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Kidney Cancer

Kidney cancer has a good outcome when it is removed while still confined to the kidney.  

The presentation of kidney cancer may be classical or bizarre.



How do I know I have Kidney Cancer?

In its early stages, kidney cancer usually causes no obvious signs or troublesome symptoms.  However, as the kidney cancer grows, symptoms may occur. 

These may include:

  • Blood in the urine (Hematuria)
    Blood may not be present everyday. The bleeding may be intermittent.  In some cases, a person can actually see the blood (gross hematuria) or traces of it may be found on testing the urine. This test is called urinalysis and is often performed as part of a regular medical checkup.
  • A lump or swelling in  the kidney area

Other less common symptoms may include:

  • Fatigue;
  • Loss of appetite;
  • Weight loss;
  • Recurrent fevers;
  • A pain in the side that doesn’t go away; and/or
  • A general feeling of poor health.

High blood pressure or a lower than normal number of red cells in the blood (anemia) may also signal a kidney cancer. However, these symptoms occur less often.

It should also be remembered that some of these symptoms may not be caused by cancer but by other, less serious problems such as an infection or a cyst. If you have any of these symptoms you may see your family doctor or a urologist, a doctor who specializes in diseases of the urinary system.

Usually, early kidney cancer does not cause pain. It is important not to wait to feel pain before seeing a doctor.  In most cases, the earlier the kidney cancer is diagnosed and treated, the better a person’s chance for a full recovery.


How does the doctor diagnose Kidney Cancer?

The doctor will ask about the patient’s medical history and does a physical exam. The abdomen is carefully examined for lumps or irregular masses. In addition to checking for general signs of health, the doctor may perform blood and urine tests.

Tests that produce pictures of the kidneys and nearby organs called imaging studies are usually necessary.  These pictures can often show changes in the kidney and surrounding tissue. These imaging tests may include CT scan and ultrasound.

Once kidney cancer is diagnosed, the stage, or extent, of the kidney cancer needs to be determined.  Staging is to find out whether the kidney cancer has spread.

To stage kidney cancer, additional x-ray studies may be needed. Swollen lymph nodes in the chest and abdomen may be detected with CT scans.  Chest x-rays can often show whether kidney cancer has spread to the lungs.  Bone scans reveal changes that may be a sign that the kidney cancer has spread to the bones.


How is Kidney Cancer Treated?

Treatment for kidney cancer depends on the stage of the disease, the patient’s general health and age, and other factors. A treatment plan is developed to fit each patient’s needs.

How is Kidney Cancer staged?

Staging is the assessment of the extent of the kidney cancer. There are 2 staging system in use, viz. the Robson and the TNM system. These are described below and placed side by side for correlation.

Tumor Status

Robson Stage

TNM Stage (2002)


Tumor ≤4.0 cm, confined to kidney




Tumor >4.0 cm and ≤7.0 cm and confined to kidney




Tumor >7.0 cm and confined to kidney




Extension to adrenal gland or perinephric fat




Renal vein or vena caval involvement below diaphragm




Vena caval involvement above the diaphragm




Single lymph node involved




More than one lymph node involved




Combination of venous and nodal involvement


T3b or c, N1 or N2


Local extension beyond Gerota's fascia




Distant metastasis



Methods of Treatment

Surgery is the most common and effective treatment for kidney cancer.  The operation to remove the kidney is called a nephrectomy. When the surgeon removes the whole kidney along with the adrenal gland and the tissue around the kidney, this procedure is called a radical nephrectomy.  The remaining opposite kidney is generally able to perform the work of both kidneys.  In another procedure, partial nephrectomy, the surgeon removes just the part of the kidney that contains the kidney cancer.

Radical Nephrectomy
If the kidney cancer is still confined to the kidney or just abutting the fat surrounding the kidney, removing the kidney with its capsule of fat in a procedure called radical nephrectomy is potentially curative.

The surgery may be performed through an open wound if the kidney cancer is large or using instruments inserted through tiny openings the size of key-holes. This is known as Laparoscopic Radical Nephrectomy. The picture below shows a sample of the keyhole wounds.



Biological therapy (also called immunotherapy) is a treatment that uses the body’s natural ability (immune system) to fight cancer.  Interleukin-2 and interferon are types of biological therapy used to treat advanced kidney cancer.

Chemotherapy is the use of drugs to kill kidney cancer cells. These can be effective even when the cancer has spread.


What are the possible causes of Kidney Cancer and can I prevent it?

At this time, scientists do not know exactly what causes kidney cancer, and they can seldom explain why one person gets this disease and another does not.  However, it is clear that this disease is not contagious; no one can “catch” kidney cancer from another person.

Researchers study patterns of cancer in the population to look for factors that are more common in people who get kidney cancer than in people who don’t get this disease.  These studies help researchers find possible risk factors for kidney cancer.  It is important to know that most people with these risk factors do not get cancer, and people who do get kidney cancer may have none of these factors.

As with most other types of cancer, studies show that the risk of kidney cancer increases with age.  It occurs most often between the ages of 50 and 70.  It affects almost twice as many men as women.

Patients on long-term use of dialysis to treat chronic kidney failure have an increased risk of developing renal cysts and renal cancer.  Further study is needed to learn more about the long-term effects of dialysis on patients with kidney failure.

Von Hippel-Lindau ( VHL) disease
Researchers have found that people who have this inherited disorder are at greater risk of developing renal cell carcinoma, as well as tumors in other organs.  Researchers have found the gene responsible for VHL, and they believe that the isolation of this gene may lead to improved methods of diagnosis, treatment, and even prevention of some kidney cancers.

People who think they may be at risk for developing kidney cancer should discuss this concern with their doctor.  The doctor may suggest ways to reduce the risk and help plan an appropriate schedule for checkups.





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