Kidney Cancer

Kidney cancer, also known as renal cancer, is a cancerous tumor in your kidneys. Your kidneys filter your blood, balance fluids in your body and get rid of waste.

Types of kidney cancer

There are different types of kidney cancer:

• Renal cell carcinoma (RCC): This type develops in the cells that line tiny tubes in your kidneys. RCC may affect one or both of your kidneys. This type accounts for 85 out of 100 cases of kidney cancer. There are more than 50 RCC subtypes, including clear cell renal carcinoma, papillary renal cell carcinoma and non-clear cell renal carcinoma.
• Transitional cell carcinoma: This type usually begins where your ureter connects to your kidney. But it can also start in your ureter or bladder. Between 6 and 7 out of 100 kidney cancer cases are transitional cell carcinoma.
• Renal sarcoma: This cancer begins in your kidneys’ connective tissues. It’s the least common form. It accounts for 1 in 100 cases of kidney cancer.
• Wilm’s tumor: This type typically affects children. It accounts for 5 in 100 cases of kidney cancer.

Symptoms of kidney cancer

Kidney cancer may not cause noticeable symptoms until it starts to spread outside of your kidneys. Symptoms may include:

• Blood in your pee
• Fatigue
• Fever that comes back
• Loss of appetite
• Lump or mass on the side of your body, between your ribs and your hip
• Pain in your sides or the back of your belly
• Weight loss

Kidney cancer causes

Kidney cancer happens when healthy cells change (mutate). They become cancerous cells that form tumors. These changes may happen for no known reason. But there are risk factors that increase your chance of developing the condition.

Risk factors

Risk factors refer to issues that increase your risk. Having a risk factor doesn’t mean you’ll get the condition. Kidney cancer risk factors include:

• Age: Kidney cancer typically affects people ages 65 to 74.
• Dialysis use: This is long-term use of dialysis to support your kidneys.
• Family medical history: You may have family members who have this condition.
• High blood pressure: This condition can damage your kidneys.
• Inherited disorders: Disorders like von Hipple-Lindau disease and tuberous sclerosis syndrome cause tumors that affect your kidneys.
• Obesity: You have obesity if your BMI (body mass index) is 30 or more.
• Smoking: Your risk of RCC increases if you smoke.

Complications of kidney cancer

Kidney cancer may cause complications like:

• Kidney failure
• Increasing cancer pain if the tumor spreads (metastasizes) to nearby tissue
• Cancer that spreads to your bones, liver or lungs

How doctors diagnose this condition

A healthcare provider will do a physical exam. They’ll ask you to describe your symptoms and how long you’ve had symptoms. They may do tests, including:

• Blood tests: A CBC may detect changes in your red or white blood cell levels that could be signs of kidney cancer. A BMP checks kidney function and may show changes in certain chemicals.
• Imaging tests: Tests like CT scan, MRI and ultrasound can detect tumors in your kidneys.
• Biopsy: Your provider may use a biopsy needle to get a small sample of kidney tissue. A medical pathologist will then cut the sample into tiny sections. They’ll look at the sections under a microscope for signs of cancer.

If tests show you have kidney cancer, your provider will refer you to an oncologist. Your oncologist will use test results and other information to plan your treatment. They may call this process cancer staging.

Kidney cancer stages

Kidney cancer may spread to nearby lymph nodes and tissue. It may also spread to your adrenal glands on top of your kidneys. Or it could reach one of the major veins that carry blood from your kidneys to other areas of your body. The cancerous tumor may even spread to those other areas of your body. There are four kidney cancer stages.

How is kidney cancer treated?

Kidney cancer treatment depends on the cancer stage. Treatment options include active surveillance, surgery, ablation (treatment that uses heat or cold to destroy cancer), immunotherapy and targeted therapies. Your oncologist may combine treatments. You may receive certain treatments when surgery isn’t an option.

Active surveillance

This treatment is an option for smaller tumors or times when tests detect kidney cancer, but you don’t have symptoms. In active surveillance, you don’t have cancer treatments like surgery or medication. Your healthcare team will do tests every three to six months to check for changes in your kidneys.

