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Health Library : Cancer Center

 

Cancer Types - Kidney (Renal Cell) Cancer

What is a risk factor?

A risk factor is anything that may increase a person's chance of developing a disease. It may be an activity, such as smoking, diet, family history, or many other things. Different diseases, including cancers, have different risk factors.

Although these factors can increase a person's risk, they do not necessarily cause the disease. Some people with one or more risk factors never develop the disease, while others develop disease and have no known risk factors.

But, knowing your risk factors to any disease can help to guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease.

What is kidney cancer?

Most cancers are named after the part of the body where the cancer first begins, and kidney cancer is no exception. Kidney cancer begins in the kidneys, two large, bean-shaped organs - one located to the left, and the other to the right of the backbone. Renal is the Latin word for kidney, and kidney cancer may also be referred to as renal cancer.

About 57,760 persons in the US are expected to be diagnosed with kidney and renal pelvic cancers in 2009. Renal pelvic cancers are actually more similar to bladder cancer and are urothelial (transitional cell) cancers. More commonly, kidney cancers are a group of cancers typically called renal cell cancer. The information contained on this page refers to renal cell cancer.

What are the risk factors for renal cell cancer?

The exact cause of renal cell cancer is unknown. However, there are certain risk factors that increase the likelihood of the disease. These risk factors, according to the American Cancer Society, are as follows:

  • smoking
    Smoking increases the risk of kidney cancer. The risk seems related to the amount you smoke.
  • asbestos
    Studies show a link between exposure to asbestos and kidney cancer.
  • cadmium
    There may be a link between cadmium exposure and kidney cancer. Cadmium may increase the cancer-causing effect of smoking.
  • family history
    Family history of kidney cancer increases a person's risk.
  • gender
    Men are twice as likely to develop renal cell cancer than women.
  • von Hippel-Lindau syndrome
    This is a disease caused by a gene mutation that increases the chances of renal cell cancer.
  • Birt-Hogg-Dubé syndrome
    Patients who have this disease are more likely to develop renal cell cancer.
  • obesity
    Obesity increases a person's risk of kidney cancer.
  • long-term dialysis
    Patients who have been on dialysis for a long time may develop kidney cysts, which may be one cause of renal cell cancer.
  • high blood pressure
    Patients who have high blood pressure have a higher risk for kidney cancer.
  • diuretics (water pills)
    Drugs that eliminate excess body fluid may raise the risk of kidney cancer, although this is not clear.
  • race
    African Americans have a slightly higher risk of kidney cancer.

What are the symptoms of renal cell cancer?

The following are the most common symptoms of renal cell cancer. However, each individual may experience symptoms differently. Symptoms may include:

  • blood in the urine
  • rapid, unexplained weight loss
  • low back pain (not caused by an injury)
  • loss of appetite
  • swelling of ankles and legs
  • mass or lump in the belly
  • fatigue
  • recurrent fever (not caused by a cold or the flu)
  • high blood pressure (less frequently)
  • anemia (less frequently)
  • unrelieved pain in the side

The symptoms of renal cell cancer may resemble other medical conditions or problems. Always consult your physician for a diagnosis. More commonly, patients are currently diagnosed with renal cell cancer by finding kidney tumors incidentally on x-rays that are ordered for other reasons.

How is kidney cancer (renal cell cancer) diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for kidney cancer may include the following:

  • blood and urine laboratory tests
  • other imaging tests (to show the difference between diseased and healthy tissues), including the following:
    • computed tomography scan (Also called a CT or CAT scan.) - a noninvasive type of x-ray procedure that takes cross-sectional images of the brain or other internal organs; to detect any abnormalities that may not show up on an ordinary x-ray.
    • magnetic resonance imaging (MRI) - a noninvasive procedure that produces very detailed two-dimensional (2D) views of an internal organ or structure, especially the brain and spinal cord.
    • ultrasound (Also called sonography.) - a diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
    • chest x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
    • bone scan - a nuclear imaging method to evaluate any degenerative and/or arthritic changes in the joints; to detect bone diseases and tumors; to determine the cause of bone pain or inflammation.

Based on results of other tests and procedures, a biopsy may be needed. A biopsy is a procedure in which a sample of the tumor is removed and sent to the laboratory for examination by a pathologist. Most commonly, imaging studies (x-rays) are better than biopsy in diagnosing kidney cancers. In some circumstances, a biopsy may be beneficial.

Treatment for kidney cancer:

Specific treatment for kidney cancer will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

Treatment may include:

  • surgery
    Surgery to remove the kidney is called a nephrectomy and it is the most common treatment for kidney cancer. The following are different types of nephrectomy procedures:
    • radical nephrectomy - the whole kidney is removed along with the adrenal gland, tissue around the kidney, and, sometimes, lymph nodes in the area and/or the adrenal gland.
    • simple nephrectomy - only the kidney is removed.
    • partial nephrectomy - only the part of the kidney that contains the tumor is removed.
    • targeted tumor ablation - extreme temperature (hot or cold) can be delivered to the tumor and border of normal tissue in order to kill the tumor and preserve surrounding kidney

    Surgery can be performed with either open or minimally invasive surgery. Minimally invasive surgery is done with key-hole incisions in the abdomen and can be done with or without robotic assistance. These allow for quicker recovery. These may be technically challenging and require sufficient expertise to be done well.

Watch a video animation about partial nephrectomy using da Vinci robotic surgery

Watch a
video animation about nephrectomy using da Vinci robotic surgery

  • The remaining kidney is generally able to perform the work of both kidneys.

  • radiation therapy (Also called radiotherapy.)
    Radiation therapy uses high-energy x-rays to kill cancer cells, and is also sometimes used to relieve pain when kidney cancer has spread to the bone.
  • biological therapy (Also called immunotherapy.)
    Biological therapy is a treatment that uses the body's own immune system to fight cancer.
  • chemotherapy
    Chemotherapy is the use of drugs to kill cancer cells.
  • arterial embolization
    Arterial embolization is a procedure in which small pieces of a special gelatin sponge, or other material, are injected through a catheter to clog the main renal blood vessel. This procedure shrinks the tumor by depriving it of the oxygen-carrying blood and other substances it needs to grow. It may also be used before an operation to make surgery easier, or to provide relief from pain when removal of the tumor is not possible.

New chemotherapy drugs and targeted therapies including Avastin`#174; (bevacizumab), Nexavar® (sorafenib), Torisel® (temsirolimus), Afinitor® (everolimus), and Sutent® (sunitinib) are being used to treat kidney cancer. A vaccine for treatment also is under study.

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