About Kidney Cancer

What is Kidney Cancer?

 

Kidney cancer, also called renal cancer, forms in the kidneys. We each have two kidneys, which are organs shaped like beans. These important organs are responsible for removing excess water, salt, and waste from the blood. The kidneys also make the hormone erythropoietin, which tells the bone marrow to make red blood cells, and the hormone renin, which controls blood pressure.

 

The American Cancer Society estimated that in 2020, there will be approximately 73,750 new cases of kidney cancer in the United States. Most people diagnosed with this form of cancer are older, with the average age being 64. It’s uncommon in individuals under 45 years old. In 2020, doctors estimate that around 14,830 people in the United States will die of kidney cancer.

 

The different types of kidney cancer include:

 

Renal cell carcinoma – This is also called renal cell adenocarcinoma or renal cell cancer. It’s the most common form of kidney cancer. One tumor typically develops within the kidney, but two or more tumors can form in one kidney. Or a tumor can develop in both kidneys.

 

Clear cell renal cell carcinoma – The most common type of renal cell carcinoma. The cancer cells look clear or very pale.

 

Non-clear cell renal cell carcinoma – There are various subtypes, described in detail below.

 

Papillary renal cell carcinoma form papillae (small finger-like projections) in some or most of the tumor. It is the second-most common subtype.

 

Chromophobe renal cell carcinoma has large, pale cancer cells. This subtype is rare, accounting for five of every 100 cases.

 

Very rare renal cell carcinomas make up less than 1 percent of cases. They include several types, including:

  • Medullary carcinoma

  • Collecting duct renal cell carcinoma

  • Neuroblastoma-associated renal cell carcinoma

  • Multilocular cystic renal cell carcinoma

  • Mucinous tubular and spindle cell carcinoma

  • Transitional cell carcinoma – Cancer forms in the lining of the renal pelvis instead of the kidney

  • Wilms tumor (nephroblastoma) – Children are typically diagnosed with this type of cancer; it is rarely seen in adults

  • Renal sarcoma – Cancer starts in the blood vessels or connective tissue of the kidney

Benign kidney tumors are non-cancerous and have not spread to other body parts. However, they could lead to medical problems. Treatment could involve removing or destroying the tumor. This depends on the size and number of tumors, whether they’re in one or both kidneys, and if they’re causing symptoms.

 

A cancer diagnosis can be scary. Fortunately, kidney cancer is curable if detected early. The five-year survival rate is 75 percent. This depends on various factors, such as the type and stage at diagnosis. About two-thirds of individuals with this type of cancer only have one kidney affected. This group of people has a 93 percent five-year survival rate. If the cancer spreads to surrounding tissues or distant body parts, survival rates decrease.

Risk Factors Associated with Kidney Cancer

 

The exact causes of kidney cancer remain unknown to science. However, doctors know that cancer forms when there are changes to a person’s DNA inside their cells. This is known as a mutation. DNA is a chemical that makes up an individual’s genes and performs the following functions:

  • Tumor suppressor genes control cell division and cause cells to die at the right moment

  • Oncogenes divide, grow, and keep cells alive

DNA mutations can be inherited from a family member or acquired over a lifetime:

  • Inherited gene mutations – Families pass down this type of mutation from generation to generation. Someone who gets this gene from their parent could have an increased risk of kidney cancer in the future.

  • Acquired gene mutations – Instead of inheriting mutations from a parent, it can happen during someone’s life. Most types of kidney cancer are the result of acquired gene mutations.

A risk factor is something that increases a person’s risk of developing cancer or another disease. Scientists discovered multiple factors that could increase the risk of kidney cancer:

  • High blood pressure (hypertension)

  • Old age

  • Male

  • African-American

  • Obesity

  • Smoking

  • Inherited syndromes, such as tuberous sclerosis complex

  • Long-term dialysis treatment

  • Family history

You should keep in mind that having any of the risk factors above does not mean you will get kidney cancer. If these risk factors apply to you, you should see your doctor and talk about monitoring your health for any abnormal cells. Remaining diligent in your medical care could improve your chance of diagnosing kidney cancer early, so that numerous treatment options are available.

