CT, MRI, sonograms) may be periodically required to follow the appearance of your remaining kidney.
Allaf, Mohamad Ezzeddine, M.D.
Professor of Urology
Professor of Oncology
Executive Vice Chairman, Department of Urology
Director of Adult Urology
Director, Minimally Invasive and Robotic Surgery
Expertise, Disease and Conditions: Kidney Cancer, Laparoscopic Kidney Surgery, Prostate Cancer, Robotic Prostatectomy, Urology
Han, Misop, M.D.
Professor of Urology
Professor of Oncology
David Hall McConnell Professor of Urology and Oncology
Director, Urology Residency Program
Director, Urology Informatics
Expertise, Disease and Conditions: Kidney Cancer, Laparoscopic Nephrectomy, Prostate Cancer, Robotic Prostatectomy, Robotic Surgery, Urologic Surgery, Urology
Pavlovich, Christian Paul, M.D.
Professor of Urology
Professor of Oncology
Director, Urologic Oncology, Johns Hopkins Bayview Medical Center
Director, Urologic Oncology Fellowship
Expertise, Disease and Conditions: Kidney Cancer, Prostate Cancer, Robotic Prostatectomy, Urology
The Johns Hopkins Hospital: 410-955-6100
Johns Hopkins Bayview Medical Center: 410-550-7008
In the event of an emergency and you need to contact someone in the evening hours or on the weekend, please call the paging operator at 410-955-6070 for The Johns Hopkins Hospital or 410-550-0100 for Johns Hopkins Bayview Medical Center and ask to speak to the urologist on call.
Note: Patients must remember to bring all pathology reports, PSA values and glass pathology slides to their consultation appointment. The pathology slides will be submitted for review at Johns Hopkins.
Directions to The Johns Hopkins Hospital
Kidney removal – discharge
Plan to have someone drive you home from the hospital. DO NOT drive yourself home. You may also need help with everyday activities for the first 1 to 2 weeks. Set up your home so it is easier to use.
You should be able to do most of your regular activities within 4 to 6 weeks. Before then:
- DO NOT lift anything heavier than 10 pounds (4.5 kilograms) until you see your doctor.
- Avoid all strenuous activity, including heavy exercises, weightlifting, and other activities that make you breathe hard or strain.
- Taking short walks and using the stairs is OK.
- Light housework is OK.
- DO NOT push yourself too hard. Slowly increase the amount of time and the intensity of your exercise. Wait until you follow up with your health care provider to be cleared for exercise.
To manage your pain:
- Your provider will prescribe pain medicines for you to use at home.
- If you are taking pain pills 3 or 4 times a day, try taking them at the same times each day for 3 to 4 days. They may work better this way. Be aware that the pain medicine can cause constipation. Try to maintain normal bowel habits.
- Try getting up and moving around if you are having some pain. This may ease your pain.
- You may put some ice over the wound. But keep the wound dry.
Press a pillow over your incision when you cough or sneeze to ease discomfort and protect your incision.
Make sure your home is safe as you are recovering.
Kidney cancer patients should try to eat a healthy, well balanced diet. The ‘eatwell plate’ helps patients to get the balance right. It shows the proportion of each food group that should be consumed for a healthy diet. About one third of a healthy diet should be fruit and vegetables, one third carbohydrates, such as bread, rice, potatoes, pasta and other starchy foods, and the remaining third should be composed of milk and dairy foods, meat, fish, eggs, beans, and a small proportion of foods high in fat and/or sugar. A healthy diet is very important because it provides sufficient energy and nutrients to prevent a deficiency in any particular nutrient, helps to optimise health, and reduces the risk of disease.
The body mass index (BMI) is used to determine whether a person has a healthy weight for their height. It is calculated by dividing weight in kilograms by height in meters squared. BMI is not specific for different ethnic groups, for example black people have a larger proportion of muscle mass in their bodies, and because muscle weighs more than fat they may appear to be overweight on the chart.
To eat healthily it is important to have enjoyable meals, a regular meal plan and a good balance of starchy foods, fibre, fats, sugar, salt, fruit, vegetables and alcohol.
Regular meal plan
A regular intake of meals ensures that energy is spread throughout the day; it prevents peaks and troughs in blood sugar levels and prevents the temptation to overeat and binge. If people don’t eat regularly, they can tend to binge and put on weight. Patients should try to eat regular meals and not skip meals, especially breakfast, which is the most important meal of the day because it breaks the overnight fast. Many studies have shown that eating regular meals can help with weight loss.
Starchy foods, such as potatoes, rice, cereals and pasta, are important in the diet because they are the main source of energy for the body. Patients should aim to include some starchy food in each meal. Whole grain varieties of starchy food, such as brown rice and wholemeal bread, also contain fibre. Starchy foods are a good source of B vitamins needed to support and increase the rate of metabolism, and also contain some calcium and iron.
