In this conversation with Dr. Toni Choueiri, a leading kidney cancer expert at Dana-Farber Cancer Institute, he shares practical guidance on complementary therapies, exercise, and strategies to maintain quality of life. He offers encouragement for patients and families facing a diagnosis, emphasizing the importance of a whole-body approach for navigating treatment and side effects. View the full webinar for the full discussion on treatment options, clinical trials, new research, and more.
The following questions and responses have been lightly edited for grammatical purposes.
1) Are there integrative oncology or complementary therapies that kidney cancer patients could discuss with their doctors to help manage side effects?
Dr. Choueiri: Absolutely. I’m a big believer in this, especially for managing side effects rather than directly treating cancer. That’s where the support system, nursing, nutrition, and other care team members come in.
Some of our drugs, particularly anti-angiogenic targeted therapies like sunitinib, pazopanib, and cabozantinib, can cause side effects such as hand-foot skin reactions or neuropathy. We often involve dermatologists or podiatrists, and some patients benefit from acupuncture to help with pain or neuropathy.
Many patients also experience taste changes, called dysgeusia, which can make eating difficult. Sometimes simple interventions, like sucking on a lemon a couple of times a day, can help restore taste. Steroid rinses can help for patients on everolimus. Massage therapy may help with chronic pain.
We also cannot forget mental health. Cancer brings stress, anxiety, and emotional challenges. Social workers, therapists, and complementary therapies can be valuable in helping patients cope. It’s important to consider these approaches and not overlook their benefits.
2) How do you balance treatment effectiveness with quality of life, especially for patients with metastatic disease?
Dr. Choueiri: Sometimes we have to address side effects step by step. For example, if a patient has severe diarrhea, we start with dietary changes, then medications like Imodium, or even codeine in some cases. If these don’t work, dose reduction or interruption may be necessary.
We always try to maintain the highest effective dose, but quality of life is crucial. Simple adjustments can make a big difference for patients’ day-to-day well-being.
3) What role does exercise play for kidney cancer patients?
Dr. Choueiri: Exercise is very important. It’s something hard to do, especially if your mental health is suffering. I would say, integrate exercise as much as possible. It’s the most natural and effective antidepressant you can have.
Start with any exercise, even brisk walking or biking. It’s not like you have to do pilates or yoga and spend thousands of dollars. Now, you may not also want to become a running back for your local team. You have to be careful with age, but sweating and the endorphins that are released is great for everything.
Exercise is good, but I do feel like it’s very hard. It’s hard on me and it’s probably 10 times harder on a patient.
4) What message would you share with patients and families who may feel overwhelmed or isolated after a kidney cancer diagnosis?
Dr. Choueiri: You are not alone. We are here and we have a growing kidney cancer community. Kidney cancer is not uncommon; it’s one of the top 10 cancers. There is hope in stage IV disease. Multidisciplinary research is extremely active. It has changed the survival of stage IV from 1 year to 5 years on average, and there’s more to come.
It doesn’t mean we won’t see patients dying of kidney cancer, but it seems we can see more patients alive with kidney cancer. Hopefully, they can thrive and stay until the next clinical trial, until the next drug comes, so they can celebrate a milestone in their life. There is hope. It’s not doom and gloom.
Watch the full webinar here.