Common Signs and Symptoms of Kidney Cancer

 

When kidney cancer is in earlier stages, you might not have any symptoms. Some symptoms might not be of concern or could indicate another disease or medical problem. You should schedule an appointment with your doctor if you have risk factors for kidney cancer and are experiencing any of the following symptoms:

  • Loss of appetite

  • Blood in the urine (hematuria)

  • Lump on the lower back or side

  • Anemia

  • Weight loss

  • Fatigue

  • Low back pain on one side that isn’t the result of an injury

  • Fever that doesn’t go away and isn’t due to an infection

If you have developed any of the symptoms above and they’re persistent or cause concern, you should seek the help of a medical professional. Most of the time, symptoms occurring singly or infrequently indicate a minor issue that will resolve on its own. You should not try to self-diagnose or assume the worst. Only an experienced doctor can examine you to determine what’s causing your symptoms and perform testing for kidney cancer.

 

Is it Possible to Prevent Kidney Cancer?

Since the cause of kidney cancer is unknown, there isn’t a definitive solution for preventing this disease. However, you might be able to reduce your risk of getting it by improving your overall health and taking certain precautions.

  • Quit smoking - It is widely known that smoking can cause cancer and other types of diseases. You might be able to reduce your risk of kidney cancer if you quit. There are many options that could help you quit. This can be discussed with your doctor or while attending a support program.

 

  • Lower blood pressure – Schedule an appointment with your primary care physician to check your blood pressure. If it’s high, there are lifestyle changes you could make to lower it. Dietary changes, weight loss, and exercise could all help. If necessary, your doctor could prescribe medication.

 

  • Maintain weight – Obesity is a known risk factor for kidney cancer. If you are obese or overweight, you could try increasing your daily physical activity or cut high-fat foods out of your diet. A nutritionist or personal trainer could assist you with this issue.

Screening Options for Kidney Cancer

 

Some types of kidney cancer are discovered before they have a chance to spread outside the kidney. Unfortunately, some aren’t found until they reach an advanced stage. The reasons that could happen are:

  • Physical exams typically don’t uncover small tumors since the kidneys are deep inside a person’s body

  • Symptoms might not develop until cancer becomes large

  • Recommended screening tests are not available for someone who doesn’t have an increased risk of developing the disease

Some tests could detect kidney cancer before it progresses, but since it isn’t recommended for people at average risk, you might have to advocate for yourself and speak to a doctor if you develop any of the common symptoms.

Possible screening tests might include the options below.

People at Average Risk

Typically, someone at average or low risk of kidney cancer won’t undergo screenings. They discover the disease only if they go to a doctor for another medical issue or symptoms they don’t believe are related to a serious disease.

  • Urinalysis – This could detect small amounts of blood in a urine sample. Sometimes blood in the urine could result from kidney stones, urinary tract infections, or another medical problem. Even if someone does have kidney cancer, they might not have blood in their urine if the tumor is small or has not spread.

  • Imaging – Magnetic resonance imaging (MRI) and computed tomography (CT) scans could detect small forms of kidney cancer; however, they are expensive. If you don’t have health insurance, you could end up spending thousands of dollars. An ultrasound is a cheaper option and could discover an early type of kidney cancer. Unfortunately, imaging tests can’t distinguish between benign tumors and renal cell carcinomas.

People at Increased Risk

Anyone with inherited conditions is at a higher risk of developing kidney cancer and should undergo regular imaging testing to locate tumors and determine if they’re cancerous. Whether you get an MRI, CT, or ultrasound will depend on your specific situation. You can discuss this with your doctor to determine the best option and how often you should see them.

