Kidney cancer is a term used to describe cancers that arise from the solid functional part of the kidney. This is different from cancers that arise in the urinary drainage system of the kidney. Renal cell carcinoma is another name for kidney cancer. Kidney cancers are often found at earlier stages due to increased use of CT, ultrasound and MRI imaging. Some renal cancers are still detected as part of an evaluation for symptoms. There are several types of renal cell carcinoma but the most common are the clear cell and papillary types. Wilms’ tumor is a rare renal cancer that mainly occurs in children.
Several factors may contribute to kidney cancer such as smoking, family history of kidney cancer, age, obesity and high blood pressure. Kidney cancer is also more prevalent in kidney failure and patients with syndromes such as polycystic kidney disease and von Hippel Lindau Syndrome.
Renal cell carcinoma is typically asymptomatic and incidentally found on imaging when it is in an early stage. There are certain findings that increase the suspicion for more aggressive renal cancer and should be evaluated further. These include:
- Blood in the urine
- Ongoing pain in the back or flank
- Abdominal mass
- Loss of appetite and sudden weight loss
- Night sweats
Once a suspicious renal mass is detected on imaging, further evaluation and treatment will be determined at the discretion of your urologist. Further imaging, blood tests and possible may all be used to decide the best course of action.
Most kidney cancer treatments will require surgical intervention. If the cancer has not yet spread, this may be the only treatment required.
Surgery for kidney cancer will be done to remove either the tumor alone (partial nephrectomy) or the entire kidney (radical nephrectomy). This decision depends on various factors including the size and location of the tumor as well as patient-specific considerations like baseline kidney function and underlying diseases. If possible, your doctor may remove only the area of the kidney containing the tumor in order to preserve kidney function.
Small tumors can sometimes be observed or treated in other minimally invasive options. Cryoablation is a treatment in which the cancer cells are frozen with cold gas injected through a needle. Radiofrequency ablation is another technique where a probe runs high-energy radio waves to heat and kill the cancerous cells.
In more severe cases of kidney cancer, radiation therapy, immunotherapy, or more radical surgery that removes other organs or areas of localized spread may be necessary. These treatments may carry some severe side effects.