Within the second a part of our dialog with Dr. Ravi Munver, vice chair of Urology at John Theurer Most cancers Heart and chief of Minimally Invasive and Robotic Surgical procedure at Hackensack College Medical Heart,
Munver shares insights on how minimally invasive methods enable sufferers to protect kidney operate, the advantages of a multidisciplinary care method, and sensible steerage for navigating therapy and long-term follow-up.
CURE: What elements do you take into account when deciding between partial versus radical nephrectomy for a affected person?
Munver: The query of partial versus radical nephrectomy is a good one. Once I began my fellowship about 25 years in the past, we have been taking out the overwhelming majority of kidneys, even for small tumors the scale of a pea or a marble. Now, with the event of minimally invasive methods like laparoscopic surgical procedure and, most just lately, robotic surgical procedure, we’re in a position to provide partial nephrectomy for the overwhelming majority of our sufferers. The truth is, greater than 80% of the kidney most cancers surgical procedures that we do at Hackensack College Medical Heart are partial nephrectomies, so we will save the kidneys within the overwhelming majority of sufferers.
The sufferers that want radical nephrectomies are sufferers which have very massive kidney plenty. Generally they’ve multiple kidney mass, or the kidney is just not working very properly with a doubtlessly smaller tumor, during which case saving the kidney does not make any distinction if the kidney is just not functioning, or if sufferers have recurrence of tumors in that kidney that is probably not amenable to slicing the tumor out and reconstructing the kidney.
Simply yesterday, I had a really fascinating case of a gentleman who was 71 years outdated. He had a kidney biopsy as a result of he had an enormous mass that was invading deep into his kidney, and he was instructed by two different establishments within the space that he wanted his kidney eliminated. He got here to me as a result of the pathology outcomes got here again as kidney most cancers, and we painstakingly did a really complicated robotic partial nephrectomy yesterday, and have been in a position to take away the tumor, save his kidney and he went residence this morning.
How does multidisciplinary care at your middle enhance affected person outcomes and help total therapy planning?
The primary two folks I met after I got here to Hackensack College Medical Heart over twenty years in the past have been a medical oncologist and a radiation oncologist. I am a surgical oncologist, so I function on sufferers to take away cancers, however in conjunction, we’ve a multidisciplinary method towards kidney most cancers with our medical oncologist and our radiation oncologist. Within the cases {that a} kidney most cancers is metastatic or superior, these sufferers should profit from surgical procedure, however they could additionally want focused therapies, together with immunotherapies. Most of these therapies along with surgical procedure can provide sufferers higher outcomes than both focused therapies or immunotherapies or surgical procedure alone.
Our multidisciplinary method not solely consists of surgical oncologists just like the urologist, medical oncologists who administer immunotherapies, focused therapies, and chemotherapies, and radiation oncologists that administer radiation remedy, however we additionally work with our radiologists and our pathologists to have a look at imaging research, to have a look at the pathology reviews once we take away a tumor or carry out a biopsy of a tumor. And we additionally work with our nephrologists, or medical kidney medical doctors, in sufferers which have pre-existing kidney illness or who could develop kidney illness down the street in the event that they produce other medical issues which will predispose them to doubtlessly needing dialysis sooner or later.
For sufferers who’re newly identified with kidney most cancers, what key recommendation would you give about navigating therapy choices and extra long-term care?
For sufferers which are just lately identified with kidney most cancers, it will be significant for them to do quite a lot of various things.
Primary, they should perceive the illness course of. Kidney most cancers is extremely treatable and extremely curable within the overwhelming majority of circumstances, when the cancers are detected early.
Quantity two, sufferers have to go to a middle of excellence. Hackensack College Medical Heart is one such middle the place we satisfaction ourselves in providing not solely the newest in imaging applied sciences, percutaneous biopsies, which implies by way of the pores and skin, to biopsy tumors, surgical therapies with robotics, immunotherapies, focused therapies and radiation therapies. We’re a premier middle for kidney most cancers, and it is necessary for sufferers with kidney most cancers to go to facilities of excellence in order that they will obtain the most effective therapy that’s specialised for them.
Quantity three, they should perceive that even after receiving a remedy, whether or not it is surgical procedure or whether or not it is radiation or whether or not it is some kind of focused remedy or immunotherapy, that it may be a protracted course. Once I say a protracted course, I imply that even when sufferers are cured at yr one or yr two, they will proceed their relationship with their surgeon or their medical oncologist or their radiation oncologist, such that they continue to be cancer-free for the remainder of their life. So annual visits are necessary. The lengthy haul by way of follow-up is very necessary in order that sufferers can stay wholesome and disease-free, completely.
Transcript has been edited for readability and conciseness.
Reference
- Understanding Latest Remedy Developments in Kidney Most cancers Care, by Ryan Scott. CURE; Sept. 22, 2025. https://www.curetoday.com/view/understanding-recent-treatment-advancements-in-kidney-cancer-care
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