 

Your doctor might recommend genetic testing if any of your blood relatives were diagnosed with an inherited condition associated with cancer or kidney cancer, especially if they were young at the time. Genetic tests can detect gene mutations that lead to certain conditions in your DNA. It is only meant to diagnose inherited conditions, not to detect cancer. However, if you have an inherited condition, you could have increased risk of developing kidney cancer.

Diagnosing Kidney Cancer

 

If you have symptoms of kidney cancer, visit your healthcare provider immediately. They will review your medical history, family history, and risk factors of the disease. They will also perform a physical exam to check for lumps in suspicious areas. If they believe you could have kidney cancer, they will recommend further testing.

Different tests you could undergo to determine if you have kidney cancer include the following:

Blood tests – Laboratory results don’t definitively tell us whether someone has cancer but could indicate a problem with the kidneys. If you already have cancer, labs could determine if cancer spread to other parts of the body and provide the doctor with a sense of your overall health. It could also indicate whether you could handle an operation.

Testing is done on urine samples to detect blood and other substances. Approximately half of the individuals who have renal cell cancer have blood in their urine. Cytology could show cancer cells in the urine if someone develops transitional cell carcinoma.

  • Complete blood count (CBC) – This test measures the number of cells a person has in their blood. If kidney cancer is present, the result of the test should be abnormal. Anemia is common in individuals with this form of cancer. CBC is also necessary for determining if someone can undergo surgery.

  • Blood chemistry test – Kidney cancer can affect the level of chemicals in an individual’s blood. This type of test could detect high levels of liver enzymes or calcium. It can also measure kidney function to determine if there’s anything abnormal.

Imaging – Imaging tests create pictures of the inside of the body for any of the following reasons:

  • Determine where cancer spread

  • Look at suspicious areas that could indicate cancer

  • Determine if treatment has been effective

  • Check for signs of recurrence

The type of imaging your doctor recommends will depend on different factors. Some people can’t undergo certain tests because of an allergy or underlying medical conditions.

  • Computed tomography (CT) – X-rays make a cross-sectional image of the body to provide information about the tumor’s location, shape, and size. It can also detect if the cancer spread to lymph nodes nearby or other organs. An intravenous (IV) contrast dye is typically necessary to improve the scan's visibility of certain areas. You will need to get a blood test to check your kidney function because this contrast could damage the kidneys.

  • Magnetic resonance imaging (MRI) – If your kidney function is poor or you’re allergic to the contrast dye, an MRI might be a better option. This type of scan takes cross-sectional images from different angles. It also takes better pictures of blood vessels than CT scans.

  • Ultrasound – High-frequency sound waves that go through your body create images called sonograms. It can detect a mass and determine if it’s filled with fluids or solid. Doctors can also use an ultrasound to differentiate between malignant and benign tumors. 

  • Angiography – This is a type of X-ray that uses a contrast dye to look at blood vessels. It can indicate which blood vessels are feeding the tumor.

  • Chest X-ray – This type of image could determine if cancer metastasized (spread) to the lungs.

  • Bone scan – During a bone scan, a doctor will inject a low-level radioactive substance into the blood to detect abnormal areas of the bone and show if that’s where cancer has spread.

  • Biopsy – A small sample of tissue is taken from the kidney during a biopsy. It is sent to a lab for evaluation under a microscope to determine if there are cancerous cells. It might not be necessary since imaging tests could detect a tumor.

If you were diagnosed with kidney cancer, your doctor would have to determine if it spread and which parts of the body might be affected. This is known as staging and involves the TNM system. There are three major factors needed to determine the stage of kidney cancer:

  • Tumor (T) – Size and extent of the primary tumor (where it originated)

  • Nodes (N) – Whether cancer spread to nearby lymph nodes

  • Metastasis (M) – Whether cancer spread to other organs

A number or letter placed after the T, N, or M indicates the amount of cancer in the body and whether it is at an advanced stage. The different stages of kidney cancer use Roman numerals between I and IV.

