Kidney Cancer

You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. The tubes inside filter and clean your blood, taking out waste products and making urine. Kidney cancer forms in the lining of tiny tubes inside your kidneys.

Kidney cancer becomes more likely as you age. Risk factors include smoking, having certain genetic conditions, and misusing pain medicines for a long time.

You may have no symptoms at first. They may appear as the cancer grows.

SEE YOUR HEALTH CARE PROVIDER IF YOU NOTICE

• Blood in your urine
• A lump in your abdomen
• Weight loss for no reason
• Pain in your side that does not go away
• Loss of appetite

Treatment depends on your age, your overall health and how advanced the cancer is. It might include surgery, chemotherapy, or radiation, biologic, or targeted therapies. Biologic therapy boosts your body’s own ability to fight cancer. Targeted therapy uses substances that attack cancer cells without harming normal cells.

Risk Factors

• Smoking: Smoking tobacco is an important risk factor for kidney cancer. People who smoke have a higher risk than nonsmokers. The risk is higher for those who smoke more cigarettes or for a long time.
• Obesity: Being obese increases the risk of kidney cancer.
• High blood pressure: Having high blood pressure may increase the risk of kidney cancer.
• Family history of kidney cancer: People with a family member who had kidney cancer have a slightly increased risk of the disease. Also, certain conditions that run in families can increase the risk of kidney cancer.
  • Von Hippel-Lindau (VHL) syndrome: VHL is a rare disease that runs in some families. It’s caused by changes in the VHL gene. People with a changed VHL gene have an increased risk of kidney cancer. They may also have cysts or tumors in the eyes, brain, or other parts of the body. Family members of those with VHL can have a test to check for a changed VHL gene.

Many people who get kidney cancer have none of these risk factors, and many people who have known risk factors don’t develop the disease.

Symptoms

COMMON SYMPTOMS OF KIDNEY CANCER INCLUDE:

• Blood in your urine (which may make urine look rusty or darker red)
• Pain in your side that doesn’t go away
• A lump or mass in your side or abdomen
• Weight loss for no known reason
• Fever
• Feeling very tired

These symptoms may be caused by kidney cancer or by other health problems, such as an infection or a kidney cyst. People with these symptoms should tell their doctor so that any problem can be diagnosed and treated as early as possible.

Diagnosis

If you have symptoms that suggest kidney cancer, your doctor will try to find out what’s causing the problems. You may have a physical exam.

ALSO, YOU MAY HAVE ONE OR MORE OF THE FOLLOWING TESTS:

• Urine tests: The lab checks your urine for blood and other signs of disease.
• Blood tests: The lab checks your blood for several substances, such as creatinine. A high level of creatinine may mean the kidneys aren’t doing their job.
• Ultrasound: An ultrasound device uses sound waves that can’t be heard by humans. The sound waves make a pattern of echoes as they bounce off organs inside your abdomen and create a picture of your kidney and nearby tissues. The picture can show a kidney tumor.
• CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your abdomen. You may receive an injection of contrast material so your urinary tract and lymph nodes show up clearly in the pictures. The CT scan can show cancer in the kidneys, lymph nodes, or elsewhere in the abdomen.
• MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of your urinary tract and lymph nodes. You may receive an injection of contrast material. MRI can show cancer in your kidneys, lymph nodes, or other tissues in the abdomen.
• IVP: You’ll receive an injection of dye into a vein in your arm. The dye travels through the body and collects in your kidneys. The dye makes them show up on x-rays. A series of x-rays then tracks the dye as it moves through your kidneys to your ureters and bladder. The x-rays can show a kidney tumor or other problems.
• Biopsy: The removal of tissue to look for cancer cells is a biopsy. In some cases, your doctor will do a biopsy to diagnose kidney cancer. Your doctor inserts a thin needle through your skin into the kidney to remove a small sample of tissue.
• Surgery: After surgery to remove part or all of a kidney tumor, a pathologist can make the final diagnosis by checking the tissue under a microscope for cancer cells.

Treatment

Common treatment options for people with kidney cancer are surgery, targeted therapy, and biological therapy. You may receive more than one type of treatment.

THE TREATMENT THAT’S RIGHT FOR YOU DEPENDS MAINLY ON THE FOLLOWING:

• The size of the tumor
• Whether the tumor has invaded tissues outside the kidney
• Whether the tumor has spread to other parts of the body
• Your age and general health

You may have a team of specialists to help plan your treatment. Your doctor may refer you to a specialist, or you may ask for a referral.

You may want to see an urologist, a surgeon who specializes in treating problems of the urinary tract. Other specialists who treat kidney cancer include urologic oncologists (surgeons who specialize in cancers of the urinary tract), medical oncologists, and radiation oncologists.

Your health care team may also include an oncology nurse and a registered dietitian. Your health care team can describe your treatment choices, the expected results of each, and the possible side effects.

Because cancer therapy often damages healthy cells and tissues, side effects are common. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. You and your health care team can work together to develop a treatment plan that meets your needs.

Surgery is the most common treatment for people with kidney cancer. The type of surgery depends on the size and stage of the cancer, whether you have two kidneys, and whether cancer was found in both kidneys.

You and your surgeon can talk about the types of surgery and which may be right for you.

Recovery

You’ll need regular checkups (such as every 6 months) after treatment for kidney cancer. Checkups help ensure that any changes in your health are noted and treated if needed.

Kidney cancer may come back after treatment. Your doctor will check for return of cancer. Checkups may include blood tests, a chest x-ray, CT scans, or an ultrasound.