CONDITIONS
Kidney Cancer
Globally, more than 430,000 new cases of kidney cancer were diagnosed. The rate of kidney and renal pelvis cancer was 17.2 per 100,000 men and women per year in 2023.
Kidney cancer is cancer that begins in the kidneys and the most common type of kidney cancer in adults is renal cell carcinoma.
What are the symptoms of Kidney Cancer?
Kidney cancer generally does not have any signs or symptoms in early stages. But in time, signs and symptoms may develop, including:
- Blood in the urine, which may appear pink, red or cola coloured
- Pain in the back or side that doesn’t go away
- Loss of appetite
- Unexplained weight loss
- Tiredness
- Fever
- Anemia
What are the causes and risk factors of Kidney Cancer?
The reasons of kidney cells changes are unknown. However certain factors increase the risk of developing kidney cancer:
- Smoking
- Being overweight (obese)
- High blood pressure (hypertension)
- Gender – about twice as many men as compared to women develop kidney cancer
- Being on dialysis treatment for advanced chronic kidney disease
- Family members with kidney cancer
- Long-term use of a pain-relieving drug called phenacetin
- Certain rare genetic diseases, such as von Hippel-Lindau disease, Birt Hogge Dube syndrome, and others
- History of long-term exposure to asbestos or cadmium
How is Kidney Cancer diagnosed?
The doctor may diagnose kidney cancer by reviewing medical history and doing a physical exam, along with blood and urine tests.
Imaging tests:
Computed tomography (CT) scans using x-rays are used and a complete picture of the kidneys and abdomen (belly) are generated and may be done with or without a contrast dye. The CT scan often shows if a tumor appears cancerous or if it has spread beyond the kidney.
Magnetic resonance imaging (MRI) scans take a complete picture of the kidneys and abdomen, but without radiation but it should be avoided in people on dialysis or with very low kidney function.
Ultrasound is done by using sound waves to provide a complete picture of the kidneys and abdomen without radiation and may be useful in helping to decide if a mass in the kidneys is a fluid-filled cyst or a solid tumor. This test is done without contrast dye.
A biopsy is done is some cases but is typically not recommended. A biopsy requires a very small piece of the kidney to be removed with a needle and then tested for cancer cells.
Staging of kidney cancer:
Once a kidney lesion is identified as cancer, the next step is to determine the stages of cancer. The stages of kidney cancer are from I to IV, with the lowest stages indicating cancer that is confined to the kidney. By stage IV, the cancer is considered advanced and may have spread to the lymph nodes or to other areas of the body.
What are the treatment options for Kidney Cancer?
Surgery is the most common treatment for kidney cancer and most people with early stage cancer (stages 1, 2, and 3) can be cured with surgery.
The goal is to remove the cancer while preserving normal kidney function. Surgical procedures include:
- Removing the affected kidney (nephrectomy).
- Removing the tumor from the kidney (partial nephrectomy)
Kidney-sparing surgery is a common treatment for small kidney cancers, and it may be an option if a person has only one kidney.
Nonsurgical options
- Thermal ablation – Kills the tumor by burning or freezing and is generally for small tumors in people who cannot undergo nephrectomy surgery
- Active surveillance – Active surveillance is used if a small tumor is less than 4 centimeters (1.5 inches)
- Chemotherapy and radiation – Forms of chemotherapy and radiation used in other forms of cancer are not usually effective treatments for most forms of kidney cancer
Treatment for Advanced and recurrent kidney cancer
Kidney cancer recurrence post treatment or the cancer kidney that spreads to other parts of the body may not be curable but treatments are to keep the patients comfortable and the cancer controlled. These may be:
- Surgery to remove as much of the kidney cancer as possible
- Radiation therapy – Destroying cancer cells, often as a primary treatment where surgery is non optional or undesirable.
- Immunotherapy – Triggering the body’s immune system to fight cancer cells, either in kidney or throughout the body
- Targeted therapy – To treat advanced cancer when other treatments don’t work.
- Enrolling in clinical trials
Can Kidney Cancer be prevented?
Taking steps to improve health may help reduce your risk of kidney cancer. To reduce your risk, try to:
Quit smoking: Smokers should quit. Many options for quitting exist, including support programs, medications, and nicotine replacement products.
Maintain a healthy weight: Work to maintain a healthy weight. In case a person is overweight or obese, reduce the number of calories consumed each day and try to be physically active most days of the week.
Control high blood pressure: If a person’s blood pressure is high, they can discuss options for lowering the numbers. Lifestyle measures such as exercise, weight loss and diet changes may help. Some people may need to add medications to lower blood pressure.
References
- Cancer Stat Facts: Kidney and Renal Pelvis Cancer. NIH National Cancer Institute. 2023. https://seer.cancer.gov/statfacts/html/kidrp.html
- Kidney Cancer. National Kidney Foundation. April 2024. https://www.kidney.org/atoz/content/kidney-cancer
- Kidney Cancer. Mayo Clinic. March 2024. https://www.mayoclinic.org/diseases-conditions/kidney-cancer/diagnosis-treatment/drc-20352669
- Understanding Kidney Cancer. WebMD. March 2024. https://www.webmd.com/cancer/understanding-kidney-cancer
