Kidney Cancer

What is kidney cancer?

Kidney cancer is the abnormal growth of cells in your kidney tissue. In time, these cells form a mass called a tumor. Cancer begins when something triggers a change in the cells, and they divide out of control.

A cancerous or malignant tumor can spread to other tissues and vital organs. When this happens, it’s called metastasis.

Who does kidney cancer affect?

Kidney cancer is most common in people between the ages of 65 and 74. Men are twice as likely as women to develop the disease. It’s also more common in Native American and Black populations.

Kidney cancer is much less common in children. However, 500 to 600 children are diagnosed with a Wilms tumor (a type of kidney cancer) every year in the United States.

What are the types of kidney cancer?

There are different types of kidney cancer, including:

• Renal cell carcinoma (RCC): This is the most common form of kidney cancer in adults and accounts for 85% of all kidney cancers. Renal cell carcinoma usually develops as a single tumor in one kidney, but it can affect both kidneys. The cancer begins in the cells that line your kidney’s tubules (tiny tubes that return nutrients and fluid back to your blood). The most common type of RCC is clear cell renal cell carcinoma (ccRCC).
• Transitional cell cancer: Transitional cell carcinoma accounts for 6% to 7% of all kidney cancers. This cancer usually begins in the area where your ureter connects to the main part of your kidney. This area is called your renal pelvis. Transitional cell carcinoma can also occur in your ureters or bladder.
• Renal sarcoma: This is the least common form of kidney cancer, accounting for only 1% of kidney cancer cases. It begins in the connective tissues of your kidneys and, if not treated, can spread to nearby organs and bones.
• Wilms tumor: This is the most common type of kidney cancer in children. It accounts for about 5% of kidney cancers.

How common is kidney cancer?

Kidney cancer represents about 3.7% of all cancers in the United States. Each year, more than 62,000 Americans are diagnosed with kidney cancer. The risk of kidney cancer increases with age.

What are the signs of kidney cancer?

Kidney cancer may not produce any noticeable symptoms in its early stages. But as the tumor grows, symptoms may begin to appear. For that reason, kidney cancer often isn’t diagnosed until it has begun to spread.

Kidney cancer symptoms may include:

• Blood in your pee (hematuria).
• A lump or mass in your kidney area.
• Flank pain.
• Tiredness.
• A general sense of not feeling well.
• Loss of appetite.
• Weight loss.
• Low-grade fever.
• Bone pain.
• High blood pressure.
• Anemia.
• High calcium.

What is the primary cause of kidney cancer?

The exact cause of kidney cancer isn’t known, but there are certain risk factors that may increase your chances of getting the disease. These include:

• Smoking: People who smoke are at greater risk for kidney cancer. In addition, the longer a person smokes, the higher the risk.
• Obesity: Obesity is a risk factor for kidney cancer. In general, the more overweight a person is, the higher the risk.
• High blood pressure: Also called hypertension, high blood pressure has been linked to an increased risk of kidney cancer.
• Family history: People who have family members with kidney cancer may have an increased risk of developing cancer themselves.
• Radiation therapy: Women who have been treated with radiation for cancer of their reproductive organs may have a slightly increased risk of developing kidney cancer.
• Gene changes (mutations): Genes contain instructions for a cell’s function. Changes in certain genes can increase the risk of developing kidney cancer.
• Long-term dialysis treatment: Dialysis is the process of cleaning your blood by passing it through a special machine. Dialysis is used when a person’s kidneys aren’t functioning properly.
• Tuberous sclerosis complex: Tuberous sclerosis is a disease that causes seizures and intellectual disabilities, as well as the formation of tumors in many different organs.
• von Hippel-Lindau disease (VHL): People with this inherited disorder are at greater risk for developing kidney cancer. This disorder causes noncancerous tumors in your blood vessels, typically in your eyes and brain.

How serious is a tumor on the kidney?

It depends. Some kidney tumors are benign (noncancerous). These tumors are generally smaller than cancerous tumors and don’t spread to other parts of your body. Surgical removal is the most common treatment for noncancerous kidney tumors.

Whether your kidney tumor is cancerous or noncancerous, you should move forward with treatment as soon as possible to avoid complications.

How is kidney cancer diagnosed?

If you have kidney cancer symptoms, your healthcare provider will perform a complete medical history and physical exam. They also may order certain tests that can help in diagnosing and assessing cancer. These tests may include:

• Urinalysis: A sample of your urine (pee) is tested to see if it contains blood. Even very small traces of blood, invisible to the naked eye, can be detected in tests of urine samples.
• Blood tests: These tests count the number of each of the different kinds of blood cells, as well as look at different electrolytes in your body. A blood test can show if there are too few red blood cells (anemia), or if your kidney function is impaired (by looking at the creatinine).
• CT scan: This is a special X-ray that uses a computer to create a series of images, or slices, of the inside of your body. This test is often done with intravenous contrast (dye). People with impaired kidney function may not be able to receive the dye.
• Magnetic resonance imaging (MRI): This is a test that produces images of the inside of your body using a large magnet, radio waves and a computer.
• Ultrasound: This test uses high-frequency sound waves that are transmitted through body tissues to create images that are displayed on a monitor. This test is helpful in detecting tumors, which have a different density from healthy tissues.
• Renal mass biopsy: During this procedure, a thin needle is inserted into the tumor, and a small sample of your tissue is removed (biopsy). A pathologist will look at the tissue under a microscope to see if there are any cancer cells. Because biopsies for kidney cancer aren’t always completely reliable, your healthcare provider may or may not recommend this test.

