Embracing the New Normal After a Kidney Cancer Diagnosis
Not sure what to expect? Some things in life will change after kidney cancer—but these experts offer plenty of reassurances.by Sarah Ludwig Rausch Health Writer
You’ve just been diagnosed with kidney cancer. As you absorb the news, you may feel like the path you thought you were on has suddenly veered off into a thick fog, and you aren’t sure where to go. What will your diagnosis mean for your future? Where will it lead you? What aspects of your life are going to be different? What adjustments will you need to make?
It’s true that a cancer diagnosis is life-altering, sometimes in small ways, but often in bigger ones. “A kidney cancer diagnosis can change many things in a person’s life,” says Moshe Ornstein, M.D., a medical oncologist who specializes in treating the disease at the Cleveland Clinic. Let’s take a look at what your “new normal” might look like.
Experiencing many emotions is to be expected.
If your kidney cancer diagnosis has you riding an emotional roller coaster with no end in sight, take heart. “A new diagnosis of kidney cancer can make patients sad, anxious, or depressed,” Dr. Ornstein says. “This is a normal response.” He says it’s important to talk to your doctor about any emotional changes you’re having because there are tons of resources available that can help you work through it all. Not only are there therapists, social workers, and psychologists who specialize in treating people with cancer, there are also online and in-person support groups that can help you through your journey.
In addition, you should also make sure you have a candid and open relationship with your providers, says Sumanta “Monty” Pal, M.D., an American Society of Clinical Oncology (ASCO) expert in kidney cancer and co-director of the kidney cancer program at City of Hope Comprehensive Cancer Center in Duarte, CA. “Your relationship with your oncologist is a precious one,” he adds. “If not, consider switching.” Also, spending time with your loved ones and talking to them openly about what you’re dealing with is an important way to cope with your emotions.
Newer treatments are often better tolerated.
Obviously, no one wants to be diagnosed with cancer. Now that you have been, consider this: “Over the last 10 to 20 years, there has been tremendous progress in the field,” says Dr. Ornstein. “Most patients who have kidney cancer that [hasn’t spread beyond the kidney] will be cured with surgery. Of the smaller percentage of patients who have metastatic kidney cancer or kidney cancer that has come back, there are many new treatment options that have been shown to extend life while maintaining a good quality of life.”
Traditional chemotherapy is rarely used to treat kidney cancer, especially when it’s only in the kidney. “In general, the newer therapies we have, such as targeted therapies and immunotherapies, are much better tolerated,” Dr. Ornstein says. Targeted therapies are taken orally or through intravenous (IV) infusions. Examples include Inlyta (axitinib), Lenvima (lenvatinib), Sutent (sunitinib), and Votrient (pazopanib). Immunotherapies are given as IV infusions or injections and include Bavencio (avelumab), Keytruda (pembrolizumab), Opdivo (nivolumab), Yervoy (ipilimumab), and interleukin-2.
Post-op pain is usually well-managed.
If your kidney cancer diagnosis is still fresh, you may be wondering what’s in store for you in terms of pain management. It depends on the stage and extent of your cancer, Dr. Pal says. Dr. Ornstein says that if you need surgery, your pain will most likely be limited to the surgical area and will improve within days to weeks.
If you have metastatic kidney cancer, your pain might be related to the cancer and/or the cancer treatment. “In our practice, we work closely with palliative medicine physicians to optimize pain control,” says Dr. Ornstein. Ask your oncologist what sort of pain management services are available, Dr. Pal advises.
The good news? “Most patients do not require more than over-the-counter pain relievers to manage their pain,” Dr. Ornstein says.
A diet revamp may be in order.
If potato chips, soda, and other heavily processed foods played a big part in your diet before your diagnosis, you may want to consider a makeover. There’s no concrete evidence to recommend any specific dietary changes for people with kidney cancer, says Dr. Pal. That said, “I do recommend that, in the spirit of improving long-term outcomes, patients take on a good, heart-healthy diet,” he says.
So, what exactly does that mean? A heart-healthy diet means you focus on:
Eating more fruits, vegetables, and whole grains
Decreasing your intake of saturated and trans fats
Limiting processed foods such as white flour and white pasta, desserts, soda, and sweets.
Swapping out high-fat protein (think bacon, ribs, and whole milk) for lower-fat options such as skinless poultry, low-fat dairy products, fish, eggs, and legumes
Dr. Ornstein says you should keep in mind that side effects from your cancer treatment might limit what you can eat. Some of the medications used for kidney cancer can change your appetite and how food tastes, too. “In these instances, we refer patients to a dietitian to optimize their nutrition,” he says.
