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 60 to 70 years old.

The exact cause is unknown.

The following may increase your risk of kidney cancer:

Smoking
Obesity
Dialysis treatment
Family history of the disease
High blood pressure
Horseshoe kidney
Long-term use of certain medicines, such as pain pills or water pills (diuretics)
Polycystic kidney disease
Von Hippel-Lindau disease (a hereditary disease that affects blood vessels in the brain, eyes, and other body parts)
Birt-Hogg-Dube syndrome (a genetic disease associated with benign skin tumors and lung cysts)

Symptoms

Symptoms of this cancer may include any of the following:

Abdominal pain and swelling
Back pain
Blood in the urine
Swelling of the veins around a testicle (varicocele)
Flank pain
Weight loss
Fever
Liver dysfunction
Elevated erythrocyte sedimentation rate (ESR)
Excessive hair growth in females
Pale skin
Vision problems

Exams and Tests

The health care provider will perform a physical exam. This may reveal a mass or swelling of the abdomen.

Tests that may be ordered include:

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

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

Treatment

Surgery to remove all or part of the kidney (nephrectomy) is usually 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. But even if some cancer is left behind, there may be a benefit from surgery.

Chemotherapy is generally not effective for treating kidney cancer in adults. Newer immune system medicines (immunotherapy) and targeted therapies may help some people. Your provider can tell you more.

Radiation therapy is usually done only when the cancer spreads to the bone or brain.

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 fourth of people, the cancer has already spread (metastasized) at the time of diagnosis.

How well someone with kidney cancer 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

Complications of kidney cancer include:

High blood pressure (hypertension)
Too much calcium in the blood (hypercalcemia)
High red blood cell count (erythrocytosis)
Spread of the cancer

When to Contact a Medical Professional

Contact your provider any time you see blood in the urine. Also contact your provider if you have any other symptoms of this disorder.

Prevention

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

References

National Cancer Institute website. Renal cell cancer treatment (PDQ) -- health professional version. www.cancer.gov/types/kidney/hp/kidney-treatment-pdq. Updated March 1, 2024. Accessed May 6, 2024.

National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology: kidney cancer. Version 3. 2024. www.nccn.org/professionals/physician_gls/pdf/kidney.pdf . Updated March 11, 2024. Accessed May 6, 2024.

Weiss RH, Jaimes EA, Hu SL. Kidney cancer. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 41.