Kidney Cancer

Kidney cancer often shows no symptoms in its early stages, and appears as the cancer grows. Signs and symptoms may include:

• Blood in your urine
• A lump in your abdomen
• Back pain in your side, just below the ribs, that doesn't go away
• Unexplained weight loss
• Loss of appetite
• Fatigue
• Intermittent fever

Kidney cancer is cancer that starts in the kidneys. Your kidneys are a pair of bean-shaped, fist-sized organs located behind your abdomen. One sits on each side of your spine.

The kidneys main job is to filter your blood and help the body get rid of excess water, salt and waste products. They also produce hormones that monitor blood pressure and regulate the production of red blood cells.

While each person has two kidneys, it is possible to live with less than even one complete kidney. In fact, some people live without any working kidneys and rely on a process called dialysis, where a machine takes on the job of filtering waste products from the blood.

In adults, the most common type of kidney cancer is renal cell carcinoma, which begins in the lining of the small tubes that make up the kidney. Although renal cell carcinoma typically develops as a single tumor in one kidney, it sometimes affects more than one part of a kidney or even both kidneys. Children are more likely to develop a form of kidney cancer called Wilms’ tumor.

How does kidney cancer occur?

Kidney cancer occurs when abnormal kidney cells grow and divide uncontrollably. The accumulating abnormal cells form a tumor that can extend beyond the kidney. Some cells can break off and spread (metastasise) to distant parts of the body. Even if a person has kidney cancer, their kidneys may still function normally.

What are the types of kidney cancer?

There are several types of kidney cancer. The most common forms include:

• Renal cell carcinoma: Renal cell carcinoma accounts for most kidney cancers. There are several subtypes of renal cell carcinoma, based mainly on how the cancer cells look under a microscope. The most common subtypes are clear cell cancer, papillary cell cancer, and chromophobe renal cell cancer.
  • Clear cell cancer: This is the most common form of renal cell carcinoma. According to the American Cancer Society , about 7 out of 10 people with renal cell carcinoma have this type. When seen under a microscope, the cells of this form of cancer look either clear or very pale.
  • Papillary cell cancer: This is the second most common subtype. These cancers make little finger-like projections, called papillae, in some, if not most, of the tumor.
  • Chromophobe renal cell carcinoma: This subtype accounts for a small number of cases of renal cell carcinoma. The cells of these cancers are also pale, like the clear cells, but are much larger and differ in other ways.
• Transitional cell carcinoma: About 5% to 10% of cancers in the kidney are transitional cell carcinomas. Transitional cell carcinomas don’t start in the kidney itself but rather in the lining of the renal pelvis (where the urine goes before it enters the ureter). People with transitional cell carcinoma often have the same signs and symptoms as people with renal cell cancer – blood in the urine and, sometimes, back pain.
• Wilms tumor: About 5% of all kidney cancers are Wilms tumors. This type of cancer is almost always found in children and is very rare in adults. These mostly develop before age 5.

After cancer is diagnosed and staged, your doctor will talk with you about different treatment plans. Your kidney cancer treatment options may include:

• Surgery: Surgery is the most important treatment for the majority of kidney cancers. However, it only cures the disease if the entire cancer is removed. Even when surgery can't remove all of your cancer, in some cases it can be helpful to remove as much of the cancer as possible. The type of surgery recommended by your doctor will be based on your cancer and its stage, as well as your general health. The most common surgical procedures for kidney cancer are:
  • Nephrectomy: In radical nephrectomy, the entire affected kidney is removed. This procedure could also involve removing a border of healthy tissue, the adjacent lymph nodes or the adrenal gland.
  • Partial nephrectomy: During a partial nephrectomy, the surgeon only removes the part of the kidney that contains the tumor. This is a common treatment for small kidney cancers. With this operation, however, there is a risk that some cancer cells may be left behind.
• Targeted therapy: Targeted treatments block or limit specific abnormal signals in kidney cancer cells that allow them to spread and grow. These drugs have shown promise in treating kidney cancer that has spread to other areas of the body.
• Immunotherapy (also called biological therapy): Immunotherapy drugs help your body’s immune system fight and destroy cancer cells. Drugs in this category include interferon and aldesleukin (Proleukin), which are synthetic versions of chemicals made in your body.
• Radiation therapy: Radiation therapy uses high-energy radiation beams to kill cancer cells. These radiation beams can target the cancer while sparing surrounding healthy tissue. Radiation therapy can be used with other treatments to lessen symptoms, and can also be used in patients who are too ill to undergo surgery.

While in many cases the cause of kidney cancer is not known, taking steps to improve your health can reduce your risk of developing the disease. These include:

• Stop smoking: Avoiding tobacco can lower your risk. Harvard Health estimates that one-third of kidney cancer cases are linked to smoking. For those who smoke, speak with your doctor to discuss your options for quitting.
• Maintain a healthy weight: Obesity is another risk factor for kidney cancer. If you are overweight or obese, reducing the number of calories you consume each day and exercising regularly can help. It is best to speak with your doctor about healthy strategies for weight loss.
• Eat a healthy diet: Diets rich in a variety of fruits and vegetables helps ensure that you’re getting all the nutrients you need.
• Control high blood pressure: For those who have high blood pressure, making lifestyle changes or taking medications to lower your blood pressure may help prevent kidney cancer.
• Avoid exposure to harmful substances in the workplace: Avoiding exposure to large amounts of harmful substances, such as absetos or cadmium, can also protect against kidney cancer.