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Kidney Cancer

Kidney cancer is the eighth most commonly diagnosed cancer among men and women in the United States, with approximately 76,000 new cases diagnosed each year.

Risk Factors

  • Smoking
  • Obesity
  • High blood pressure
  • Family history of kidney cancer
  • Hereditary conditions
    • von Hippel-Lindau disease
    • Hereditary papillary renal cell carcinoma
    • Hereditary leiomyoma-renal cell carcinoma
    • Birt-Hogg-Dube syndrome
    • Familial renal cancer
    • Cowden syndrome
    • Tuberous sclerosis
  • Advanced kidney disease/dialysis

Signs and Symptoms

Early stage (small) kidney cancers often do not cause any signs or symptoms and may be found incidentally on abdominal imaging studies performed for a completely different reason.

If kidney cancers are larger, they may cause:

  • Blood in the urine
  • Low back pain on one side
  • Fatigue
  • Weight loss
  • Mass or lump in the abdomen or flank

Screening and Diagnosis

Currently, there is no routine screening recommended for kidney cancer. Most are diagnosed early as small kidney masses found incidentally on abdominal imaging studies. Simple kidney (or renal cysts) are benign and do not require further investigation. If a complex cyst or solid renal mass is identified, you should seek urologic consultation for further imaging studies to determine if the mass is concerning for kidney cancer. Your doctor or urologist may order a special CT or MRI with contrast for better definition of the mass.

If masses are found to be enhancing (taking up contrast on the specialized imaging), these are likely to be kidney cancer about 80% of the time, with about 20% being benign renal masses. Some patients may elect to undergo a biopsy of the kidney mass before deciding on treatment. Talk to your doctor about whether a biopsy would help guide treatment options in your situation.

Treatment

Masses that are localized to the kidney (no evidence of spread outside the kidney or to other organs) can be treated using minimally invasive surgery with partial nephrectomy (removing part of the kidney) or radical nephrectomy (removing the entire kidney). Being able to remove part of the kidney is determined by tumor size, location, and proximity to major blood vessels or the urine collecting system of the kidney. If the mass is larger or in certain locations within the kidney, a radical nephrectomy may be a better and safer option. The pathologist will then determine the type of kidney cancer and the stage.

Some kidney tumors, if biopsy-proven kidney cancer, may be amenable to less invasive ablation treatments such as radiofrequency ablation (heat therapy) or cryotherapy (freeze therapy). These options may be limited by tumor size, location within the kidney, and proximity to major blood vessels and surrounding organs. An interventional radiology consultation would be required for these methods.

A majority of localized kidney cancers are treated with surgery alone and only require surveillance abdominal imaging at regular intervals. In those patients with metastatic kidney cancer, immunotherapy drugs may be offered. Traditional chemotherapy and radiation treatments are not common in the treatment of kidney cancer.