Kidney Cancer

OverviewSymptomsDiagnosisTreatmentPatient Education ResourcesOther ResourcesPatient Stories

Overview

  • More than 60,000 people are diagnosed with kidney cancer in the United States each year, both men and women, although men are diagnosed more often. 
  • Recent advances are curing or controlling the disease in many patients.
  • In the medical field kidney cancer is known as renal cell carcinoma and abbreviated as RCC.  There are several subtypes of RCC, and each behaves differently. 

Symptoms

  • Most cases are diagnosed by imaging (x-rays, ultrasound, CT and MRI) in patients who do not have any symptoms at all.
  • Blood in the urine can be a symptom or sign of kidney cancer (among other problems)
    • Visible blood (“gross hematuria”) should prompt a patient to visit a medical professional.
    • Blood the doctor finds on urine testing (“microscopic hematuria”) prompts an evaluation that sometimes reveals RCC
  • Pain or swelling in the flank: This is rare
  • Weight loss
  • Pain from sites where RCC has spread

Diagnosis

  • The majority of RCC are diagnosed “incidentally” when patients undergo xrays or imaging procedures for other reasons, such as back pain, or abdominal pain. 
    • Other times they are found when symptoms such as the above prompt a workup by a medical professional
  • CT scan and MRI are commonly used to diagnose RCC.  These show great detail of the kidneys as well as lymph nodes, blood vessels, and other organs to identify tumors, or their spread, and to plan treatment
  • Chest xray can show spread of RCC to the lungs, and can also be used for follow up appointments
  • Ultrasound of the kidneys can identify RCC but is less detailed than CT and MRI
  • Bone scan, PET scan, and IVP are xrays that should be used only in very specific situations
  • Biopsy is sometimes done to prove that a growth on the kidney is RCC

Treatment

  • In cases where the RCC has not spread, the main treatment is surgery
    • Nephrectomy (total or radical) removes the entire kidney
    • Partial nephrectomy removes just the tumor and leaves the rest of the kidney in place
    • These operations can be done in several ways, including traditional large incisions and minimally invasive ways.  Laparoscopic and robotic techniques use small incisions to make recovery from the surgery less painful.
  • Small tumors can often grow slowly and three options can be considered based on the patient’s overall health and preferences
    • Observation with treatment if growth occurs
    • Surgical removal
    • Treatment known as “ablative therapy” where the tumor is killed by freezing it (“cryotherapy”) or heating it (“radiofrequency ablation” or RFA)
  • When RCC has spread, known as metastatic disease, there are treatments that can be effective in controlling the cancer.  These are not chemotherapy or radiation treatments, but rather pills that work by stopping blood vessel growth (“angiogenesis inhibitors”) in the tumor or in the metastases.  If a tumor cannot grow blood vessels, it often stops enlarging because it can’t get enough nutrition. 
    • Sometimes surgery is still done in these cases and is known as cytoreductive nephrectomy, because the angiogenesis inhibitor medications may work better if there is less cancer to be treated.
  • Embolization is done in rare situations.  This is done by a specialist called an interventional radiologist who reaches the kidney blood supply in the same way that cardiologists do heart catheterizations or angiograms—through an incision in the groin—and blocks the blood supply to the kidney or the RCC.

Patient Education Resources

American Cancer Society
National Cancer Institute
Urology Care Foundation
Kidney Cancer Association

Other Resources

NC Cancer Hospital Urologic Oncology Program
National Cancer Institute - Live Help or 1–800–4–CANCER (1–800–422–6237)
National Cancer Institute - Support for People with Cancer