Reassessing your relationship with alcohol might be a good idea, too.
Will you still be able to savor your nightly glass of wine or mug of craft beer (or whatever alcoholic beverage you enjoy)? Probably not every night—but the occasional cocktail might be OK. Dr. Ornstein says you should talk to your doctor about what’s right for you when it comes to drinking. “There are many factors to consider, including the risk of the cancer coming back, the risk of the cancer getting worse, and the interaction of alcohol with cancer treatment,” he says. One benefit of limiting your alcohol intake is that doing so can help prevent dehydration, which “can pose a challenge to the kidneys,” Dr. Pal says.
Upping your exercising game is a good thing.
As with your diet, if you haven’t been great about getting in regular exercise before, this is a good time to rethink your fitness routine. “It is critical for patients who were recently diagnosed with kidney cancer to maintain a physically active lifestyle,” says Dr. Ornstein.
Another reason to get moving: The American Cancer Society says that getting 2.5 to 5 hours of moderate-intensity activity (like water aerobics, slow biking, or brisk walking) or 1.25 to 2.5 hours of high-intensity activity (like running, jump roping, and hiking) every week is linked to lowering your risk for seven different types of cancer. These include breast cancer, colon cancer, kidney cancer, endometrial cancer, liver cancer, non-Hodgkin lymphoma, and multiple myeloma.
To get going, think about activities you enjoy. Virtually anything you might be into—from dancing to kick boxing to yoga—can be found online, some for free. Even making small efforts like walking around the block a few times a day, taking the stairs instead of the elevator, parking further from the store entrance, and getting up from your chair every so often to move around is helpful. If you’re not used to exercising, try doing some gentle stretching, gradually increasing the number of steps you take every day. When in doubt, ask your doctor what he or she recommends.
If you’ve had (or are going to have) surgery for your kidney cancer, he says to be sure to talk to your surgeon about exercising safely since your body will need time to heal from surgery. Dr. Pal says that staying active will help you recover from surgery, as well as improve how well you tolerate any cancer treatments you might need that target your whole body.
Skimping on sleep should be a thing of the past.
It’s no surprise that getting good sleep on a regular basis is especially important when you have cancer. Sleep supports your body’s ability to heal, says Dr. Ornstein, and helps you tolerate the medications you may need to treat your cancer.
In general, good sleep hygiene involves optimizing your sleep habits, as well as your sleeping environment. Going to bed at the same time every night and getting up at the same time every morning, having a consistent bedtime routine, and maintaining a healthy lifestyle are ways to improve your sleep habits. You can optimize your bedroom by doing things like putting up blackout curtains, making sure your pillow and mattress are comfortable, and keeping your room cool at night.
If you have difficulty sleeping, Dr. Pal recommends seeing a therapist. Research has shown that a specific form of therapy called cognitive behavioral therapy for insomnia (CBT-I) can be extremely effective for treating sleep issues.
Your outlook on life may change—maybe for the better.
Remember, that there are lots of resources out there to help, Dr. Pal says. He recommends checking out sites like ASCO’s Cancer.Net (he chairs the kidney cancer sections) and other patient-based resources like the American Cancer Society to help you understand what you’re going through and what your treatment options are.
This time could also be a good opportunity to reassess where you want to go next. “While a cancer diagnosis can be devastating, it can afford an opportunity to refocus perspective on what is important in one’s life,” Dr. Pal says. “I have personally witnessed many patients deepen relationships with friends and family on account of their diagnosis.”
Heart-Healthy Diet: Cleveland Clinic. (2018.) “Heart Healthy Diet.” my.clevelandclinic.org/health/articles/17079-heart-healthy-diet
CBT-I: Mayo Clinic. (2016.) “Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills.” mayoclinic.org/diseases-conditions/insomnia/in-depth/insomnia-treatment/art-20046677
Sleep Hygiene: SleepFoundation.org. (2020.) “Sleep Hygiene.” sleepfoundation.org/articles/sleep-hygiene
Targeted Therapies: American Cancer Society. (2020.) “Targeted Therapy for Kidney Cancer.” cancer.org/cancer/kidney-cancer/treating/targeted-therapy.html
Immunotherapies: American Cancer Society. (2020.) “Immunotherapy for Kidney Cancer.” cancer.org/cancer/kidney-cancer/treating/immunotherapy.html