Kidney cancer occurs when cells in the kidney grow uncontrollably, forming a tumor.
What is kidney cancer?
Kidney cancer, also known as renal cell carcinoma (RCC), is a disease characterized by the uncontrolled growth of abnormal cells in the kidneys. The kidneys are two bean-shaped organs responsible for filtering waste products from the blood, regulating blood pressure, and producing red blood cells. Renal cell carcinoma forms in the small tubes of the kidney that filter the body’s waste. RCC is the most common type of kidney cancer in adults, about 9 out of 10 kidney cancers are RCC.
There are around 81,000 new cases of kidney cancer in the U.S. annually, according to the American Cancer Society, making it a somewhat less common type of cancer. Early detection of the disease is challenging because there are often no symptoms in the early stages of the disease. Many cases are discovered during imaging scans that are being performed for other reasons such as abdominal pain. Routine screening for kidney cancer or kidney tumors is usually not recommended for the general population. There are exceptions for those who have a strong family history of RCC, other kidney cancer or tumors, those with certain genetic syndromes, and those with Hippel-Lundau (VHL) disease. AHN kidney cancer specialists and oncologists understand the complexities of this disease and will work with you to determine what is best for your specific health history and health needs.
Kidney cancer care at AHN: Why choose us?
AHN offers state-of-the-art technology and compassionate, tailored care to our patients undergoing a kidney cancer. We understand the intricacies of a kidney cancer diagnosis and work with you to determine the precise care you will need and coordinate that care with other areas within AHN to provide multidisciplinary care that treats your whole health.
Because the number of new cases of kidney cancer is on the rise, we understand the necessity of developing new treatments. That’s why we are leading the way in researching new therapies and surgical approaches. So, our patients have more options for receiving life-saving care that meets their personal needs.
Our team of oncologists, urologists, and radiologists use standardized protocols to work with patients who agree to participate in our research studies. And we identify individuals who may be eligible for national clinical trials. We also contribute to the growth of the field by sharing our research data at educational programs for the larger medical community.
Kidney cancer symptoms and signs
Kidney cancer often develops silently, without symptoms in the early stages. As the tumor grows, it can press on nearby organs or blood vessels, leading to various symptoms. It's important to note that these symptoms can also indicate other health conditions, so it's crucial to consult a doctor for proper diagnosis.
Common symptoms and signs of kidney cancer include:
- Urinary changes
- Hematuria (blood in urine): This is often the first noticeable symptom. The urine may appear pink, red, or rusty-colored.
- Pain and discomfort
- Flank pain: A dull ache or sharp pain in the back or side, below the ribs and above the hips.
- Abdominal pain
- Pain in the bones (if cancer spreads to bones)
- General symptoms
- Unexplained weight loss
- Loss of appetite
- Persistent fatigue
- Anemia (low red blood cell count)
- Fever that comes and goes
- High blood pressure (hypertension) that's difficult to control
- Swelling in the legs, ankles, or feet
- Less-common symptoms
- Varicocele (enlarged veins in the scrotum), usually only on the left side
- Hypercalcemia (high blood calcium levels)
- Liver dysfunction
Early signs of kidney cancer
Kidney cancer is often called a "silent disease" because early-stage kidney cancer typically doesn't cause symptoms. However, as the tumor grows, some common early warning signs to pay attention to are:
- Blood in the urine (hematuria): This is often the first noticeable symptom and may appear as pink, red, or rusty-colored urine. The amount of blood can vary, and it might not be present in every urination.
- Pain in the back or side (flank pain): Most everyone experiences pain from time to time, but if you notice a constant or intermittent pain that is a dull ache or sharp pain below the ribs and above the hips, this could be an early sign of kidney cancer.
- A lump or mass in the abdomen or side: Any unusual lumps or masses you feel in your body should be examined by a doctor. If you notice a lump or mass in the abdomen or side, it could be a later sign of kidney cancer.
Causes and risk factors
The exact causes of kidney cancer, specifically renal cell carcinoma (RCC), aren't fully understood, but several factors are known to increase the risk. Those risk factors have been known to include both genetic and environmental factors.