Most people’s diet does not contain enough fibre and people need to aim for 18 g of fibre a day. Fibre helps the digestive system to process food and absorb nutrients. A healthy diet needs fibre to reduce the risk of bowel cancer and constipation, and reduce the level of cholesterol in the blood. Fibre also contributes to the control of blood sugar levels that may also help to control appetite. There are two types of fibre; insoluble fibre is found in brown rice, pasta, bread, lentils, beans, oats and pulses, while soluble fibre is found in all fruit and vegetables, and is high in oats, strawberries, pears and barley. Drinking plenty of water enhances the effectiveness of fibre.
Fats are a concentrated source of energy and provide the fat-soluble vitamins A, D, E and K; we all need fat in our diets. Fats are required to protect organs, and are involved in metabolism and tissue repair. There are two main types of fat; saturated and unsaturated.
Saturated fats come from animal products, such as meat, full fat milk, cream, full fat yogurts, butter, cheese, ghee, and hydrogenated margarine. Trans fatty acids (a type of saturated fat) are present in processed foods, such as cake, biscuits, crisps etc. and are added to food to prolong shelf life. Both saturated and trans fats should be limited in a healthy diet because they raise cholesterol levels and may contribute to the risk of certain cancers, stroke and heart disease.
Unsaturated fats are found in vegetable oils (e.g. olive oil), seeds, oily fish (e.g. mackerel, pilchards, sardines, trout and herring), nuts, avocados and soft margarine, and are a healthier alternative to saturated fats. Unsaturated fats contain essential fatty acids that can’t be made by the body and omega 3, which can protect against heart disease.
Fat can be reduced in the diet by;
- Using lean cuts of meat and removing any visible fat from the meat before cooking, such as fat on red meat and the skin from chicken.
- Using less butter and opting for a vegetable-based spread or oil.
- Grilling, steaming or baking food, rather than frying.
- Choosing low fat dairy products, such as semi-skimmed milk, and low fat yogurts and cheeses.
- Taking fruit, seeds or nuts as a snack rather than biscuits, cakes or crisps.
Fruit and vegetables
Fruit and vegetables are a very important component of a healthy diet. They are high in fibre, especially soluble fibre, and therefore may help to reduce the incidence of some bowel cancers. Fruit and vegetables also help to reduce blood cholesterol levels and control blood sugar levels. However, fruit can increase blood sugar because it contains fructose, a sugar found naturally in fruit. Fruit and vegetables are also a good source of antioxidants, vitamins and minerals, which are essential for the body, and are low in calories.
A healthy diet should contain at least five portions of fruit and vegetables from a variety of sources a day. One portion is one glass of unsweetened fruit juice (150 ml), one medium fruit e.g. an apple or an orange, two tablespoons of vegetables, one small bowl of side salad, two small fruits e.g. plum or satsuma, or one handful of berries or dried fruit. Kidney cancer patients should not avoid eating bananas, but do not eat excessive amounts as they are rich in potassiuma and kidney function can be compromised following a nephrectomy.
Most of the salt in our diets comes from the salt added to processed food during the manufacturing process. Bread contains one of the highest amounts of salt of all the foodstuffs we eat. Most of us eat about 12 g of salt per day; the National Institute of Health and Care Excellence (NICE) have set a target for the population to reduce salt intake to 5 g per day by 2015, and 3 g per day by 2020. High salt intake is linked to high blood pressure. Food manufacturers are looking at ways to reduce the amount of salt they add to processed food by looking at alternative flavours, such as potassium chloride. However, this could have implications for patients with compromised kidney function. A shop-bought ready meal contains about 3 g of salt; this can be reduced to 1 g by preparing a meal at home and avoiding the use of stock cubes. One stock cube contains about 4 g of salt while one teaspoon is 5 g.
Salt intake can be reduced by:
- Keeping salt off the dinner table – try food before putting salt on!
- Using herbs and spices for flavouring, such as garlic, thyme, rosemary and lemon.
- Being aware that stock cubes, seasoning and ready-made sauces often contain lots of salt.
- Avoiding smoked and cured foods that contain high levels of salt.
- Avoiding salt substitutes, such as Lo-salt, since these contain lots of potassium.
- Rock salt and sea salt are no healthier than normal table salt!
More information on salt intake can be found here.
Life is for living, so patients are allowed some sugary treats; however, sugary treats should be eaten in moderation. Sugary treats should be eaten after a meal to prevent large fluctuations in blood sugar levels, which is especially important for diabetics. Sugar provides empty calories and if eaten in excess will contribute to weight gain and also tooth decay.
Sugar intake can be reduced by;
- Drinking diet fizzy drinks or drinks without any added sugar.
- Using sweeteners instead of sugar in tea and coffee or cut back on the sugar until no longer needed or wanted.
- Ensuring that fruit juice is not sweetened.
Sweeteners, such as aspartame, saccharin and sorbitol, are used to reduce the calorie content of food. The Food Standards Agency (FSA) governs the use of sweeteners in the manufacturing of food. In animal studies, there is some concern that high levels of sweeteners in food are associated with the development of bladder cancer; however, this has not been proven in humans. Low fat foods tend to have more sugar or sweeteners added to compensate for the low fat levels.
