Kidney Cancer (Renal Cell Carcinoma)

What is kidney cancer?

Kidney cancer is an abnormal growth of cells in the kidneys. Renal cell cancer (or renal cell carcinoma) is the most common type of kidney cancer.

The kidneys are located on each side of the spine just above the waist. They make urine by filtering waste products and extra water from the blood. They also help regulate blood pressure.

How does it occur?

The cause of this disease is not known. It occurs mostly in adults who are over 40 years old. The risk for kidney cancer is higher if you:

• are male
• smoke tobacco
• have high blood pressure or diabetes
• are obese
• have von Hippel-Lindau syndrome (a hereditary disease).

What are the symptoms?

Signs and symptoms can include:

• blood in the urine (most common sign)
• a lump that can be felt in the abdomen
• pain in the lower side of the back or the side (called flank pain) that does not go away
• weight loss
• loss of appetite
• fatigue
• fever and night sweats.

Many of these symptoms can be caused by urinary infections or other problems. Make sure that you report symptoms to your healthcare provider so the cause can be found as soon as possible.

How is it diagnosed?

Kidney cancer may be hard to diagnose. Sometimes kidney tumors are found when X-rays are taken for other reasons.

Your healthcare provider will ask about your symptoms and examine you. Tests may be done to look at the kidney and see how well it is working. The tests may include:

• blood tests to check for infection, anemia, and kidney function
• urine tests to check kidney function
• intravenous pyelogram (an X-ray test also called an IVP)
• ultrasound of the kidneys
• CT scan of the kidneys
• arteriogram (a special X-ray of the arteries and veins of the kidneys).

How is it treated?

The treatment for renal cell cancer depends on how large the tumor is, whether the tumor has spread to other parts of the body, and your general health.

Usually the kidney is removed with surgery. Other possible treatments are:

• Renal artery embolization, a procedure that is done to block the blood flow through the artery that leads to the affected kidney. This decreases blood flow to the cancer. The tumor may then become smaller and easier to remove. This procedure may also be done to help to relieve symptoms, such as pain and bloody urine, when surgery is not possible.
• Radiation therapy, which is the use of high-energy rays to kill cancer cells, is sometimes used before surgery to shrink the tumor. Rarely, it is used after surgery to kill cancer cells that may still be in the tumor area. Radiation treatment can also help relieve pain caused by spread of the cancer to other areas, such as the bones.
• Biological therapy, which helps the body's own defenses to fight the cancer. It is used when the cancer has spread outside the kidney.

How long will the effects last?

The chances of cure depend on how large the tumor is and whether it has spread to other parts of the body. If the cancer does not appear to have spread to nearby lymph nodes or other organs, the long-term survival rates after surgical removal of the kidney are good. Most people can live with just 1 kidney if the other is removed. With dialysis, you can live without both kidneys. If the disease has spread to other organs, surgery is not as helpful.

After treatment your provider will recommend regular checkups to follow your recovery and to check for signs and symptoms that the cancer has come back or spread. These checkups may include lab tests, X-rays, and scans. It is important to follow your provider's recommendations for checkups so that any problems can be found early.

How can I take care of myself?

• Follow the full course of treatment prescribed by your healthcare provider.
• Eat a healthy diet.
• Recognize that having the cancer is an added stress in your life. Take more time for your important relationships and for rest.
• Ask your healthcare provider any questions you have about the course of the disease, treatments, side effects of the treatments, support groups, and anything else that concerns you.
• Ask your provider about some alternative methods for pain control, such as relaxation techniques, guided imagery, and hypnosis.

How can I help prevent kidney cancer?

Limit or prevent, if possible, your exposure to cigarette smoke, which is associated with increased risk for this disease. Have regular checkups to check your blood pressure, blood sugar, and general health.