Kidney Cancer

What is kidney cancer?

The kidneys are a pair of bean shaped organs that are part of the urinary system.  Their function is to filter blood and rid the body of liquid waste products.  Kidney cancer, also referred to as renal cancer, is cancer of the kidneys.  The majority of kidney cancers are renal cell carcinomas. 

What are risk factors for kidney cancer?

Risk factors increase the risk for a person getting kidney cancer, but not everyone with a risk factor gets kidney cancer.

• Smoking – People who smoke have a much higher risk of getting kidney cancer than non-smokers.
• Medical conditions – People with von Hippel-Lindaus and hereditary papillary renal cell carcinoma tend to develop kidney cancer.
• Pain medication – Overuse and misuse of certain pain medication increases the risk for kidney cancer.
• Obesity – People who are obese have a higher risk of kidney cancer.
  

What are prevention strategies for kidney cancer?

There are no established prevention guidelines for kidney cancer, but there are ways to decrease risk factors.

• Smoking – Avoid smoking, and if you current smoke, quit (link to tobacco prevention page) smoking.
• Pain medication – Use pain medication only as directed by your doctor.
• Diet – It is important to eat a diet low in fat and high in fruits and vegetables.  This helps to maintain a healthy body weight. 
  

Is screening available?

There are no established national screening guidelines for kidney cancer.  If a person is experiencing symptoms that may indicate kidney cancer, they should discuss this with their doctor.

What are the symptoms of kidney cancer?

Symptoms of kidney cancer may also indicate other medical conditions.  It is important to see your healthcare provider if you experience any of the following symptoms.

• Fatigue
• Unexplained or unintentional weight loss
• Lump in the abdomen
• Blood in the urine
• Swelling in the ankles and legs
• Prolonged fever not caused by an obvious infection
• Pain in the side
  

How is kidney cancer diagnosed?

If kidney cancer is suspected, several diagnostic tests may be used.

• Physical examination and medical history
• Urinalysis – This is done to check the color and content of the urine.
• Ultrasound – This test uses sound waves to create a picture of the body tissue.
• Intravenous pyelogram, also called intravenous urography – Dye is injected into the bloodstream and pictures are taken to determine if there are any blockages.
• Computed tomography (CT) scan – This is used in making an initial diagnosis and helpful in staging the cancer.
• Magnetic resonance imaging (MRI) – Like the CT scan, it is helpful with diagnosis and staging.
• Positron emission tomography (PET) scan – Radionuclide glucose is injected into the vein and the PET machine takes pictures of where the glucose is absorbed.  Malignant tumors show up brighter because they take up more glucose than normal cells.
• Biopsy – a thin needle is inserted into the tumor and cells are examined under a microscope by a pathologist to determine if cancers cells are present.
  

What is staging?

Staging describes the extent of the cancer.  It determines if the cancer has spread, and if so, what parts of the body are affected.  Staging a cancer is important to assist the doctor with determining the appropriate course of treatment and assess an accurate prognosis. 

The most common staging system is the TNM.

• T – size of the tumor
• N – degree to which regional lymph nodes are involved
• M – the absence or presence of distant metastases

Once the TNM has been determined, then a stage of I, II, III or IV is assigned.

• Stage I – cancers are small and local and usually curable
• Stage II & III – typically these are locally advanced and could involve the lymph nodes
• Stage IV – cancer has metastasized and can be inoperable
  

What are treatment options?

There are four standard treatments for kidney cancer. 

• Surgery – This is the most common form of treatment for kidney cancer.  It may involve removing the entire kidney, part of the kidney, and some of the metastases (most often done to remove pain).

• Chemotherapy – This systemic drug is administered through the veins to kill cancer cells.

• Radiation therapy - This uses high energy rays to kill cancer cells.
• Biological therapy – This form of treatment helps the body’s immune system attack and destroy cancer cells and may help the body recover from some of the side effects of treatment.
  

What clinical trials are available?

Clinical trials are studies that seek to find better ways to prevent, screen, diagnose and treat a disease such as cancer.  Clinical trials test new approaches to treatment, such as new drugs, new approaches to surgery or radiation therapy, or a combination of treatments.

Learn more about clinical trials.

What questions should I ask my doctor?

It is often helpful to make a list of questions before an appointment.  This will help you to remember what the doctor says.  Patients and care givers can write notes or ask if they may use a tape recorder.  Sometimes it is helpful to have a family member or friend at the appointment to take notes, ask questions or just listen.  Below are a few suggested questions a patient may ask their doctor.

Will you please write down the type of cancer that I have?

What stage is my cancer and what does that mean?

What are my treatment options?

What treatment do you recommend and why?

What are the risks and benefits of each treatment?

What are possible side effects of treatment?

How will you help manage my side effects?

How will treatment affect my normal activities?

Are there specific things I must do to get ready for treatment?

Are there other things I can be doing to help with my treatment, such as diet and exercise?

What are resources that I can turn to learn more about my cancer and help me deal with it?

Make an appointment

Resources

American Cancer Society – www.cancer.org, 1-800-ACS-2345

American Foundation for Urologic Disease - www.afud.org

Cancer Care, Inc. - www.cancercare.org, 1-800-813-HOPE

National Cancer Institute - www.cancer.gov, 1-800-4CANCER