The government’s recommended safe intake of alcohol is 14 units per week for women and 21 units per week for men, with one unit being a single pub measure of spirit, 125 ml glass of wine, or half a pint of beer or lager. Like sugar, alcohol provides calories devoid of nutritional benefit (empty calories). There is about 100 calories in a glass of wine.
Food labelling has improved considerably in recent years, but is still sometimes very difficult to interpret. However, the green-amber-red system is used more frequently on supermarket foods and helps to direct people to more healthy options.
Vitamin or mineral supplements are not needed if you eat a varied and healthy balanced diet, and the use of excessive supplements can be harmful to health. As we get older, bone health becomes more important and exposure to the sun to increase vitamin D production can help with this. Exposure of the skin to ultraviolet light from the sun results in the production of vitamin D by the skin cells. The use of high factor sun creams can lead to vitamin D deficiency since the creams block the action of the sun on skin to reduce vitamin D production by the body.
Pre- and probiotics promote the growth of the good bacteria in the gut and are important for good digestive system health. They can help with the digestion of food and prevent tummy bugs. They may be added to some vitamin and mineral supplements, yogurts and yogurt drinks, and can be bought at most supermarkets and health food shops.
Plant stanols and sterols are clinically proven to reduce the absorption of cholesterol from the gut, therefore lowering the amount of bad cholesterol (low density lipoprotein, LDL) in the blood. They need to be consumed according to the manufacturer’s instructions to confer any benefits.
Kidney cancer patients should aim to undertake at least 30 minutes of moderate activity for five days of the week. Moderate activity includes some of the actions involved in daily life, such as walking or cycling. It can make you feel warmer or even sweaty if it is a hot day. Exercise can make you feel better because of the released feel-good hormones (endorphins) that are release in the body when we exercise. Exercise can also help with weight management.
- Prior to the Surgery
- What to Expect after Surgery
- Our Surgeons
Living as a Kidney Cancer Survivor
For some people with kidney cancer, treatment can remove or destroy the cancer. The end of treatment can be both stressful and exciting. You may be relieved to finish treatment, but yet it’s hard not to worry about cancer coming back. This is very common if you’ve had cancer.
For other people, the kidney cancer might never go away completely. Some people may get regular treatment with chemotherapy or targeted therapy or other treatments to try and help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful.
Life after kidney cancer means returning to some familiar things and also making some new choices.
Ask your doctor for a survivorship care plan
Talk with your doctor about developing a survivorship care plan for you. This plan might include:
- A suggested schedule for follow-up exams and tests
- A schedule for other tests you might need in the future, such as early detection (screening) tests for other types of cancer, or tests to look for long-term health effects from your cancer or its treatment
- A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
- Diet and physical activity suggestions
- Reminders to keep your appointments with your primary care provider (PCP), who will monitor your general health care
Even if you have completed treatment, you will likely have follow-up visits with your doctor for many years. It’s very important to go to all your follow-up appointments. During these visits, your doctors will ask if you are having any problems and may do exams and lab tests or imaging tests to look for signs of cancer or treatment side effects.
Some treatment side effects might last a long time or might not even show up until years after you have finished treatment. Your doctor visits are a good time to ask questions and talk about any changes or problems you notice or concerns you have. It’s very important to report any new symptoms to the doctor right away.
To some extent, the frequency of follow up visits and tests will depend on the stage of your cancer, the treatment you received, and the chance of it coming back.
Survivors of kidney cancer should also follow the American Cancer Society guidelines for the early detection of cancer, such as those for breast, cervical, lung, and prostate cancer.
Keeping health insurance and copies of your medical records
Even after treatment, it’s very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.
At some point after your cancer treatment, you might find yourself seeing a new doctor who doesn’t know about your medical history. It’s important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment. Learn more in Keeping Copies of Important Medical Records.
Can I lower my risk of kidney cancer coming back?
Most people want to know if there are specific lifestyle changes they can make to reduce their risk of cancer coming back. Unfortunately, for most cancers there is little solid evidence to guide people. This doesn’t mean that nothing will help – it’s just that for the most part this is an area that hasn’t been well studied. Most studies have looked at lifestyle changes as ways of preventing cancer in the first place, not slowing it down or keeping it from coming back.
At this time, not enough is known about kidney cancer to say for sure if there are things you can do that will be helpful. Adopting healthy behaviors such as not smoking, eating well, being active, and staying at a healthy weight may help, but no one knows for sure. Still, we do know that these types of changes can have positive effects on your health that can extend beyond your risk of kidney cancer or other cancers.
Lifestyle Changes After Cancer of the Kidney
You can’t change the fact that you have had cancer. What you can change is how you live the rest of your life – making choices to help you stay healthy and feel as well as you can. This can be a time to look at your life in new ways. Maybe you are thinking about how to improve your health over the long term. Some people even start during cancer treatment.
