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Kidney Cancer / Renal Cell Carcinoma

Definition

Renal cell carcinoma is a type of kidney cancer that starts in the lining of very small tubes (tubules) in the kidney.

Alternative Names

Renal cancer; Kidney cancer; Hypernephroma; Adenocarcinoma of renal cells; Cancer - kidney

Causes

Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in men ages 50 - 70.

The exact cause is unknown.

The following may increase your risk of kidney cancer:

  • Dialysis treatment
  • Family history of the disease
  • High blood pressure
  • Horseshoe kidney
  • Polycystic kidney disease
  • Smoking
  • Von Hippel-Lindau disease (a hereditary disease that affects blood vessels in the brain, eyes, and other body parts)

Symptoms

Other symptoms that can occur with this disease:

  • Constipation
  • Cold intolerance
  • Excessive hair growth in females
  • Pale skin
  • Vision problems

Exams and Tests

The health care provider will perform a physical exam. This may reveal:

  • Mass or swelling of the abdomen
  • A varicocele in the male scrotum

Tests include:

  • Abdominal CT scan
  • Blood chemistry
  • Complete blood count (CBC)
  • Intravenous pyelogram (IVP)
  • Liver function tests
  • Renal arteriography
  • Ultrasound of the abdomen and kidney
  • Urine tests

The following tests may be done to see if the cancer has spread:

  • Abdominal CT scan
  • Abdominal MRI
  • Bone scan
  • Chest X-ray and CT scan
  • PET scan

Treatment

Surgery to remove of all or part of the kidney (nephrectomy) is recommended. This may include removing the bladder, surrounding tissues, or lymph nodes. A cure is unlikely unless all of the cancer is removed with surgery.

Hormone treatments may reduce the growth of the tumor in some cases.

Chemotherapy is generally not effective for treating renal cell carcinoma. However, the drug interleukin-2 (IL-2) may help a small number of patient. It tells the body’s own immune system kill the cancer cells. It is very toxic.

Other chemotherapy drugs have been used, but patients generally do not live long once the disease has spread outside the kidney.

Newer medicines to treat kidney cancer include:

  • Sorafenib (Nexavar)
  • Sunitinib (Sutent)
  • Temsirolimus (Torisel)
  • Bevacizumab (Avastin)

Radiation therapy usually does not work for renal cell carcinoma so it is not often used.

Support Groups

You can ease the stress of illness by joining a support group whose members share common experiences and problems.

Outlook (Prognosis)

Sometimes both kidneys are involved. The cancer spreads easily, most often to the lungs and other organs. In about one-third of patients, the cancer has already spread (metastasized) at the time of diagnosis.

How well a patient does depends on how much the cancer has spread and how well treatment works. The survival rate is highest if the tumor is in the early stages and has not spread outside the kidney. If it has spread to the lymph nodes or to other organs, the survival rate is much lower.

Possible Complications

  • High blood pressure (hypertension)
  • Too much calcium in the blood
  • High red blood cell count
  • Liver problems
  • Spread of the cancer

When to Contact a Medical Professional

Call your health care provider any time you see blood in the urine. Also call if you have any other symptoms of this disorder.

Prevention

Stop smoking. Follow your health care provider's recommendations in the treatment of kidney disorders, especially those that may require dialysis.

References

Barjorin D. Tumors of the kidney, bladder, ureters, and renal pelvis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 2007.

National Comprehensive Cancer Network. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Kidney Cancer. 2011. Version 1.2011.