Doctors are finding more small kidney cancers than ever before, often showing up by accident when someone gets a CT scan for something else entirely, like a prostate or ovarian issue. While catching cancer early is usually good news, it puts a lot of pressure on hospitals to find the right way to treat it without overdoing it.

A new study out of Denmark, published in the journal Radiology, suggests that a less invasive method called ablation is just as effective as traditional surgery for these small tumors. Instead of cutting the tumor out, doctors use extreme heat or cold to destroy it.

“These incidental cancers are putting increasing pressure on health care systems,” said lead author Iben Lyskjær, Ph.D. “While early detection improves outcomes, it also raises the need for better risk stratification and treatment options.”

Real-World Results

Researchers followed nearly 1,900 patients over almost a decade. It was a nationwide look at how patients across Denmark actually fared in everyday clinical practice.

“This is not a single center but a nationwide study that reflects the everyday clinical practice in Denmark and what happens to real patients in a national health care system,” Lyskjær said.

According to the researchers, patients who chose ablation usually went home the same day and had fewer hospital visits in the month following their treatment. While the cancer did come back in the same spot slightly more often for the ablation group (about 2.4% compared to 1.2% for surgery), those patients didn’t have worse survival rates.

“Although the local recurrence rate was slightly higher in the ablation group, tumors that recur can be successfully treated with another ablation or surgery,” Lyskjær noted. “Importantly, patients in the study who had local recurrences did not have worse overall survival.”

Giving Kidney Cancer Patients a Choice

The big takeaway is that there isn’t just one “right” way to handle these small tumors. Surgery is still the standard, but ablation offers a faster recovery with similar long-term safety.

“Our study demonstrated that the overall progression rates were low across all treatment modalities, supporting the effectiveness of both ablation and resection for T1a renal cell carcinoma,” Lyskjær said.

Since some of these small, accidentally discovered tumors might never even become aggressive, choosing a lighter touch makes sense for many. As Lyskjær puts it: “The best choice depends not only on the patient’s characteristics, but also on the patient’s preferences. We should be showing patients data and asking the patients what kind of treatment they want.”