Making healthier choices
For many people, a diagnosis of cancer helps them focus on their health in ways they may not have thought much about in the past. Are there things you could do that might make you healthier? Maybe you could try to eat better or get more exercise. Maybe you could cut down on alcohol, or give up tobacco. Even things like keeping your stress level under control may help. Now is a good time to think about making changes that can have positive effects for the rest of your life. You will feel better and you will also be healthier.
You can start by working on those things that worry you most. Get help with those that are harder for you. For instance, if are thinking about quitting smoking and need help, call the American Cancer Society at 1-800-227-2345.
Eating right can be hard for anyone, but it can get even tougher during and after cancer treatment. Treatment may change your sense of taste. Nausea can be a problem. You may not feel like eating and lose weight when you don’t want to. Or you may have gained weight that you can’t seem to lose. All of these things can be very frustrating.
During treatment: Many people lose weight or have taste problems during treatment. If this happens to you, do the best you can. Eat whatever appeals to you. Eat what you can, when you can. Now is not the time to restrict your diet. You may find it helps to eat small portions every 2 to 3 hours. Try to keep in mind that these problems usually improve over time. You may want to ask your cancer team about seeing a dietitian, an expert in nutrition who can give you ideas on how to optimize your weight and diet during treatment.
After treatment: One of the best things you can do after cancer treatment is put healthy eating habits into place. You may be surprised at the long-term benefits of some simple changes.
To help maintain good health, survivors should:
- Get to and stay at a healthy weight
- Keep physically active
- Eat a healthy diet, with an emphasis on plant foods
- Limit alcohol to no more than 1 drink per day for women or 2 drinks per day for men
These steps may also lower the risk of some cancers, as well as having many other health benefits.
For more information, see Nutrition and Physical Activity During and After Cancer Treatment: Answers to Common Questions.
Rest, fatigue, and exercise
Extreme tiredness, called fatigue, is very common in people treated for cancer. This is not a normal tiredness, but a bone-weary exhaustion that often doesn’t get better with rest. For some people, fatigue lasts a long time after treatment, and can make it hard for them to be active and do other things they want to do. But exercise can help reduce fatigue. Studies have shown that patients who follow an exercise program tailored to their personal needs feel better physically and emotionally and can cope better, too.
If you were sick and not very active during treatment, it is normal for your fitness, endurance, and muscle strength to decline. Any plan for physical activity should fit your own situation. A person who has never exercised will not be able to take on the same amount of exercise as someone who plays tennis twice a week. If you haven’t been active in a few years, you will have to start slowly – maybe just by taking short walks.
Talk with your health care team before starting any exercises. Get their opinion about your exercise plans. Then, try to find an exercise buddy so you’re not doing it alone. Having family or friends involved when starting a new activity program can give you that extra boost of support to keep you going when the push just isn’t there.
If you are very tired, you will need to balance activity with rest. It is OK to rest when you need to. Sometimes it’s hard for people to allow themselves to rest when they are used to working all day or taking care of a household, but this is not the time to push yourself too hard. Listen to your body and rest when you need to. For more information on dealing with fatigue, see Cancer-related Fatigue and Anemia in People with Cancer.
Keep in mind exercise can improve your physical and emotional health.
- It improves your cardiovascular (heart and circulation) fitness.
- Along with a good diet, it will help you get to and stay at a healthy weight.
- It makes your muscles stronger.
- It reduces fatigue and helps you have more energy.
- It can help lower anxiety and depression.
- It can make you feel happier.
- It helps you feel better about yourself.
And long term, we know that getting regular physical activity plays a role in helping to lower the risk of some cancers, as well as having other health benefits.
If the cancer comes back
If the cancer does recur at some point, your treatment options will depend on where the cancer is located, what treatments you’ve had before, and your health. For more information on how recurrent cancer is treated, see Treatment Choices by Stage of Kidney Cancer.
For more general information on recurrence, you may also want to see Understanding Recurrence.
Could I get a second cancer after kidney cancer treatment?
People who’ve had kidney cancer can still get other cancers, In fact, kidney cancer survivors are at higher risk for getting another kidney cancer, as well as some other types of cancer. Learn more in Second Cancers After Kidney Cancer.
Moving on after kidney cancer
Some amount of feeling depressed, anxious, or worried is normal when kidney cancer is a part of your life. Some people are affected more than others. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others.
What it’s like living with kidney cancer and the adjustments you may need to make.
Taking care of your remaining kidney
One kidney is enough to filter your blood to keep it clean and healthy. If you have one kidney removed, as long as your other one works normally there should be no ill effects.
Your GP should monitor your blood pressure regularly (about 4 times a year). This is to make sure that the remaining kidney stays healthy. If your blood pressure increases, they can give you medicine to control it.
But it’s still important that you take care of your remaining kidney.
If you smoke, you should try to stop. Smoking has been linked to kidney cancer and many other cancers.
Giving up smoking can be very difficult, especially if you have smoked for years. You will need a lot of will power and support from your friends and family but it will be worth it.
A high protein diet has been linked to kidney cancer, and kidney disease in general. To eat more healthily, try to have more fresh fruit and vegetables and not eat so much protein. Foods high in protein include:
- meat and fish
- cheese, butter and milk
- beans and lentils
Most high protein foods are also rich in animal fats. So eating a diet lower in protein may help you to maintain a healthy weight too.
