Kidney Cancer

Kidney cancer is a condition where abnormal cells grow into a tumor in the kidney tissue.

The kidneys remove waste and excess fluid, filter the blood, control the production of red blood cells. They make vitamins, release hormones, and help regulate blood pressure.

Kidney cancer happens when abnormal cells in the kidneys grow out of control.

Symptoms of kidney cancer include blood in the urine, a lump in the abdomen, pain in the back, and painful urination.

There are many options for diagnosing kidney cancer, and its progress or stage determines treatment options. Kidney cancer treatment can include the removal of one or more kidney.

Having the kidneys removed could mean you might need a kidney transplant.

This cancer often does not display symptoms until later stages. Most kidney cancers are found on radiology tests.

Kidney cancer definition, symptoms and complications

What is kidney cancer?

The kidneys are two bean-shaped organs located just below the rib cage. Healthy kidneys perform many important functions. The kidneys are the organs responsible for processing urine and extracting waste, toxins, and extra fluid from the body. They also remove acid produced by cells and maintain important mineral balances in the blood.

Cancer beginning in the kidneys occurs when abnormal cells begin to grow out of control in the kidney tissue. The tumors beginning in these organs can spread to lymph nodes, tissues and other organs in the abdomen as the cancer progresses.

Are there different types of kidney cancer?

There are two major categories of kidney cancer:

• Renal cell cancer (also called renal adenocarcinoma): This disease is characterized by cancer cells found in the lining of tubules in the kidney. This type of cancer accounts for about 80 percent of kidney cancers. Renal cell cancer is generally what is meant by kidney cancer.
• Transitional cell cancer of the renal pelvis and ureter: In this type of cancer, malignant cells form in the renal pelvis where the ureters connect, and in the ureters, which are the long tubes that connect the kidney to the bladder.

For treatment purposes, types of primary kidney cancer are also divided into clear cell and non-clear cell types of tumors. Clear cell tumors look clear under a microscope, like bubbles.

Learn more about kidney tumors>>

What are the symptoms of kidney cancer?

The majority of small tumors have no signs or symptoms and are found on radiology tests done for another reason. However, you may experience:

• Blood in the urine
• A lump in the abdomen
• A pain in the back or side that doesn’t go away
• Loss of appetite
• Weight loss for no known reason
• Anemia (a lack of healthy red blood cells)
• Painful or frequent urination

These symptoms also become more noticeable at later stages of kidney cancer. The stages of kidney cancer are:

• Stage I: The tumor is 7 cm across or smaller (about the size of a peach) and is only in the kidney.
• Stage II: The tumor is larger than 7 cm across but is still only in the kidney.
• Stage III: The main tumor can be any size and may have progressed outside the kidney, potentially to nearby lymph nodes, but it has not spread beyond Gerota’s fascia, which is a tissue surrounding the kidney.
• Stage IV: The main tumor is growing beyond Gerota’s fascia and possibly into the adrenal gland on top of the kidney. It may or may not have spread to nearby lymph nodes, distant lymph nodes, and other organs.

Are there complications to kidney cancer?

The kidneys work like the body’s filtering system.

Kidney cancer results in the failure to correctly filter and remove wastes or balance certain minerals in the body.

Some complications include:

• High blood pressure (hypertension)
• High red blood cell count
• Too much calcium or other minerals in the blood
• Other symptoms of kidney failure

Metastasis is a complication which occurs when the cancer from kidneys spreads to other regions of the body.

Learn more about kidney health problems>>

Kidney cancer causes, risk factors and prevention

What causes or contributes to the development of kidney cancer?

It’s not clear what causes most kidney cancers. There are certain inherited conditions that may increase the risk of kidney cancer, and a history of kidney cancer in the family may indicate a genetic cause.

Are there risk factors for developing kidney cancer?

Anything that increases the risk of getting a disease is called a risk factor. Having a risk factor does not mean that someone will get a particular type of cancer; not having risk factors doesn’t mean that someone will not get a particular type of cancer.

