standard-title Kidney Cancer

Kidney Cancer

Kidney Cancer


About the Condition

Kidney Cancer

Kidney cancer is cancer that originates in the kidneys. Your kidneys are two bean-shaped organs, each about the size of your fist. They’re located behind your abdominal organs, with one kidney on each side of your spine.

In adults, the most common type of kidney cancer is renal cell carcinoma. Other less common types of kidney cancer can occur. Young children are more likely to develop a kind of kidney cancer called Wilms’ tumor.

The incidence of kidney cancer seems to be increasing. One reason for this may be the fact that imaging techniques such as computerized tomography (CT) scan are being used more often. These tests may lead to the accidental discovery of more kidney cancers.

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Signs and Symptoms

Kidney cancer rarely causes signs or symptoms in its early stages. In the later stages, kidney cancer signs and symptoms may include:

  • Blood in your urine, which may appear pink, red or cola colored
  • Back pain just below the ribs that doesn’t go away
  • Weight loss
  • Fatigue
  • Intermittent fever

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Risk Factors

Factors that can increase the risk of kidney cancer include:

  • Older age. Your risk of kidney cancer increases as you age.
  • Smoking. Smokers have a greater risk of kidney cancer than nonsmokers do. The risk decreases after you quit.
  • Obesity. People who are obese have a higher risk of kidney cancer than do people who are considered average weight.
  • High blood pressure (hypertension). High blood pressure increases your risk of kidney cancer.
  • Treatment for kidney failure. People who receive long-term dialysis to treat chronic kidney failure have a greater risk of developing kidney cancer.
  • Certain inherited syndromes. People who are born with certain inherited syndromes may have an increased risk of kidney cancer, including those who have von Hippel-Lindau disease, Birt-Hogg-Dube syndrome, tuberous sclerosis and familial papillary renal cell carcinoma.

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Diagnostic Process

Diagnosing kidney cancer

Tests and procedures used to diagnose kidney cancer include:

  • Blood and urine tests.Tests of your blood and your urine may give your doctor clues about what’s causing your signs and symptoms.
  • Imaging tests. Imaging tests allow your doctor to visualize a kidney tumor or abnormality. Imaging tests might include ultrasound, computerized tomography (CT) scan or magnetic resonance imaging (MRI).
  • Removing a sample of kidney tissue (biopsy). In rare cases, your doctor may recommend a procedure to remove a small sample of cells (biopsy) from a suspicious area of your kidney. The sample is tested in a lab to look for signs of cancer.

Kidney cancer staging

Once your doctor identifies a kidney lesion that might be kidney cancer, the next step is to determine the extent (stage) of the cancer. Staging tests for kidney cancer may include additional CT scans or other imaging tests your doctor feels are appropriate.

Then your doctor assigns a number, called a stage, to your cancer. Kidney cancer stages include:

  • Stage I. At this stage, the tumor can be up to 2 3/4 inches (7 centimeters) in diameter. The tumor is confined to the kidney.
  • Stage II. A stage II kidney cancer is larger than a stage I tumor, but it’s still confined to the kidney.
  • Stage III. At this stage, the tumor extends beyond the kidney to the surrounding tissue and may also have spread to a nearby lymph node.
  • Stage IV. Cancer spreads outside the kidney, to multiple lymph nodes or to distant parts of the body, such as the bones, liver or lungs.

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Treatment Options

Surgery

Surgery is the standard of care for the majority of kidney cancers. Surgical procedures used to treat kidney cancer include:

  • Removing the affected kidney (nephrectomy). Radical nephrectomy involves the removal of the kidney, a border of healthy tissue and the adjacent lymph nodes. The adrenal gland also may be removed.

    Nephrectomy can be an open operation, meaning the surgeon makes one large incision to access your kidney. Or nephrectomy can be done laparoscopically, using several small incisions to insert a video camera and tiny surgical tools. The surgeon watches a video monitor to perform the nephrectomy.

    In some cases, this surgery can be done robotically, which means the surgeon uses hand controls that tell a robot how to maneuver surgical tools to perform the operation.

  • Removing the tumor from the kidney (nephron-sparing surgery). During this procedure, also called partial nephrectomy, the surgeon removes the tumor and a small margin of healthy tissue that surrounds it, rather than removing the entire kidney.

    Nephron-sparing surgery can be an open procedure, or it may be performed laparoscopically or with robotic assistance.

    Nephron-sparing surgery is a common treatment for small kidney cancers. It may also be an option if you have only one kidney.

    When nephron-sparing surgery is possible, it’s generally preferred over radical nephrectomy since retaining as much kidney tissue as possible may reduce your risk of later complications, such as kidney disease and the need for dialysis.

The type of surgery your doctor recommends will be based on your cancer and its stage, as well as your health. Surgery carries a risk of bleeding and infection.

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