Try to cut down on the amount of salt you add to your food. A high salt intake puts a strain on the kidneys and is not good for your heart.
Some people take high doses of vitamins to try to treat their cancer or stop it coming back. There is no evidence that this works. In fact, with kidney cancer, you could do more harm than good. Large doses of vitamin C could damage your remaining kidney or cause kidney stones, which are very painful.
Heavy drinking will cause kidney damage eventually. Cutting down or stopping drinking alcohol is helpful.
Cancer affecting both kidneys
Rarely, people get cancer in both kidneys. Once you’ve had cancer in one kidney, there is a slightly increased chance of getting cancer in the other kidney.
You can have both kidneys removed if necessary. But your surgeon will try to remove only the tumours and leave enough working kidney tissue to keep you healthy.
If you have both kidneys completely removed, you will not make any urine.
You will need to have kidney dialysis. This is a way of getting rid of waste products and excess water that the kidneys normally filter out of your blood.
Dialysis means you can lead a more or less normal life without a working kidney. There can be problems with dialysis and you have to stick to a special diet. But many people manage very well with it.
There are 2 different types of kidney dialysis. You can use a kidney dialysis machine at a dialysis centre. Or you can use a permanent tube and bag of fluid at home.
Kidney dialysis machine
You use a kidney dialysis machine about 3 times a week to keep your blood healthy. Most people have to travel to a dialysis centre to do this. The dialysis itself takes up to 6 hours.
You have 2 needles put into your arm. One carries blood to the machine, where it is cleaned and excess water is removed. The other needle carries the cleaned blood back to your body.
Having this treatment takes up quite a bit of your time every week.
Dialysis at home
Continuous ambulatory peritoneal dialysis (CAPD) is a type of dialysis you have on your own at home every day.
You have a permanent tube (catheter) in your tummy (abdomen). Every day, you attach a bag of fluid to the tube and run it into your abdomen. You leave the fluid inside you for several hours.
While it’s in there, the fluid collects the waste products and extra water that you would normally get rid of in your urine. After a set time, you drain the fluid out again, together with the waste products and extra water. Then you put another clean bag of fluid in.
Being able to manage the dialysis yourself at home makes it easier to carry on with your usual daily routine. But you have to be very careful about keeping clean when you change the bags. However careful you are, you will almost certainly get the odd infection if you manage this type of dialysis for a while.
Diet and lifestyle on dialysis
You have to stick to a special diet that is low in protein, salt and potassium.
You also have to keep a very close check on your fluid intake. Without your kidneys to filter out extra water, you can easily become overloaded with fluid. This can cause heart or lung problems.
11 Nutrition Dos and Don’ts for People With Kidney Cancer
There’s no conclusive evidence regarding the link between kidney cancer and diet. But studies have shown that the foods we eat and other health factors, such as whether you exercise, can contribute to the occurrence of some cancers. A healthy diet that includes appropriate portions of each food group is more important than ever when you’re dealing with a serious medical condition. If you’re looking to make healthier choices, consider these nutritional dos and don’ts when being treated for kidney cancer.
Eating Well With Kidney Cancer https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/4745×3174%2B35%2B0/resize/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F71%2F6a%2F145ddfd94f319755d0669a451756%2Fimage-getty-163731690.jpg
A sensible diet is important for everyone, especially people who have kidney cancer. Healthful foods will help your body regenerate normal tissues, prevent infection, and maintain the strength and energy you’ll need to fight the cancer. Well-balanced diets include lots of fruits and veggies, as well as whole grains, and usually a limited amount of red meat. The specific foods you need depend on your treatment plan and stage of cancer, so talk to your doctor or a dietitian for recommendations.
Do: Eat a variety of healthful foods. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/1494×999%2B5%2B0/resize/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F51%2Fe7%2F1b9fe1654fda8177bf68cce81ec8%2Fresizes%2F1500%2Fimage-senior-couple-making-salad.jpg
Your kidneys make urine, which helps control the amount of fluid in your body. With kidney cancer, your kidney function isn’t optimal, and your body might not make the proper amount of urine. Too much fluid can cause swelling, high blood pressure, and shortness of breath. So be sure to stay hydrated; just don’t overdo it.
Don’t: Drink too much water and other fluids. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F89%2Fc0%2F586e26a24385a820564061a2ea85%2Fimage-getty-561139685.jpg
A diet high in animal proteins—rather than plant proteins—may be linked to kidney cancer, although there is no conclusive evidence about whether it’s a risk factor. You do need protein in your diet to maintain muscle mass, but be aware of how much of it you eat. Your kidneys filter the waste out of your body, but that waste can build up in your bloodstream when your kidneys aren’t functioning normally. So, ask your doctor how much animal protein is recommended for your situation.