Most patients don’t have an identifiable risk factor. However, kidney cancer has been linked to smoking, certain genetic conditions, such as von Hippel-Lindau disease or hereditary papillary renal cell carcinoma, and being exposed to certain dyes and chemicals used in making leather goods, textiles, plastics, and rubber.

Other factors linked to higher risk of kidney cancer include:

• Older age
• Obesity
• High blood pressure
• A history of long-term treatment for kidney failure, such as dialysis

Can kidney cancer be prevented? How?

The risk of developing kidney cancer can be reduced by avoiding some of the risk factors. However, many of the genetic and kidney-failure based risks are not avoidable.

Maintaining weight and blood pressure while also living a healthy lifestyle can reduce the likelihood of developing kidney cancer.

Kidney cancer diagnosis and treatment

How is kidney cancer diagnosed?

The following screenings, tests and procedures may be used to detect or diagnose kidney cancer and determine the stage of its progress:

• Physical exam and history to examine the patient’s past illnesses and treatments, and any signs of disease or abnormalities.
• MRI or CT scan for detailed pictures inside the body.
• Ultrasound: Imaging using sound waves instead of radiation to identify abnormal areas in the kidneys, or ureters.

Laboratory tests, including:

• Urinalysis: This test looks at a urine sample for its color and content, such as sugar, protein, red and white blood cells.
• Urine cytology: A urine sample is examined under a microscope for abnormal cells.
• Blood chemistry studies: A blood sample is checked to measure the amounts of certain substances released into the blood by the kidneys. An unusually higher or lower than normal amount can be a sign of kidney disease.
• Liver function test: A blood sample is checked to look for unusual amounts of certain enzymes that might indicate that cancer has spread to the liver.
• Ureteroscopy: A ureteroscope is inserted through the urethra into the bladder, ureter and renal pelvis. A tool may be inserted through the ureteroscope to biopsy tissue samples to be checked under a microscope for signs of disease.

What options are available for kidney cancer treatment? Are any more common or successful?

There are multiple factors of kidney cancer that require medical attention, and several methods of treatment may be necessary to address all patient symptoms. Treatment also depends on cancer stage.

Treatment methods include:

• Surgical procedures: Surgery depends on the stage, size and location of the tumor at which it is diagnosed, whether the cancer has spread outside the kidney, the patient’s age and overall health. Many types of surgery are available, including different types of nephrectomy (kidney removal), resection of the ureter, and arterial embolization. WashU Medicine kidney surgeons perform innovative surgical techniques, such as laparoscopic and robotic surgery, that have been linked to shorter hospital stays, less pain, and faster recovery times.
• Chemotherapy: Chemo treatment options are also available. Chemotherapy involves the administration of drugs, either orally or intravenously to kill cancer cells. Over the last five years, several new drugs have increased the options for physicians treating patients with kidney cancer. Therapy that falls under medical treatment has a wide range of approaches, including timing of treatment. It can be given before or after surgery, in conjunction with radiation or by itself. Biologic or immunotherapy and targeted therapy are often paired with chemotherapy.

Siteman Cancer Center also offers non-surgical treatment for kidney cancer, especially for patients ineligible for any type of surgery due to their health or age. This group of patients may receive percutaneous cryoablation, a procedure that involves inserting probes through the skin to freeze small tumors in the kidney. This procedure is currently appropriate only for small tumors or for patients who have no other alternatives. Because this technique holds the promise for being the least debilitating of all kidney cancer treatments, researchers are focused on expanding its application for the future.

What is the prognosis for kidney cancer? Is there a cure?

The prognosis and treatment options depend on the following:

• The stage of the cancer (whether it affects part of the kidney, involves the whole kidney, or has spread to other places in the body)
• Whether the tumor can be completely removed by surgery
• The patient’s general health

A person can live with part of one working kidney, but if both kidneys are removed or are not working, the person will need dialysis or a kidney transplant.