What is Kidney Cancer?
Kidney cancer, also known as renal cell cancer, (RCC) is a malignancy that starts in the functioning outer parts of the kidney. This is different than cancer that can occur within the inner lining of the kidney called the renal pelvis. These cancers start on the lining similar to bladder cancer and are referred to as urothelial cancer or transitional cell carcinoma (TCC). RCC is more common than TCC and is diagnosed in a little over 30,000 Americans yearly. Like most cancer, RCC and TCC are treatable and often curable when caught early.
Risk Factors for Kidney Cancer
The More Common Risk Factors Associated With Kidney Cancer Are:
- Smoking (more with TCC than RCC)
- Age, sex and race African Americans and male patients over 60 are at higher risk
- High blood pressure
- Exposure to substances such as asbestos or certain dyes and paints
- Family history
- Long term hemodialysis
- Certain genetic disorders such as Von Hippel-Lindau disease or Tuberous Sclerosis
Kidney Cancer Symptoms
Early TCC may be caught early because of blood in the urine, however RCC kidney cancer usually has no early symptoms but may be found by chance during a CT scan or ultrasound that is performed for other reasons. The symptoms of more advanced kidney cancer are:
- Mass or lump in your abdominal area
- High blood pressure — seen in some rare kidney cancers
- Pain in your side, flank or lower back
- Swelling in your legs and ankles
- persistent fatigue and rapid weight loss
Diagnosing Kidney Cancer — How it’s done
Following a thorough history and physical examination, your doctor may order additional imaging and lab tests, including:
- CT Scan, MRI or ultrasound
- Blood tests
- Chest CT or X-ray — to determine if cancer has spread to the lungs
- X-ray of chest — to determine if cancer has spread to the lungs
- Bone scan and possible X-ray of bones — to determine if cancer has spread to the bones
- Needle biopsy of the mass can be helpful; however, the diagnosis usually can be made based on the CT or MRI findings
Different Stages of Kidney Cancer
Kidney Cancer is assigned to one of four stages that describe how advanced and how aggressive the kidney cancer is. Earlier stages have a better prognosis.
- Stage 1: the tumor is less than or equal to 7 centimeters and confined to the kidney
- Stage 2: the tumor is larger than 7 centimeters but still confined to the kidney
- Stage 3: the tumor has spread through the capsule of the kidney or to nearby lymph nodes
- Stage 4: the tumor has spread more extensively (liver, lungs, bone and/or brain)
Treatment for Kidney Cancer
Treatment will depend on a number of factors, including your age and overall health, and the extent to which the cancer has spread. When appropriate, your urologist will collaborate with other specialized doctors to provide one or more of the following:
- Surgery: the standard treatment for kidney cancer. The following procedures often can be performed laparoscopically or robotically, where several small incisions replace one larger one to permit less pain and faster recovery.
- Radical nephrectomy: total removal of the kidney, nearby adrenal gland and lymph nodes
- Partial nephrectomy: Removing the part of the kidney where the tumor is found to include a margin of normal tissue surrounding the mass. studies have shown that this approach is as effective as a radical nephrectomy for patients with early stage kidney cancer. Preserving as much normal kidney tissue as possible, when safe to do, so is always the goal.
- Cryosurgery: freezing cancer cells to destroy them. This can be done with CT guidance through a small puncture and is usually coordinated with interventional radiology.
- Radiofrequency ablation: using heat to destroy cancer cells. Also done in coordination with interventional radiology who uses CT or ultrasound to direct a needle capable of high frequency radio energy to thermally ablate the tumor.
- Radiation therapy: using high energy X-rays to destroy cancer cells and shrink tumors; usually this is not curative and is used to reduce pain if cancer has spread to the bones.
- “Immuno” therapy: a systemic therapy similar to chemotherapy that uses medication to boost the immune system and fight cancer.
- Chemotherapy: using medications to treat cancer cells that have spread throughout the body
Follow-Up After Treatment for Kidney Cancer
To assure no cancer recurrence, follow-up appointments will start at three to six-month intervals and gradually extend to yearly if there is no evidence of remaining kidney cancer.