Do: Pay attention to the protein you eat. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/4735×3168%2B16%2B0/resize/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F8a%2F75%2F493dd1ff4fcba3897458ceb3cb82%2Fimage-getty-161712608.jpg
Salt should be used in limited amounts for any diet, but that’s especially true for people with kidney cancer or who have had a kidney removed (a nephrectomy). Sodium can cause high blood pressure, which intensifies kidney problems. So, try to find other seasonings you like besides salt, such as herbs or lemon juice. Also stay away from processed snacks and meats, canned foods, and fast food, all of which can contain a lot of sodium.
Don’t: Consume too much salt. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F39%2Fce%2F8720bc1f4544855a39c18c1f923f%2Fimage-getty-479952412.jpg
You can still enjoy seeds, nuts and beans—which are all high in phosphorus—but pay attention to how much you eat. Phosphorus, which is a chemical element, can build up in your bloodstream when your kidneys don’t work at full capacity, which can lead to itchiness and joint pain. If you notice these symptoms, talk with your doctor to see whether phosphorus could be the problem. If so, you might need to cut back on these foods and possibly even on diary and meats, which have moderate amounts of phosphorus.
Do: Monitor the amount of phosphorus in your diet. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/1500×1003%2B0%2B3/resize/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2Ff2%2Fef%2F37f0950a436dae82bb87413f16a8%2Fresizes%2F1500%2Fimage-can-of-nuts.jpg
Some studies have shown that moderate consumption of alcoholic drinks may actually protect against kidney cancer. Although drinking too much is never a healthy choice, having an adult beverage is usually safe even if you’ve had a nephrectomy. However, be sure to talk to your doctor about including any amount of alcohol in your diet to make sure it won’t interfere with your kidney cancer treatment.
Don’t: Be afraid to have alcohol in moderation. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/1496×1001%2B3%2B0/resize/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F83%2F89%2F4f516e2d412abace3a741695f6f8%2Fresizes%2F1500%2Fgettyimages-546825081.jpg
Talk with your doctor about whether your well-balanced diet is nutritious enough for you and gentle enough for your kidneys. Your doctor might recommend a prescription for vitamins and minerals to supplement your diet. Supplements aren’t always necessary, though, so talk with your doctor before stocking up at the drugstore.
Do: Consider taking supplements. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/7342×4912%2B0%2B0/resize/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2Fa9%2F81%2F5fea2401434a80e8ab33f8846c68%2Fimage-getty.jpg
This isn’t a requirement with kidney cancer, but it may help some people get the nutrition they need without creating any additional gastrointestinal distress. Kidney cancer treatments can cause nausea, diarrhea and constipation, so you may need to adjust how and when you eat, not just what you eat. Instead of large meals at breakfast, lunch and dinner, try smaller portions every few hours to see whether it helps you feel better.
Do: Eat smaller meals throughout the day. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/1494×999%2B0%2B0/resize/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2Fef%2Fee%2F4347756f4f7ab303f6c0b76e84bb%2Fresizes%2F1500%2Fimage-cheese-and-crackers.jpg
As you investigate diet plans for kidney cancer, be careful that you aren’t reading nutrition recommendations for people with kidney disease. Kidney cancer—and the types of treatment that go along with it—may call for a very different nutrition plan than kidney disease. The same goes for kidney cancer vs. other types of cancer. Diet recommendations can be different for every condition, so make sure you’re looking at nutrition information specifically for kidney cancer.
Don’t: Think all diseases come with the same food recommendations. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/1494×999%2B5%2B0/resize/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2Fc2%2F01%2F94b98cfe443686d039a5fabb6f12%2Fresizes%2F1500%2Fimage-man-opens-refrigerator.jpg
Because kidney cancer can cause weight loss, nausea, diarrhea, and constipation, you might need help finding foods that provide the nutrition you need without making you feel sick. Treatment might even throw off your sense of taste, making some foods unappealing. Find a registered dietitian to help you map out a nutritional plan customized for your needs. He or she will be able to keep your plan on track and make adjustments as needed throughout your kidney cancer treatment.
Do: Ask a dietitian if you need help. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/1500×1003%2B0%2B230/resize/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F34%2Fc6%2F5ac6fd29429a8d79e9c47a5b635a%2Fresizes%2F1500%2Fimage-dietitian.jpg
You might feel significant fatigue when you’re undergoing kidney cancer treatment or if you’ve just had surgery to remove all or part of a kidney. Even so, it’s important to get some exercise. Talk with your doctor about the type of workout that’s best for you. With a plan, you’ll get the exercise you need without overexerting yourself.
Don’t: Give up on exercise. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2Ff1%2F25%2F6dcfc285497c9dfd4d146c7a11a0%2Fresizes%2F1500%2Fimage-women-exercising.jpg
Foods That Fight Kidney Cancer
Some studies suggest that several different strains of cancer can be avoided by consuming the right types of foods and drinks. In honor of Kidney Cancer Awareness month, I’ve decided to make a guide identifying foods that are rich in nutrients that can help prevent cancer. These dietary restrictions in combination with other holistic cancer treatments can be a powerful way to affect cancer without the use of chemotherapy or other traditional cancer treatments.
