According to the recent years of responding to the online renal tumor patients’ inquiries and my experience of renal tumor diagnosis and treatment in the past few years, I found that there are many renal tumor patients who have misunderstandings about the diagnosis and treatment of this disease. Through this article, I can reduce repeated replies to the same questions and improve the patients’ accurate understanding of the diagnosis and treatment of this disease. 1.Suspecting kidney tumor and anxious to treat it, worrying that the tumor will grow up quickly As the saying goes, “the disease is urgent”, some patients are very tense and anxious when they discover kidney tumor by ultrasound, and they can’t sleep at night, so they don’t listen to the treatment plan provided by some unprofessional medical institutions. As a result, some middle and late-stage patients miss the time of surgery, and some early-stage tumor patients are over-treated, which increases patients’ pain and economic burden. For renal tumors found by ultrasound, it is better to go to large formal medical institutions to do enhanced renal CT to clarify the nature of the tumor and related conditions. We often find that the quality of CT provided by the patients is very poor, or the requirements are not in line with the details of renal cancer treatment (for example, renal blood vessels), which can only be reexamined in a short period of time, and it is not only a waste of money but also an increase in the amount of radiation of the patient’s x-rays. The viewpoint of early diagnosis and treatment of kidney tumor is right, but generally small kidney tumors do not grow fast, waiting for a week, a month, or even several months, the tumor will not grow up significantly to affect the choice of treatment plan, so do not be afraid of delaying the condition and choosing the treatment hastily without clearing up the diagnosis. The more expensive the examination for diagnosing renal tumor, the better. Some patients who found renal tumor on ultrasound want to clarify the nature of the tumor and firstly think of doing PET-CT in one step. Expensive PET-CT is very helpful for the diagnosis of lymph nodes and distant metastasis of renal tumor, but it is not advantageous for the judgement of the nature of renal tumor locally, which is not as good as common enhanced renal CT or enhanced magnetic resonance examination. Therefore, the examination should be carried out step by step according to the need. Enhanced CT and magnetic resonance can clarify the benign and malignant nature of renal tumors. At present, preoperative judgment of the nature of renal tumors mainly relies on enhanced CT or magnetic resonance, but the benign and malignant nature of the tumors ultimately rely on pathological examination to make it clear. Especially for some small renal tumors (less than 3cm), the accuracy rate of enhanced CT and MRI to determine the nature of the tumor is only about 80%, and the smaller the tumor is, the lower the accuracy rate is. Therefore, for the small renal cancers diagnosed by CT or MRI, we must be careful in choosing radical surgery so as to avoid unnecessary resection of kidneys. 4.Nephroprotective surgery cannot completely treat renal tumor As the discovery rate of early kidney has increased significantly, renal-protective surgery has become more and more common, and there are still many patients who are afraid that renal-protective surgery cannot completely treat the tumor and choose radical surgery. A lot of evidence-based medicine at home and abroad has confirmed that for renal tumors smaller than 4cm, as long as the location of the tumor is suitable, renal conserving surgery can completely treat renal tumors, and the effect is the same as that of radical surgery. The latest information shows that choosing the right 4-7cm renal tumor for kidney preservation surgery can also achieve complete treatment of the tumor. Of course, kidney preservation surgery is more difficult for doctors and may increase the incidence of some complications, but it is still controllable, especially for experienced doctors. Laparoscopic surgery for renal tumors is still immature Laparoscopy, as the trend of minimally invasive treatment, has been developing rapidly in China and can be said to be developing in parallel with foreign countries. Some domestic laparoscopic surgeons who have carried out the surgery earlier can be comparable with the first-class foreign experts, and this is even more true in the surgical treatment of renal tumors. At present, more than 80% of radical surgeries for renal tumors can be done laparoscopically, which can achieve the same effect as that of open surgeries and significantly reduce the trauma of patients, which has reached a consensus both at home and abroad. The technology of laparoscopic kidney preservation surgery is also mature, but the requirements for surgeons are higher, so the popularity is not very wide, and it is also a very good choice for experienced laparoscopic surgeons, depending on the actual situation. Laparoscopic surgery is very mature in the surgical treatment of renal tumors, especially in tertiary hospitals in big cities. 6.Metastatic advanced kidney cancer has no need for surgical treatment There are many metastatic advanced tumors and then more traumatic surgical treatment is really unnecessary, but kidney tumors are different from some other tumors. For some kidney cancer patients with distant metastasis such as lymph node or lung metastasis, if the patient’s systemic condition permits, it is still necessary to choose to remove the primary foci of kidney tumor or even distant metastatic foci if the difficulty of removing kidney tumors is not very big, which is helpful for patients to delay the survival time and improve the effect of adjuvant therapy. 7, All kidney cancers need auxiliary treatment after surgery Kidney cancer treatment firstly chooses surgery, and surgery is the only way to cure the tumor. We meet some patients who ask for adjuvant therapy because they are worried about recurrence and metastasis after tumor surgery. Some doctors will recommend some irregular adjuvant treatments to patients. In general, there is no need for special adjuvant examination for early-stage kidney cancer after radical surgery or kidney-sparing surgery, and only regular review is needed, and additional adjuvant treatment will not reduce the incidence of recurrence and metastasis of the tumor. There is no need for adjuvant chemotherapy, radiotherapy, immunotherapy with interferon or interleukin, or targeted therapy for early-stage renal cancer. These additional adjuvant treatments not only have no special effect on the tumor, but also produce side effects of the drugs, which may even affect the renal function. The high-dose interferon and interleukin immunotherapy and targeted therapy are for intermediate and advanced renal tumors, which should be used selectively to avoid adverse effects on patients. Some of the misunderstandings in the diagnosis and treatment of renal tumors are caused by the patients’ incomplete knowledge, some are caused by the fact that some doctors do not know how to mislead the patients to choose the treatment method, and some are caused by the doctors’ personal interests and induce the patients’ choices. Therefore, to eliminate these misunderstandings rely on patients and doctors to work together to achieve the best diagnosis and treatment results.