Patients may also present with a dull, aching flank pain or a palpable abdominal mass. Other presenting symptoms include fever, weight loss, anemia, and hypercalcemia. Nephrectomy is not usually performed in patients with disseminated disease. Bleeding, pain, and fever related to tumor growth can usually be better controlled by angioinfarction. Regional retroperitoneal lymph node dissection is often performed along with radical nephrectomy, although its impact on survival is not clear.
Pain can be quite severe after nephrectomy.
Patients may experience incisional pain and, as a result of the position on the operating table, muscular discomfort as well. After surgery, relief can be provided with moist heat, massage, and pillows to support the patient's back while they are lying on their side. The use of radiotherapy for renal cell tumors is controversial, but pre- and postoperative radiotherapy may be combined with nephrectomy. Chemotherapy has not been effective in the treatment of renal cell carcinoma. Respiratory distress, coma and myocardial infarctions have also been reported.