Organic Plant Foods: All plant foods contain nutrients that aid healing. Leafy green vegetables, cruciferous vegetables (broccoli, cabbage, cauliflower, etc.), sea vegetables, fruits, garlic, ginger, and turmeric have the potential to protect against and fight off the proliferation of cancer. These foods are also known to strengthen and cleanse the body.
Quinoa, Lentils, and Almonds: Eliminate all animal protein if possible. Replace meat with other sources of protein, such as quinoa or lentils. If you don’t want to completely cut out meat, you should restrict yourself to small amounts of organic, pasture-fed beef or poultry and wild-caught fish.
Tomatoes: Tomatoes are a source of a potent antioxidant carotenoid called lycopene. This superfood is also a good source of vitamins A, C, and E, each of which help fight against cancer-friendly free radicals. Making homemade organic tomato sauce can be a delicious way to incorporate this valuable food into your diet.
Nuts: Nuts contain phytochemicals that are known to fight several different types of cancer. Additionally, nuts are rich in copper. Many studies have found a connection between copper deficiency and increased risk of cancer. Nuts are a healthy, on-the-go snack that can effectively hold you over until your next meal.
Green Tea: Green tea is filled with beneficial antioxidants, including a catechin called EGCG. These antioxidants are known to inhibit the development of new blood cells that nourish cancer tumors, which can speed up the death of these tumors. Green tea is a good alternative to your morning coffee because it not only gives you that much-needed caffeine boost, but it’s packed with beneficial, cancer-fighting nutrients.
Broccoli Sprout: Broccoli is a concentrated source of sulforaphane, which has been known to block the growth and progression of cancer tumors. Steamed or roasted broccoli can be a tasty addition to any meal. However, broccoli is even healthier when added to a salad and eaten raw.
Citrus Fruits: The flavonoids and vitamin C in citrus fruits have cancer fighting properties. Citrus fruits seem to block cancer cells from invading your body’s healthy tissues. Adding lemon to your water can be an easy way to sneak more citrus into your diet.
Red Grapes: Grapes are rich in resveratrol, a powerful anti-cancer agent that fights chronic inflammation. Try freezing grapes for a healthier alternative to your favorite frozen desserts.
Apples: Apples’ unique combination of phytochemicals makes them an excellent source of anti-cancer nutrients. The apple peel is especially rich in antioxidants. Like they always say, “An apple a day keeps the doctor away!”
According to the physicians of the EuroMed Foundation, a well-established alternative cancer treatment center in Arizona, cancer treatment plans should be highly individualized to each patient’s needs. Talk to your doctor about incorporating dietary changes into your treatment. Cutting out processed foods and replacing them with organic, nutrient-rich ones can boost your cancer therapies and provide many other benefits.
Supportive care for kidney cancer
Supportive care helps people meet the physical, practical, emotional and spiritual challenges of kidney cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.
Recovering from kidney cancer and adjusting to life after treatment is different for each person, depending on the stage of the cancer, the type of treatment and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A person who has been treated for kidney cancer may have the following concerns.
Living with one kidney
You can live a normal and healthy life with one working kidney or with only part of a kidney. Your remaining kidney tissue can still filter waste and extra water from the blood.
It’s important that you take care of your remaining kidney. You can help keep your kidney working properly by doing the following.
Smoking is the strongest risk for developing kidney cancer. It also increases the risk that kidney cancer will come back. If you smoke, get help to quit.
Talk to a dietitian about your diet
When the remaining kidney is healthy, you usually don’t need to make any changes to your diet. If the remaining kidney is not completely healthy or you only have part of a kidney, talk to a dietitian about changes you can make to your diet.
Try to eat less protein such as meat, fish, eggs, milk and products or beans. Eating too much protein puts stress on the kidney.
Lower the amount of salt in your diet. Avoid pretzels, chips, popcorn, cured and canned meat, fish and poultry. Don’t add salt to your food and limit how often you eat food from restaurants. The kidneys filter salt from the blood. If there are high levels of salt in your food, the remaining kidney has to work harder.
Limit how much phosphorus you eat. When your kidneys aren’t working very well, the phosphorus levels in your blood may go up. This can cause problems like joint pain. Your dietitian may suggest you limit foods that are high in phosphorus, such as nuts, seeds, peanut butter, lentils and beans.
Limit how much fluid you take in, such as water, coffee, tea, soup, gelatin dessert and ice cream. Staying well-hydrated is important, but extra fluids can put a strain on your kidneys.
Limit the amount of alcohol you drink. Drinking large amounts of alcohol can cause kidney damage. If you chose to drink alcohol, have no more than 1 drink a day.
When the kidneys don’t work properly (called kidney failure), dialysis is needed to remove wastes from the blood. Kidney failure may be a short-term or long-term side effect of treatments for kidney cancer. In rare cases, people may need to have dialysis for the rest of their lives because both kidneys were removed, or their one working kidney was removed.
Hemodialysis uses a machine to filter wastes and extra water from the blood. A special tube (called a dialysis catheter) is placed into a large vein in your body. Your blood is removed from your body in small amounts, filtered by the machine and then returned to your body.