Surgery

Surgery to remove all or part of your kidney is the most common treatment for kidney cancer. Options are:

• Partial nephrectomy: Your surgical oncologist removes the part of your kidney that contains the tumor.
• Radical nephrectomy: Your surgeon removes your kidney and some of your nearby tissue. They may also remove nearby lymph nodes. The kidney that remains is usually able to take over tasks like filtering blood and getting rid of waste.

Ablation therapy

Ablation therapy uses heat or cold to destroy cancer cells. Your oncologist may recommend that you have cryoablation or radiofrequency ablation:

• Cryoablation (cryotherapy): This treatment involves freezing cancer cells with cold gas. Your provider delivers the cold gas through a needle that they place through your skin, into your kidney.
• Radiofrequency ablation: In this case, an electric current kills cancer cells. The current moves through a needle that’s placed in your kidney.

Immunotherapy

Immunotherapy works against kidney cancer by boosting your own immune system. The treatment helps your body recognize and destroy cancer cells more effectively. You may have immunotherapy along with surgery or as an individual treatment.

Targeted therapies

Targeted therapies are drugs that block certain characteristics that help cancer cells thrive. For example, these drugs can stop the growth of new blood vessels or proteins that feed cancer. You may have targeted therapy after surgery to reduce the risk that the cancer will come back. It’s also a treatment when surgery isn’t an option.

Radiation therapy

This is a treatment option if you only have one kidney or when surgery isn’t a treatment option. Radiation therapy kills cancer cells. It also helps with kidney cancer pain.

Recovery time

Your recovery time depends on your treatment. For example, it may take several weeks to completely recover from surgery to remove your kidney. Your oncologist will explain what you can expect after treatment.

When should I seek care?

Symptoms like blood in your pee or pain in your side that doesn’t go away are reasons to schedule an appointment with a healthcare provider. They’ll do tests to find out why you’re having symptoms. If tests show you have kidney cancer, your provider will refer you to an oncologist for more tests.

Kidney cancer treatment often involves surgery. Contact your cancer care team if you have issues after surgery that may mean you have an infection. Symptoms include:

• An opening in the incision (cut) line, which may make it deeper, longer or wider
• Fever (greater than 101 degrees Fahrenheit or 38.4 degrees Celsius)
• Pus coming from the incision
• Skin discoloration around the incision
• Tenderness around the incision

​Is kidney cancer curable?

Kidney cancer is often curable. Like most kinds of cancer, it’s easier to treat and cure before it spreads outside of your kidney.

What is the survival rate of kidney cancer?

Kidney cancer survival rates are estimates based on the experiences of large groups of people receiving treatment for kidney cancer. The U.S. National Cancer Institute (NCI) publishes data about relative survival rates for many kinds of cancer. A relative survival rate compares people with the same type and stage of cancer to people in the overall population.

NCI data shows that overall, 77% of people with kidney cancer are alive five years after their diagnoses. NCI data further breaks out cancer survival rates by tumor location at time of diagnosis.

Cancer survival rates are estimates that reflect people’s experiences with cancer. What was true for those people may not be true for you. Ask your surgeon to explain survival rate data and how it applies to your case.

Can you fully recover?

Yes, surgery may remove the tumor in your kidney. Other treatments might reduce the risk that cancer will come back. But one analysis found kidney cancer came back in 1 in 5 people with early-stage kidney cancer.

Your age, your family medical history and treatment for kidney cancer factor into whether cancer will come back. Your oncologist may be able to estimate the chance you’ll have recurrent kidney cancer.

Can you live a long life after kidney cancer?

Data shows 7 in 10 people with kidney cancer are alive 10 years after diagnosis. But how long you’ll live depends on factors other than surviving kidney cancer. For example, you may have another serious illness that affects your life expectancy.

Is there anything I can do to feel better?

Kidney cancer symptoms and cancer treatment side effects can be exhausting and painful. Ask your oncologist about cancer rehabilitation programs and palliative care treatment.

Cancer rehabilitation support may include physical therapy before or after your cancer treatment. Palliative care focuses on symptom relief, as well as social and spiritual support.