Kidney Cancer (Renal Cell Cancer)

What is renal cell cancer?

Renal cell cancer (or renal cell carcinoma) is the most common type of kidney cancer. It is a life-threatening tumor, which is an abnormal growth of cells.

Your kidneys are located on each side of your spine just above your waist. They make urine by filtering waste products from your blood, control the balance of salt and water in your body, and help regulate your blood pressure.

How does it occur?

The cause of this disease is not known. It occurs mostly in adults who are 50 to 79 years old. You are more at risk for kidney cancer if you:

• are male
• smoke tobacco
• misuse certain pain medicines, including nonprescription pain medicines, for a long time
• have high blood pressure
• are being treated with long-term dialysis
• have been exposed to asbestos
• are overweight
• have a family history of kidney cancer
• have von Hippel-Lindau syndrome (a hereditary disease)
• have been exposed to cadmium (a type of metal) from batteries, paint, or welding materials.

What are the symptoms?

Symptoms vary, depending on how advanced the tumor is when it is found. Symptoms can include:

• blood in the urine (most common symptom)
• a lump that can be felt in the abdomen
• pain in the lower side of the back (called flank pain) that does not go away.

Some other, more general symptoms can include:

• weight loss
• fatigue
• fever.

How is it diagnosed?

Kidney cancer may be difficult to diagnose. Many kidney tumors are found when x-rays are taken for other reasons.

Your health care provider will ask about your symptoms and examine you. The tumor is felt during an abdominal exam only 20% of the time. For this reason, tests to view the kidney and tests of its function are done. These tests may include:

• blood tests to check for infection, anemia, and kidney function
• urine tests to check kidney function
• intravenous pyelogram (a kidneys x-ray study)
• ultrasound of the kidneys
• CT scan of the kidneys
• arteriogram (a special x-ray of the arteries and veins of the kidney).

To look for possible spread of kidney cancer, other studies may include a chest x-ray.

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.

Surgery to remove the kidney is usually done to treat renal cell cancer. If the cancer has not spread to nearby lymph nodes or other tissues, the long-term survival rates 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 likely to be helpful.

Your health care provider may also do a renal artery embolization, in which the blood flow through the artery that leads to the affected kidney is blocked. This decreases blood flow to the cancer. The tumor may become smaller then and may be easier to remove.

If the doctor removes all the cancer that can be seen at the time of the surgery, you will probably not be given chemotherapy or radiation therapy.

Another possible treatment is immunotherapy, which helps your body's own defenses to fight the cancer.

How long will the effects last?

The chances of cure vary, depending on how large the tumor is, whether it affects the surrounding tissue, and whether it has spread to other parts of the body.

Most of the symptoms of renal cell cancer occur when the cancer is fairly advanced. Because the chance for cure depends on finding the disease early, it is important to have regular medical checkups. It is also important to report symptoms such as blood in the urine or abdominal pain to your health care provider as soon as possible.

After treatment your provider will recommend regular checkups to see if the cancer has returned or spread. It is important to follow your provider's recommendations so that any recurrence can be found early. It is possible to have recurrences many years after removal of the cancer. In rare cases, similar cancer may appear in the other kidney.

How can I take care of myself?

• Follow the full course of treatment prescribed by your health care 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 health care 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 renal cell cancer?

Limit or prevent, if possible, your exposure to cigarette smoke, asbestos, and cadmium, which are associated with increased risk for this disease.