You will have hemodialysis 3 times a week. You will be connected to the machine for a number of hours for each hemodialysis session. If you need to be on dialysis for the rest of your life, the surgeon will place a permanent access to your bloodstream during a surgical procedure.
Peritoneal dialysis uses the membrane that surrounds the organs in your abdominal cavity (called the peritoneum). The most common type of peritoneal dialysis is called continuous ambulatory peritoneal dialysis (CAPD).
The doctor places a tube (catheter) through the muscles in your abdomen. This tube is left in place permanently. During dialysis, the healthcare team attaches bags filled with a special dialysis solution to the tube. This solution flows into your abdomen. The peritoneum allows waste products and extra fluid to pass from the blood into the dialysis solution. The dialysis solution stays in your abdomen for many hours absorbing the wastes. The solution is then drained and replaced with fresh solution.
The advantage of peritoneal dialysis is that it can be done at home, which allows you to continue your activities of daily living.
A dietitian may suggest a special diet to help keep you healthy while you’re on dialysis. They may suggest:
- limiting the amount of fluids that you take in
- eating a high-protein diet (because protein is lost during dialysis)
- lowering the amount of salt, potassium and phosphorus in your diet
Questions to ask about supportive care
To make decisions that are right for you, ask your healthcare team questions about supportive care.
7 Kidney-Friendly Superfoods
Most natural foods provide nutritional benefits, but some are considered superfoods. While there is no scientific definition of the term “superfood,” most consider it to be a food that has an unusually high amount of antioxidants, vitamins or other nutrients.
Here are 7 kidney-friendly* superfoods that pack a nutritional punch for overall health:
- Apples: Apples are a good source of pectin, a soluble fiber that can lower cholesterol and glucose levels. And don’t forget the peel! It is a significant source of antioxidants, including one called quercetin, which is thought to protect brain cells. Fresh apples are also a good source of Vitamin C. For a tasty treat, sprinkle apples with cinnamon.
- Blueberries: Ranked #1 among fresh or frozen fruits and vegetables in antioxidant power, blueberries are a low-calorie source of fiber and Vitamin C. They are being studied for their potential to protect against cancer and heart disease and for possible brain health benefits. You can find fresh berries in season at farmers’ markets or your local supermarket. In the off-season, frozen berries are a good substitute. Eat them raw, mix them in a fruit smoothie or add them to cereal.
- Fish High in Omega-3 Fatty Acids: Omega-3 fatty acids are essential nutrients our body cannot make, so we must get them through the foods we eat. They have many important functions in the body including controlling blood clotting and building cell membranes in the brain. Omega-3 fatty acids have been shown to decrease risk of abnormal heartbeats, decrease triglyceride levels and slightly lower blood pressure. They are being looked at for their potential benefits for conditions such as cancer, autoimmune diseases and inflammatory bowel diseases. Salmon is a favorite “go-to” source of omega–3 fatty acids, but you can also consider mackerel, albacore tuna, herring and sardines.
- Kale**: This glorious green is packed with Vitamins A and C, calcium and many other important minerals. Kale is also a serious source of carotenoids and flavonoids, which may translate to super eye health and anti-cancer benefits. Kale contains significant sources of Vitamin K. People taking blood thinners, such as warfarin, should speak to their health care provider before adding to their normal diet any foods high in Vitamin K. Its peak season is winter, which makes kale a great choice during a season with fewer fresh veggie choices. Replace those unhealthy potato chips in your pantry with baked unsalted kale chips. Simply slice, drizzle with olive oil and bake!
- Strawberries: Strawberries may be small in size, but they are big in benefits! This delicious red fruit is a powerhouse of vitamins, antioxidants and fiber. The fiber and nutrients in strawberries have been associated with heart protection, as well as anti-cancer and anti-inflammation properties. Toss them in a salad or even eat them plain for a healthy treat!
- Spinach***: This leafy green vegetable is high in vitamins A, C, K and folate. The beta-carotene found in spinach is important for boosting your immune system health and protecting your vision. It is also a good source of magnesium. Instead of lettuce in your salad, try spinach. You can also easily incorporate spinach into your diet by making a simple side dish of steamed spinach, spiced up with garlic and olive oil.
- Sweet Potatoes**: These super spuds are packed with beta-carotene and are an excellent source of vitamins A and C. Sweet potatoes are also a good source of vitamin B-6 and potassium. One medium (5-inch long) sweet potato contains 112 calories and nearly 4 grams of fiber, according to the USDA National Nutrient Database. You can eat them mashed or even make your own oven-baked fries.
*This article is meant to offer general health information. Before you make changes to your daily diet, consult with your doctor, dietitian or other healthcare practitioner to ensure your diet meets your nutritional and overall needs.
**Kale is considered a medium potassium food choice and should be limited by people on dialysis and those with a dietary potassium restriction.
**Spinach and sweet potatoes are considered high potassium food choices and should be limited by people on dialysis and those with a dietary potassium restriction.