Renal cell carcinoma
Renal cell carcinoma is a type of kidney cancer that starts in the lining of very small tubes (tubules) in the kidney.
Renal cancer; Kidney cancer; Hypernephroma; Adenocarcinoma of renal cells; Cancer - kidney
Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in men 50 to 70 years old.
The exact cause is unknown.
The following may increase your risk of kidney cancer:
- Dialysis treatment
- Family history of the disease
- High blood pressure
- Horseshoe kidney
- Long-term use of certain medicines, such as pain pills or water pills (diuretics)
- Polycystic kidney disease
- Von Hippel-Lindau disease (a hereditary disease that affects blood vessels in the brain, eyes, and other body parts)
- Birt-Hogg-Dube syndrome (a genetic disease associated with benign skin tumors and lung cysts)
Symptoms of this cancer may include any of the following:
- Abdominal pain and swelling
- Back pain
- Blood in the urine
- Swelling of the veins around a testicle (varicocele)
- Flank pain
- Weight loss
- Liver dysfunction
- Elevated erythrocyte sedimentation rate (ESR)
- Excessive hair growth in females
- Pale skin
- Vision problems
Exams and Tests
The health care provider will perform a physical exam. This may reveal a mass or swelling of the abdomen
Tests that may be ordered include:
- Abdominal CT scan
- Blood chemistry
- Complete blood count (CBC)
- Intravenous pyelogram (IVP)
- Liver function tests
- Renal arteriography
- Ultrasound of the abdomen and kidney
The following tests may be done to see if the cancer has spread:
Surgery to remove all or part of the kidney (nephrectomy) is usually recommended. This may include removing the bladder, surrounding tissues, or lymph nodes. A cure is unlikely unless all of the cancer is removed with surgery. But even if some cancer is left behind, there is still benefit from surgery.
Chemotherapy is generally not effective for treating kidney cancer in adults. The immune system medicines interleukin-2 (IL-2) or nivolumab may help some people. Medicines that target the development of blood vessels that feed the tumor may be used to treat kidney cancer. Your provider can tell you more.
Radiation therapy is usually done when the cancer spreads to the bone or brain.
You can ease the stress of illness by joining a support group whose members share common experiences and problems.
Sometimes, both kidneys are involved. The cancer spreads easily, most often to the lungs and other organs. In about one third of people, the cancer has already spread (metastasized) at the time of diagnosis.
How well someone with kidney cancer does depends on how much the cancer has spread and how well treatment works. The survival rate is highest if the tumor is in the early stages and has not spread outside the kidney. If it has spread to the lymph nodes or to other organs, the survival rate is much lower.
Complications of kidney cancer include:
- High blood pressure (hypertension)
- Too much calcium in the blood
- High red blood cell count
- Liver and spleen problems
- Spread of the cancer
When to Contact a Medical Professional
Call your provider any time you see blood in the urine. Also call if you have any other symptoms of this disorder.
Stop smoking. Follow your provider's recommendations in the treatment of kidney disorders, especially those that may require dialysis.
Babaian KN, Delacroix SE, Wood CG, Jonasch E. Kidney cancer. In: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier; 2016:chap 41.
National Cancer Institute website. Renal cell cancer treatment (PDQ) – health professional version. www.cancer.gov/types/kidney/hp/kidney-treatment-pdq. Updated February 23, 2018. Accessed April 9, 2018.
National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology: kidney cancer. Version 3.2018. www.nccn.org/professionals/physician_gls/pdf/kidney.pdf. Updated February 6, 2018. Accessed April 9, 2018.