Cleveland Clinic is known around the world for its advances in the treatment of kidney disease, including cancer. In the past, the typical kidney cancer treatment was the removal of the entire kidney, called total nephrectomy. Cleveland Clinic urologists have the world’s largest experience in partial nephrectomy, removing only the cancerous part of the kidney. This kidney-sparing surgery, which is just as effective but keeps kidney tissue that may be required later in life, requires surgical expertise in both kidney reconstruction and vascular surgery techniques. This kidney cancer treatment technique was pioneered by the late Andrew C. Novick, MD, former Chairman of the Glickman Urological and Kidney Institute.
The Glickman Urological and Kidney Institute has performed more that 3,000 kidney sparing operations for kidney cancer, representing the largest experience in the world with this type of kidney surgery. Cleveland Clinic is one of the first U.S. medical centers to offer a minimally invasive approach to partial nephrectomy for selected patients. This gives patients the benefits of less pain after kidney surgery, a shorter hospital stay and faster return to normal activities.
What is kidney cancer?
As with all cancers, kidney cancer and benign tumors evolve from a disruption in one or more genes in a cell's DNA. Genes control cell activities including division and growth. When cells die, a normal and common event, they are replaced by new cells as the body needs them. However, when the genes that orchestrate this natural replacement process are disrupted by chemicals, illness, or other unknown factors, control over cell division and growth is lost. The resultant uncontrolled mass of tissue is a tumor.
Approximately 85% of all kidney cancers are renal cell carcinoma (RCC). This cancer develops in the tubules and is usually a single tumor although there have been instances in which there are more than one tumor. Transitional cell cancer (TCC) of the renal pelvis is less common accounting for about 8% of diagnosed cancers. Treatment for TCC is similar to treatment for bladder cancer. Sarcomas are malignant tumors growing from connective tissues, such as cartilage, fat, muscle or bone. They comprise approximately 3% of kidney cancers. Wilms' Tumor, a kidney cancer, affects infants and children and is rare. This kidney tumor usually appears before a child is three-years-old.
There are also a variety of benign growths. These are actually tumors but they are usually non-threatening initially. The five principal benign tumors are renal adenoma, renal oncocytoma, angiomyolipoma, fibroma and lipoma. The adenomas are the most common. Oncocytomas are not unique to the kidneys and can appear throughout the body. Angiomyolipomas are inherited and are associated with rare genetic disease called tuberous sclerosis. Fibromas are rare tumors that originate in the fibrous tissue in and around the kidney. They are more common in women. Lipomas originate in fat cells in and around the kidneys. They have the potential for becoming cancerous and are usually treated with nephrectomy – removal of the kidney. Most of these kidney tumors appear without symptoms and are usually discovered incidentally in the course of a routine examination or found while pursuing a diagnosis for another problem.
Catch Kidney Cancer Early – Know the Symptoms
Kidney cancer, which most often occurs in men 50 to 70 years old, rarely produces symptoms in its early stages. Eventually, though, a tumor in one of the kidneys may trigger one or more of the following:
- blood in the urine (most common symptom)
- persistent pain in the back, just below the ribs
- a lump in the abdomen
- general symptoms such as persistent fatigue, unexplained weight loss, recurrent fevers, high blood pressure, swelling in the ankles
- Being aware of these signs can help patients catch their condition and begin treatment as soon as possible.
Options for treating kidney cancer include surgery to remove the kidney, chemotherapy, radiation therapy, hormone therapy, and biological or immunotherapy. Sometimes, when the disease is tightly confined, treatment may involve removing only the affected portion of the kidney. This procedure is called a partial nephrectomy or nephron-sparing surgery and can help preserve the function of the involved kidney.