Brian Shuch, MD, director of the UCLA Kidney Cancer Program, discusses the treatment of large kidney tumors. Historically, most kidney cancers presented as large masses, but with advancements in imaging, many tumors are now detected early. Large renal tumors are considered to be 7 cm or greater, accounting for about 15% to 25% of kidney tumors. These tumors can cause symptoms such as blood in the urine, flank pain, and an abdominal bulge. The risk of a large tumor being cancerous is greater than 95% when it exceeds 13 cm. The main treatment for large kidney tumors is radical nephrectomy, where the kidney is removed along with the surrounding fat and connective tissue. In some cases, a partial nephrectomy can be performed. The surgical approach depends on various factors, including the tumor’s size and location, and the patient’s body habitus. Minimally invasive surgery, including laparoscopic and robotic-assisted surgery, can be used to remove large tumors, reducing bleeding, pain, hospital stay, and postoperative recovery.