  • Stage I – The tumor is no more than 2 ¾ inches in diameter and is located in only one kidney

  • Stage II – The tumor is over 23/4 inches in diameter and still in only one kidney

  • Stage III – Cancer spread to surrounding tissues and might be in nearby lymph nodes

  • Stage IV – Cancer spread to more than one lymph node or distant organs or body parts, such as the lungs, bones, or liver

Common Types of Kidney Cancer Treatment

 

Stages I, II, and III of Kidney Cancer

Surgery is typically an option to remove cancer. The two common types include:

  • Radical nephrectomy – Remove the entire affected kidney

  • Partial nephrectomy – Remove part of the affected kidney; this is usually an option if the tumor is less than three inches in size

The surgeon might also be able to remove the nearby lymph nodes affected. In some Stage III cases, it might have spread to nearby veins, and the surgeon can open the veins to remove cancer.

 

After surgery, those at risk of recurrence might benefit from targeted therapy. This involves using specific drugs that target abnormalities in the cancer cells and destroy them.

 

If surgery is not a good option due to another serious medical condition, you might be able to try radiation therapy. Typically, external beam therapy is used to focus radiation from outside the body onto the cancer. If your cancer spread to a single area, stereotactic body radiation therapy could be a good option.

Stage IV Kidney Cancer

Surgery might still be an option, depending on the extent of cancer and what areas of the body have become affected. If cancer only spread to one other place and the primary tumor can be removed, a surgeon could remove the entire kidney and the area where the cancer spread.

 

If cancer spreads extensively throughout the body, removing the primary tumor might not be a good option. In that situation, systemic therapy might be a recommendation. That could include targeted therapy on its own, two immunotherapy drugs, or an immunotherapy drug with targeted therapy.

 

If all treatments have been exhausted, it may be possible to enroll in a Phase I trial (The first time a new drug is used in a person). This is an important decision that should be discussed with your doctor to understand if it makes sense for you.

Alternative Medicine

Although it has not been proven that alternative medicine can cure kidney cancer, it might manage your symptoms and the side effects of medical treatments, boost your mood, and help you cope. These types of treatment include:

  • Music therapy

  • Art therapy

  • Exercise

  • Meditation

  • Spirituality

  • Massage therapy

  • Relaxation exercises

Take These Steps to Prepare for Your Appointment

 

If you don’t have symptoms that concern you, make your initial appointment with your primary care physician. They could refer you to a specialist if they believe you might have kidney cancer. You should show up prepared and write down questions, so you don’t forget to discuss anything while you are there.

 

When you call to make the appointment, ask the receptionist if you have to do anything before showing up, such as restricting your diet, fasting, or avoiding certain activities or medications.

 

Make a detailed list of the following information:

  • Personal details, such as life changes or stressors

  • Family history of kidney cancer

  • Your history of kidney cancer or other types of disease

  • Diagnosis of current medical conditions

  • Medications you are taking, including herbal supplements, vitamins, and over-the-counter drugs

  • Symptoms you’ve been experiencing and how long you’ve had them

Crucial questions you could ask the doctor during your appointment include:

  • What tests will you perform to determine if I have kidney cancer?

  • Has the cancer spread to other parts of my body?

  • What are my treatment options?

  • What’s the prognosis of my diagnosis?

  • What are some side effects I could experience from each treatment?

  • How will this affect my daily routine?

You should gain as much knowledge from your doctors as possible. Don’t be afraid to seek a second opinion to ensure you were diagnosed correctly and received all the information you need to make an informed decision about your treatment. Your doctor will recommend the treatment option they believe is best for your situation, but it’s ultimately your choice on how to proceed.

Fight Kidney Cancer with Our Help

The START Center for Cancer Care understands the battle you’re facing. When you’re diagnosed with kidney cancer, it can be scary, confusing, and overwhelming. We have more than 35 years of experience providing quality medical care for our patients so they can treat their disease and move forward with their lives.

 

If you have kidney cancer and want to find out your options, call us at (210) 593-5700 today or fill out our online form.