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Renal cell carcinoma
     
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Renal cell carcinoma

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

 

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

Causes

 

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

  • Abdominal MRI
  • Biopsy
  • Bone scan
  • Chest x-ray
  • Chest CT scan
  • PET scan

 

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 is still benefit from surgery.

Chemotherapy is generally not effective for treating kidney cancer in adults. The immune system medicines interleukin-2 (IL-2) or nivolumab may help some people. Medicines that target the development of blood vessels that feed the tumor may be used to treat kidney cancer. Your provider can tell you more.

Radiation therapy is usually done 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 third 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
  • High red blood cell count
  • Liver and spleen problems
  • Spread of the cancer

 

When to Contact a Medical Professional

 

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

 

 

References

Babaian KN, Delacroix SE, Wood CG, Jonasch E. Kidney cancer. In: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier; 2016:chap 41.

National Cancer Institute website. Renal cell cancer treatment (PDQ) – health professional version. www.cancer.gov/types/kidney/hp/kidney-treatment-pdq. Updated February 23, 2018. Accessed April 9, 2018.

National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology: kidney cancer. Version 3.2018. www.nccn.org/professionals/physician_gls/pdf/kidney.pdf. Updated February 6, 2018. Accessed April 9, 2018.

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  • Kidney anatomy

    Kidney anatomy

    illustration

  • Kidney tumor - CT scan

    Kidney tumor - CT scan

    illustration

  • Kidney metastases, CT scan

    Kidney metastases, CT scan

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  • Kidney - blood and urine flow

    Kidney - blood and urine flow

    illustration

    • Kidney anatomy

      Kidney anatomy

      illustration

    • Kidney tumor - CT scan

      Kidney tumor - CT scan

      illustration

    • Kidney metastases, CT scan

      Kidney metastases, CT scan

      illustration

    • Kidney - blood and urine flow

      Kidney - blood and urine flow

      illustration

    A Closer Look

     

    Talking to your MD

     

      Self Care

       

        Tests for Renal cell carcinoma

         
         

        Review Date: 1/19/2018

        Reviewed By: Richard LoCicero, MD, private practice specializing in hematology and medical oncology, Longstreet Cancer Center, Gainesville, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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