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A less invasive approach to kidney tumors

April 16, 2015 | Camila Hernandez

A growth on a kidney can pose a dilemma.

Traditionally, the safest way to find out whether it is cancerous – without possibly spreading cancer cells, if it is indeed malignant – has been to remove the entire kidney. But that practice has resulted in a high rate of healthy kidneys being removed. Until now.

No risk of spreading cancer 

UCI Health urologist Dr. Jaime Landman and his team at the Center for Urological Care recently developed an innovative ultrasound technique that enables urologists to safely perform kidney biopsies without the risk of seeding – that is, spreading malignant cancer cells throughout the body. The minimally invasive technique prevents patients from having unnecessary kidney surgery.

Typically when a mass is found in the kidney, no biopsy is performed to determine if it is cancerous. Because biopsies are considered to be risky procedures that require a great deal of precision and skill to prevent seeding and other complications, urologists recommend removing the organ altogether.

Nationally, up to 30 percent of kidney surgeries are unnecessary because tumors are later revealed to be benign.

“In a traditional biopsy, an ultrasound probe is used to identify the location of the tumor. Then, a biopsy needle is deployed next to the probe,” Landman said. “It takes a certain level of skill to accurately target the tumor using this method because the needle and the probe are separate.”

Safer and more accurate

With the help of industry leaders, Landman and his team devised a safer and more accurate ultrasound-guided technique, which allows the biopsy needle to go through the probe itself. For even greater accuracy, the ultrasound machine projects a virtual dotted line on a screen that shows the path the needle will follow once it is deployed, targeting the tumor with precision and significantly reducing the risk of seeding.

After thorough testing in the lab, the urology team at UCI Health began performing the ultrasound-guided kidney biopsy procedure on patients, with excellent results.

Yorba Linda resident David Pearl, 71, is one of the patients who has benefited from the new procedure. He remembers being startled by news that a growth was found in his kidney. “The specialist who discovered it told me he was certain it was cancerous and I would need surgery right away,” Pearl said.

Getting a second opinion

Pearl and his wife, Ricki, asked for a second opinion and were referred to Landman at the UCI Health Center for Urological Care. After reviewing Pearl’s records, Landman thought the tumor might not be cancerous and that surgery might not be necessary. He recommended instead that Pearl undergo the innovative biopsy procedure to confirm his opinion.

Landman was right. Within a week of having his kidney biopsied, Pearl received the good news: he did not have cancer and would likely never need surgery.

Like Pearl, many of the patients Landman biopsies turn out to have benign tumors and do not need surgery to remove the kidney.

“We developed this technique with our patients in mind. We want to provide them with options and avoid unnecessary procedures,” Landman said. “At UCI Health, we are truly changing the way we diagnose and treat kidney cancer. No other medical center in Orange County is doing this. I’m surprised we’re not doing this all over the world.”

David Pearl's story

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