Kidney cancer: diagnosis and management

When referring someone with suspected renal cell carcinoma (RCC) for initial investigations, follow the recommendations in the section on patient information and support in NICE's guideline on suspected cancer.

Healthcare professionals in all settings (including primary care, genetics services and multidisciplinary services) should provide ongoing information and support to people with suspected or confirmed RCC, based on a personalised assessment of what the person needs at different times, in line with:

• NICE's guideline on patient experience in adult NHS services, particularly the recommendations on:

  • patient views and preferences

  • patient concerns

  • communication

  • information

  • knowing the patient as an individual

  • continuity of care and relationships

  • an individualised approach to services

  • involvement of family members and carers

• NICE's guideline on shared decision making, particularly the recommendations on:

  • putting shared decision making into practice

  • communicating risks, benefits and consequences

• NICE's guideline on workplace health

• NICE's guideline on people's experience in adult social care services, particularly the recommendations on co-production and enabling people to make decisions.
  
  See also section 3.5 (management communication and shared decision making) in the Getting It Right First Time (GIRFT) guide Urology: Towards better care for patients with kidney cancer.

Offer clinical nurse specialist support in secondary care to people with suspected or confirmed RCC during diagnosis, management and follow-up or palliative care.

The clinical nurse specialist supporting the person with suspected or confirmed RCC should:

• act as the key worker to address the person's information and care needs and

• give their contact details to the person and

• have training and experience in kidney cancer care and

• attend multidisciplinary team meetings and

• act as a link between the urology and oncology teams and

• liaise between secondary and primary care, supporting communication and care coordination.

Give the person with suspected or confirmed RCC the contact details for a cancer care navigator, if available.

Throughout their care, discuss with the person with RCC how they are coping with emotions such as sadness, depression and anxiety, and feeling out of control over the outcome of the disease and treatment. Signpost the person to voluntary or community emotional support services, or refer the person to NHS psychological health support services, if and when appropriate.

See also NICE's guideline on depression in adults with a chronic physical health problem.

Offer support to help people with RCC who currently smoke to stop smoking, in line with NICE's guideline on tobacco.

Discuss involvement in clinical trials and other types of research with people with RCC, including:

• where to find information (for example, Be Part of Research, Action Kidney Cancer, Kidney Cancer UK and ISRCTN: The UK's Clinical Study Registry)

• opportunities for research involvement in their centre and others

• the benefits and risks of entering clinical trials and other studies.

Trusts, health boards and any other relevant healthcare providers should consider conducting annual satisfaction surveys of people with RCC – developed by their uro-oncology multidisciplinary team and people with RCC – and use the results to guide quality improvement programmes.