Information and symptoms of kidney cancer

Kidney cancer is a type of cancer that starts in the cells of the kidney.

In the early stages, the primary cancer forms a tumour that is confined to the kidney. As the cancer grows, it may invade organs or structures near the kidney, such as the surrounding fatty tissue, veins, adrenal glands, ureters or liver. It might also spread to other parts of the body, such as the lungs or bones.Sometimes cancers in the kidney can be a secondary cancer (metastasis) from a primary cancer located in another part of the body, however this type of cancer is not kidney cancer and behaves like the cancer in the original organ where it started.

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Types of kidney cancer

About 90 per cent of kidney cancers are renal cell carcinoma (RCC), sometimes called renal adenocarcinoma. Usually only one kidney is affected, but in rare cases, both can be affected. This might be because the RCC has spread to the other kidney, or sometimes because more than one RSS has occurred in the same person.

Other types of kidney cancer include urothelial carcinoma.

How common is kidney cancer?

About 800 people are diagnosed with kidney cancer each year in Queensland. Kidney cancer is the seventh most common cancer in Queensland. The average age of a person who gets kidney cancer is 65. Men are almost twice as likely to be diagnosed with kidney cancer as women.

Risks factors of kidney cancer

The exact causes of kidney cancer are not known. However, several risk factors are known to increase the risk of developing kidney cancer.

Risk factors include:

  • Smoking – People who smoke have almost twice the risk of developing kidney cancer as non-smokers. Up to one-third of all kidney cancers are thought to be related to smoking.
  • Heavy use of certain medications – These include diuretics and pain-killers with the ingredient phenacetin. While phenacetin is no longer used, people who took pain relievers with phenacetin (most likely before 1970) may be at a higher risk.
  • Exposure to certain substances – Those with regular exposure to certain chemicals, such as asbestos, cadmium, lead, herbicides or organic solvents, might have a higher risk.
  • Family history – People who have family members with kidney cancer, especially a sibling, are at increased risk.
  • Obesity – Excess body fat may cause changes in certain hormones that can lead to kidney cancer.
  • High blood pressure – This is often a risk factor in people who are overweight, however other medical conditions can also cause high blood pressure.
  • Kidney failure – People with advanced kidney disease have a higher risk of developing kidney cancer.

Symptoms of kidney cancer

Most people with kidney cancer have no symptoms and are often diagnosed with the disease when they see the doctor for another reason.

Symptoms can, however, include:

  • Blood in the urine (haematuria)
  • A change in urine colour to a dark, rusty brown
  • Pain in the lower back on one side that is not due to an injury
  • Pain or a lump in the abdomen or side (flank)
  • Constant tiredness
  • Unexplained weight loss
  • Fever (not caused by a cold or flu)
  • Swelling of the abdomen or extremities, e.g. ankles, feet.

You might also have a low red blood cell count (anaemia), a high red blood cell count (polycythaemia) or high levels of blood calcium. Sometimes these symptoms can cause fatigue and dizziness, which are related to hormones the kidney produces.

The symptoms listed can also occur with other illnesses. Having some of these symptoms doesn’t necessarily mean you have kidney cancer – only tests can confirm the diagnosis. If you are concerned, make an appointment with your general practitioner (GP).

Diagnosis

About one in three kidney cancers are advanced at the time of diagnosis. This is because people usually don’t have noticeable symptoms even though the cancer has been present for some time.

If your doctor suspects you have kidney cancer, you will have some of the following tests to confirm the diagnosis and show if cancer has spread to other parts of the body. You are unlikely to need all of these tests.

  • Urine test – to look for traces of blood and other abnormalities, such as proteins, that can’t be seen with the naked eye.
  • Blood test – to check for changes that could be caused by kidney cancer.
  • Internal examination (cystoscopy)- if you have blood in your urine, your doctor might want to look inside your bladder to see where the blood is coming from. The doctor will pass a tiny telescope (cystoscope) through the urethra and into the bladder to check for bleeding, tumours or other abnormalities.

Other tests include:

  • CT scan – uses x-ray beams to take pictures of the inside of your body.
  • MRI scan – uses magnetism and radio waves to build up very detailed cross-section pictures of the body.
  • Ultrasound – uses soundwaves to build up a picture of your body.
  • Chest x-ray – to check from problems in the organs and bones of the chest.
  • Radioisotope bone scan – a scan to see if any of the cancer has spread to the bones
  • Tissue biopsy – a tissue biopsy is not often used for diagnosing kidney cancer, however it might be recommended if there is a possibility the cancer has spread from elsewhere, or when the doctor suspects the tumour is not cancer.

Some tests may be repeated during or after treatment to check how well the treatment is working. Waiting for the test results can be a stressful time. It may help to talk to a friend or family member, a healthcare professional, or call Cancer Council 13 11 20.

Treatment of kidney cancer

Your medical team will recommend a treatment based on what you want, your general health, the location of the cancer and the extent that the cancer has spread. Treatments for kidney cancer include surgery and radiofrequency ablation. Other options might include cryotherapy and arterial embolisation. In some cases, your doctor may recommend active surveillance.

Surveillance refers to the process of watching small tumours using CT scans rather than treating immediately. Using the active surveillance method may help to avoid the loss of kidney function and other side effects associated with different types of treatment. This is particularly important if the tumour is unlikely to be cancerous. You may feel anxious about not treating the tumours in your body right away, even if they are benign. However this is a common approach and will only be recommended if the doctor thinks it is the best thing to do.

Surgery is the main treatment for people with kidney cancer that has not spread outside the kidney. The operation your doctor recommends will depend on the type of kidney cancer you have, your general health and the stage and grade.

For more information on the treatment of kidney cancer, including the treatment of advanced kidney cancer, please refer to the Understanding Kidney Cancer booklet.

Prognosis

Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for any doctor to predict the exact course of your disease. Instead, your doctor can give you an idea about common issues that affect people with kidney cancer.

In most cases, the earlier kidney cancer is diagnosed, the better the outcome. If the cancer is discovered after it has spread to other parts of the body, it will probably be more difficult to treat successfully.

People who are able to have surgery to remove the cancer have a higher survival rate. However, other factors such as your age, general fitness and medical history also affect prognosis.

Discussing your prognosis and thinking about the future can be challenging and stressful. It may help to talk with family and friends. You can also call Cancer Council 13 11 20 if you need more information or emotional support.

Support

Whether you have been diagnosed with a kidney cancer, or have a family member or friend who is affected by cancer, there are times when you may need support. Our professional services and support programs are here to help you.

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You don’t have to face cancer alone – we’re here to help.

For more information on kidney cancer please refer to the Understanding Kidney Cancer booklet. You can download a PDF or order a hard copy.