Genetic factors
There are some inherited genetic factors that can cause or increase the risk for kidney cancer. Some genetic conditions such as Hippel-Lindau (VHL) disease, hereditary papillary renal cell carcinoma (HPRC), and Birt-Hogg-Dubé syndrome. These conditions affect genes involved in tumor suppression. Having a family history of kidney cancer can also increase your risk. Other reasons for developing kidney cancer include advanced age, race, and the male gender.
Environmental factors
Like other cancers, there are certain environmental factors that increase one’s risk of kidney cancer. These include smoking, obesity, high blood pressure and exposure to certain chemicals such as asbestos and certain herbicides. There is also increased risk if you have been on long-term dialysis, but your care team managing your dialysis will monitor any health changes or risks.
Kidney cancer screening and diagnosis
Kidney screening and diagnosis starts with accurate testing and screening. AHN uses the most state-of-the art technology to identify kidney cancer.
- Physical exam: A physical exam checks for signs like abdominal mass or pain, though it rarely directly diagnoses kidney cancer.
- Urine tests: Urine tests can detect blood or abnormal proteins that may indicate kidney issues, prompting further investigation.
- Blood tests: With a blood test, your doctor will look at measurements of creatinine and blood urea nitrogen (BUN) to assess kidney function and may reveal anemia often associated with kidney cancer.
- Imaging tests: Imaging tests create detailed pictures of the kidneys to identify masses or abnormalities suggestive of kidney cancer.
- Ultrasound: An ultrasound is used to provide your care team with images of the kidneys, helping to visualize any tumors and assess their size and location.
- CT scan: CT scans provide cross-sectional images of the kidneys with higher detail than ultrasound, better characterizing tumors and identifying if cancer has spread.
- MRI: MRIs are used when the doctor needs detailed images of the kidney to provide the necessary information for staging tumors and assessing the involvement of surrounding structures.
- Biopsy: If your doctor finds a mass, a biopsy is done to get a sample of the tissue so it can be tested to determine if it is cancerous.
Types and stages of kidney cancer
A particular type of kidney cancer may require a different approach than others. It is important to speak to your care team about any questions you have throughout the treatment process.
- Renal Cell Carcinoma (RCC): This is the most common type of kidney cancer, accounting for about 85% of cases. It originates in the lining of the small tubes (tubules) within the kidneys. There are several subtypes of RCC, including:
- Clear cell RCC: The most common subtype, making up about 70% of RCC cases.
- Papillary RCC: Accounts for about 10-15% of RCC cases.
- Chromophobe RCC: Less common, representing about 5% of RCC cases.
- Collecting duct carcinoma: A rare and aggressive subtype.
- Urothelial Carcinoma: This type of cancer begins in the renal pelvis (the funnel-shaped structure that collects urine inside the kidney) and ureters (tubes that carry urine from the kidneys to the bladder). It accounts for about 5-10% of kidney cancers.
- Wilms tumor (nephroblastoma): This is the most common type of kidney cancer in children. It is rare in adults.
- Kidney sarcoma: This is a rare type of kidney cancer that develops in the connective tissues of the kidney.
- Lymphoma and other rare types: The kidneys can be affected by lymphoma and other rare types of cancer, but these are uncommon.
Metastatic kidney cancer, also known as stage IV kidney cancer, means that the cancer has spread from its original location in the kidney to other parts of the body. This can happen through the bloodstream, the lymphatic system, or by direct extension to nearby tissues. It may spread to your lungs, bones, liver, lymph nodes, brain and adrenal glands.
The stages of kidney cancer help doctors understand how far the cancer has spread and guide treatment decisions. A general approach focuses on size and location of the tumor:
- Stage 1: The tumor is confined to the kidney and is 7 centimeters (about 2.75 inches) or smaller.
- Stage 2: The tumor is larger than 7 centimeters but is still confined to the kidney.
- Stage 3: The cancer has spread into the fatty tissue immediately around the kidney or into the veins inside the kidney or main veins that come out of the kidney. The cancer may have spread to nearby lymph nodes.
- Stage 4: The cancer has extended into structures immediately beyond the kidney or spread to distant organs, such as the lungs, liver, or bones.
Within each stage, there are sub-classifications (e.g., Stage IA, Stage IB) that provide more detail about the tumor's size and location. A doctor will use imaging tests, such as CT scans and MRIs, to determine the stage of kidney cancer. The stage helps determine the prognosis and most appropriate treatment plan for each patient.
