Kidney Cancer

Your kidneys are a pair of bean-shaped, fist-sized organs in your abdomen, and are responsible for filtering and removing wastes and extra water from the blood by creating urine. Urine travels from the renal pelvis, a hollow space within each kidney, down thin tubes (ureters) to the bladder, which then stores urine and empties it through the urethra. Kidneys also make hormones and substances to help control blood pressure and produce red blood cells.

Kidney cancer is a cancer that forms in the tissues of the kidneys. It can include renal cell carcinoma, or cancer that forms in the lining of the small tubes that filter the blood and remove waste products; renal pelvis carcinoma, where cancer forms in the center of the kidney where urine collects; or Wilms tumor, a type of kidney cancer that usually develops in children under the age of 5.

The UC Davis Comprehensive Cancer Center provides multidisciplinary care for patients with all stages of kidney cancer. Our patients receive all of their care from a team of top academic physicians and health care practitioners. Our highly skilled, compassionate medical oncologists work closely with their colleagues in urologic oncology, surgical oncology and radiation oncology to provide each patient with accurate diagnosis and state-of-the-art, individualized treatment.

cell A diagnosis will begin with a physical exam, and may be followed by 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. The echoes 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.

Biopsy: Depending on your circumstance, the doctor may recommend a biopsy of your kidney tumor. The doctor inserts a thin needle through your skin into the kidney to remove a small sample of tissue. Your doctor may use ultrasound or a CT scan to guide the needle. A pathologist uses a microscope to check for cancer cells in the 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.

Sources: National Cancer Institute and UC Davis Comprehensive Cancer Center

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

Sources: National Cancer Institute and UC Davis Comprehensive Cancer Center

No one knows the exact cause of kidney cancer. However, studies have found the following risk factors for kidney cancer:

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 an altered 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.

Sources: National Cancer Institute and UC Davis Comprehensive Cancer Center

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 selected depends mainly on four factors: 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; and your age and general health.

Surgery

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. There are different types of surgeries, either of which may be performed via open surgery (incision into the body) or laparoscopically (smaller incisions, sometimes with a robotic surgical system):

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 may also be removed.
Partial nephrectomy: The surgeon removes only the part of the kidney that contains the tumor. People with a kidney tumor that is smaller than a tennis ball may choose this type of surgery.

If one kidney is removed, the remaining kidney is usually able to do the work of both kidneys. However, if your remaining kidney isn’t doing a good job cleaning your blood, you may need dialysis. Some people may need a transplant with a healthy kidney from a donor.

The surgeon may use other methods of destroying the cancer in the kidney. For people who have a tumor smaller than 4 centimeters and who can’t have surgery to remove part of the kidney because of other health problems, the surgeon may suggest:

Cryosurgery: The surgeon inserts a tool through a small incision or directly through the skin into the tumor. The tool freezes and kills the kidney tumor.
Radiofrequency ablation: The surgeon inserts a special probe directly through the skin or through a small incision into the tumor. The probe contains tiny electrodes that kill the kidney cancer cells with heat.

More about surgical interventions for kidney cancer

Targeted Therapy

People with kidney cancer that has spread may receive a type of drug called targeted therapy. This treatment may shrink a kidney tumor or slow its growth. Usually, this therapy is taken by mouth. Side effects may include lethargy, diarrhea, nausea, vomiting, sores on the lips or in the mouth, and high blood pressure.

Biological Therapy

People with kidney cancer that has spread may receive biological therapy, which is a treatment that may improve the body’s natural defense (the immune system response) against cancer. The biological therapy is injected intravenously or under the skin. This treatment may be given at the hospital or a doctor’s office. The treatments used for kidney cancer can slow the growth of tumors or shrink them.

Other drugs may be given at the same time to prevent side effects. The side effects differ with the biological therapy used, and from person to person. Biological therapy commonly causes a rash or swelling. You may feel very tired during treatment, or experience a headache, muscle aches, a fever or weakness.

Sources: National Cancer Institute and UC Davis Comprehensive Cancer Center