What are the kidney cancer stages?

Most cancers are grouped by stage, a description of cancer that aids in planning treatment. The stage of a cancer is based on:

• The location and size of the tumor.
• The extent to which your lymph nodes are affected.
• The degree to which the cancer spread, if at all, to other tissue and organs.

Your healthcare provider uses information from various tests, including CT, MRI and biopsy, to determine the stage of cancer.

• Stage I: The tumor is 7 centimeters (cm) across or smaller and is only in your kidney. It hasn’t spread to lymph nodes or other tissue. (Lymph nodes are small “filters” that trap germs and cancer cells and store infection-fighting cells.).
• Stage II: The tumor is larger than 7 cm across but is still only in your kidney. It hasn’t spread to lymph nodes or other tissue.
• Stage III: The tumor has spread to your major blood vessels — your renal vein and inferior vena cava — or into the tissue surrounding your kidney or to nearby lymph nodes.
• Stage IV: The tumor has spread outside of your kidney to your adrenal gland (the small gland that sits on top of your kidney), or to distant lymph nodes or other organs.

Tumors are also graded, which is a way of rating a tumor based on how abnormal its cells look. Tumor grading can also tell your healthcare provider how fast the tumor is likely to grow. Tumors whose cells don’t look like normal cells and divide rapidly are called high-grade tumors. High-grade tumors tend to grow and spread more quickly than low-grade tumors.

How is kidney cancer treated?

Kidney cancer treatment depends on the stage and grade of the tumor, as well as your age and overall health. Options include surgery, ablation, radiation therapy, targeted drug therapy, immunotherapy and sometimes chemotherapy.

Surgery

Surgery is the treatment of choice for most stages of kidney cancer. Several surgical options may be considered, including:

• Partial nephrectomy: Your surgeon removes the part of your kidney that contains the tumor.
• Radical nephrectomy: Your surgeon removes your entire kidney and some of the tissue around it. They may also remove some lymph nodes in the area.

When one kidney is removed, the remaining kidney is usually able to perform the work of both kidneys.

Ablation

Sometimes, heat and cold can destroy cancer cells. People who aren’t candidates for surgery may benefit from cryoablation or radiofrequency ablation.

• Cryoablation: During this procedure, your healthcare provider inserts a needle through your skin and into the kidney tumor. The cancer cells are then frozen with cold gas.
• Radiofrequency ablation: Your healthcare provider inserts a needle through your skin and into the kidney tumor. Next, an electrical current is passed through the cancer cells to destroy them.

Radiation therapy

Your healthcare provider may recommend radiation therapy if you only have one kidney or if you’re not eligible for surgery. Radiation therapy is most often used for easing kidney cancer symptoms, such as pain.

Targeted drug therapy

Targeted drug therapy blocks certain characteristics that help cancer cells thrive. For example, these drugs can stop the growth of new blood vessels or proteins that feed cancer.

Targeted drug therapy is often used when surgery isn’t an option. In some cases, these medications may be given after surgery to reduce the risk of cancer coming back.

Immunotherapy

Immunotherapy uses certain medications to boost your own immune system. In turn, this helps your body recognize and destroy cancer cells more effectively. Immunotherapy may be given as a standalone treatment or along with surgery.

Chemotherapy

Chemotherapy isn’t a standard treatment for kidney cancer. But it can be helpful in some cases — usually only after trying immunotherapy and targeted drug therapy. Chemotherapy medications are taken by mouth or given through a vein (intravenously) and are generally well tolerated.

Is kidney cancer preventable?

Because the exact cause of kidney cancer is unknown, there isn’t a way to prevent it altogether. However, you may be able to reduce your risk by not smoking and managing certain conditions like high blood pressure, diabetes and obesity.

What can I expect if I have kidney cancer?

Your kidney cancer prognosis depends on the type and stage of cancer (whether it’s just in your kidney or has spread to other places in your body). The chance of recovery also depends on your general state of health.

Is kidney cancer curable?

Like most cancers, kidney cancer is most treatable when found in its early stages. In general, if the cancer is detected early, before it breaks through the outer covering of your kidney, kidney cancer is often curable.

When should I see my healthcare provider?

If you develop kidney cancer symptoms, such as pain in your side, a lump near your kidney or blood in your pee, schedule an appointment with your healthcare provider right away. They can run tests to determine the cause of your symptoms and develop a personalized treatment plan.

What questions should I ask my healthcare provider?

Learning everything you can about your kidney cancer diagnosis can empower you and help you make informed decisions about your treatment. Here are some questions to ask your healthcare provider:

• What type of kidney cancer do I have?
• Where is the tumor?
• Is the cancer localized, or has it spread?
• What stage of kidney cancer do I have?
• What are my treatment options?
• What’s my prognosis?

A note from Cleveland Clinic

Receiving a kidney cancer diagnosis can be scary, saddening and frustrating. Like most cancers, kidney cancer treatment is more effective when it’s diagnosed early on. Your healthcare provider can talk with you about your treatment and give you additional resources to help you understand your options. You may also want to join a local support group or seek the help of a counselor or social worker. These things can help you maintain a healthy emotional outlook during this challenging time.