Kidney cancer treatment
Treatment options for kidney cancer depend on several factors, including the type and stage of the cancer and your overall health. There's no one-size-fits-all approach. AHN sees you and your unique needs, and will develop a treatment plan that is specific to your needs. Treatment may involve a combination of methods depending on the type of kidney cancer and whether it is localized to the kidney or metastatic (spreads to other parts of the body). Some common kidney cancer treatments include:
- Partial nephrectomy: With kidney cancer that is contained to the area, your doctor may remove only the cancerous part of the kidney, preserving as much healthy kidney tissue as possible. This is often the preferred option for small, localized tumors. It can be done through open surgery, laparoscopy (minimally invasive surgery), or robotically-assisted surgery.
- Radical nephrectomy: If a partial nephrectomy isn’t an option, your surgeon may remove the entire kidney, possibly along with the adrenal gland and surrounding lymph nodes. This is usually done for larger tumors or those that extend beyond the kidney.
- Ablation: This involves destroying the tumor using heat (radiofrequency ablation or RFA) or freezing (cryoablation). This is typically used for small tumors in people who are not good candidates for surgery due to health reasons.
- Targeted Therapy: These drugs block the growth and spread of cancer cells by targeting specific proteins involved in cancer growth. Examples include tyrosine kinase inhibitors (TKIs) like sunitinib, pazopanib, axitinib, cabozantinib, and others. These are often used as first-line treatment for metastatic disease.
- Immunotherapy: Using your own immune system to help fight the cancer cells, immunotherapy is often used in metastatic kidney cancer cases as treatment. Examples include checkpoint inhibitors like nivolumab, ipilimumab, and atezolizumab. These may be used alone or in combination with targeted therapy.
- Cytokines: These are proteins that stimulate the immune system to fight cancer cells and are often used to treat metastatic kidney cancer.
- Chemotherapy: This is less commonly used as a first-line treatment for metastatic kidney cancer, but it might be used in certain situations, such as when targeted therapy or immunotherapy isn't effective.
- Radiation therapy: This is generally not used as a primary treatment for kidney cancer, but it may be used to treat pain from bone metastases or other complications.
- Clinical trials: Participating in clinical trials can offer access to new and innovative treatments.
Kidney cancer frequently asked questions
Questions are completely normal when facing a kidney cancer diagnosis. AHN is here to help answer those and provide you with support and resources as you navigate your diagnosis. Your surgeon, oncologist and AHN Care Team are your go-to sources if you need answers beyond these topics.
How fast does kidney cancer spread?
It's impossible to say exactly how fast kidney cancer spreads without knowing details about a specific case. Generally, kidney cancer is often slow-growing, especially in its early stages. Many people live for years without symptoms, which is why it's sometimes diagnosed at a later stage. However, some types can be aggressive and spread quickly.
The rate of growth and spread can vary greatly depending on:
- Cell type: Some types of kidney cancer are more aggressive than others.
- Tumor grade: This describes how abnormal the cancer cells look under a microscope. Higher-grade tumors tend to grow and spread more quickly.
- Stage at diagnosis: Early-stage cancers are usually slower-growing than those diagnosed at a later stage.
What is the survival rate of kidney cancer?
Kidney cancer survival rates depend on a number of factors. The American Cancer Society uses information from Surveillance, Epidemiology, and End Results (SEER) database, that’s kept by the National Cancer Institute (NCI), to give survival statistics for various types of cancer. The SEER database reviews five-year survival rates for U.S. kidney cancer cases based on how or if the cancer has spread in the body. It groups survival rates based on localized, regional and distant cancers. The five-year survival rate for kidney cancer using the SEER stage include:
- Localized: there is no sign the cancer has spread outside the kidney—93% survival rate
- Regional: the cancer has spread outside the kidney to nearby lymph nodes or tissue—75% survival rate
- Distant: the cancer has spread to farther parts of the body—18% survival rate
It’s important to remember these are estimates and evolve over time based on new treatments, individual cases and how the cancer responds to treatment. Talk with your AHN Care Team to understand your specific diagnosis and treatment plan.
Contact us
Call (412) 578-HOPE (412) 578-4673 to schedule an appointment at any location within the AHN Cancer Institute or connect with a nurse navigator.