Kidney cancer (also called renal cell cancer or renal cell adenocarcinoma) is a disease in which malignant cancer cells form in tubules of the kidney. Approximately 54,000 Americans are diagnosed with kidney cancer each year according to the National Cancer Institute. 

Risk Factors

  • Age, typically affects those over 50
  • Genetic conditions, such as von Hippel-Lindau disease, Tuberous Sclerosis or hereditary papillary renal cell carcinoma
  • Long-term dialysis
  • High-fat diet
  • Obesity
  • Smoking
  • Exposure to asbestos
  • Cadmium exposure

Symptoms

In early stages there are usually no symptoms. As the disease progresses symptoms may include:

  • Blood in the urine
  • A mass or lump in the abdomen
  • A pain in the side or lower back that doesn't go away
  • Loss of appetite
  • Weight loss for no known reason
  • Anemia
  • Chronic fatigue
  • Leg and ankle swelling
  • Fever
  • Hypertension (high blood pressure)

Detection and Diagnosis

Intravenous Pyleogram (IVP): After dye is injected into the patient, a series of x-rays tracks it as it moves through the kidneys to the ureters and bladder to show a kidney tumor or other problems. This test has largely been replaced by more advanced imaging studies.

Computed Tomography Scan (CT Scan): An x-ray machine linked to a computer takes a series of detailed pictures of the kidneys. A CT scan can help show a kidney tumor in more detail as well as surrounding organs. Most renal cancers today are detected as accidental or incidental findings on CT scans done for other reasons.

Magnetic Resonance Imaging (MRI Scan): Multiple views of the kidneys and surrounding structures are taken with a powerful magnet linked to a computer.. Intravenous contrast usually is used to help enhance the visualization of the area.

Ultrasound: Uses high frequency sound waves to see inside the body. 

Biopsy: the removal of tissue to look for cancer cells. 

Treatment

Surgery

  • Radical Nephrectomy: The surgeon removes the entire kidney along with the adrenal gland and some tissue around the kidney. Some lymph nodes in the area also may be removed. This type of surgery can be done via traditional surgical, laparoscopic and robotic-assisted approaches. Laparoscopic and robotic approaches minimize the recovery time and are possible for most patients.
  • Partial Nephrectomy: The surgeon removes only the part of the kidney that contains the tumor. This type of surgery may be used when the tumor is small (less than 1.5 inches), if the patient has only one kidney or when the cancer affects both kidneys. This type of surgery can be done via traditional surgical, aparoscopic and robotic-assisted approaches. Laparoscopic and robotic approaches minimize the recovery time and are possible for most patients.
  • Ablation Therapy: Rather than removing the tumor, a probe destroys the tumor by either very high heat (radiofrequency ablation) or low temperatures (cryoablation). These probes are placed under direct visualization or with the assistance of x-ray images such as an ultrasound or CT scan.

Localized Therapy

  • Arterial Embolization: Shrinks the tumor by blocking oxygen and other substances it needs to grow.  
  • Radiation Therapy: Also known as radiotherapy, uses high doses of radiation to kill cancer cells. Although it has proven effective with other cancers, it has limited use for the treatment of kidney cancer except in extreme cases.

Systemic Therapy

Biological Therapy: Uses the body's natural ability (immune system) to fight cancer. For patients with metastatic kidney cancer, the doctor may suggest interferon alpha or interleukin-2 (also called IL-2 or aldesleukin). The body normally produces these substances in small amounts in response to infections and other diseases. For cancer treatment, they are made in the laboratory in large amounts.

Chemotherapy: Anticancer drugs enter the bloodstream and travel throughout the body. Although useful for many other cancers, anticancer drugs have shown limited use against kidney cancer.

Prevention

Some risk factors for developing kidney cancer are hereditary, but you can reduce your risk for developing this form of cancer if you:

  • Avoid tobacco products
  • Avoid exposure to asbestos and cadmium
  • Try to achieve and maintain a healthy weight