Information and symptoms of kidney cancer

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

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Types of kidney cancer

About 9 out of 10 kidney cancers are renal cell carcinoma (RCC), sometimes called renal adenocarcinoma.

In the early stages, the primary cancer forms a tumour that is confined to the kidney. Usually only a single kidney is infected, but in rare cases both kidneys can be affected. As the cancer grows, it can spread to areas near the kidney, such as the surrounding fatty tissue, veins, adrenal glands, ureters or the liver. It may also spread to other parts of the body, such as lungs or bones.

Very rarely, 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 it behaves more like the original cancer.

Other types of kidney cancer include urothelial carcinoma and Wilms tumour (nephroblastoma).

How common is kidney cancer?

About 800 people are diagnosed with kidney cancer each year in Queensland. It is twice as common in men than women. The risk of kidney cancer increases with age, and most cases occur in people over 50.

Risks factors of kidney cancer

The factors listed below may increase the risk of a person developing kidney cancer. However, having one or more of these risk factors does not mean you will develop cancer.

  • Smoking – People who smoke have almost twice the risk of developing kidney cancer as nonsmokers. Up to one-third of all kidney cancers are thought to be related to smoking.
  • Obesity – Excess body fat may cause changes in certain hormones that can lead to kidney cancer.
  • High blood pressure – Whatever the cause, high blood pressure increases the risk of kidney cancer.
  • Kidney failure – People with end-stage kidney disease have a higher risk of developing kidney cancer.
  • Family history – People who have family members with kidney cancer, especially a sister or brother, are at increased risk.
  • Inherited conditions – About 2-3% of kidney cancers occur in people who have particular inherited syndromes, including von Hippel-Lindau disease, hereditary papillary RCC and Birt-Hogg-Dube syndrome
  • Exposure to toxic substances at work – The risk may be higher after regular exposure to certain chemicals, such as metal degreasers, arsenic or cadmium.

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 an unrelated reason.

Symptoms can, however, include:

  • Blood in the urine (haematuria) – this may be obvious or the urine may just look dark, rusty or brown
  • Pain in the lower back or on one side that is not caused by injury
  • A lump in the abdomen
  • Constant tiredness
  • Unexplained weight loss
  • Fever (not caused by a cold or flu)

Cancer can affect the amount of hormones produced by the kidneys and this may lead to a low red blood cell count (anaemia), a high red blood cell count (polycythaemia) or high levels of calcium in the blood (hypercalcaemia). Sometimes these problems can cause symptoms such as fatigue, dizziness, headaches, constipation, abdominal pain and depression.

The symptoms listed can also occur with other illnesses, so they don’t necessary mean you have kidney cancer – only tests can confirm the diagnosis. If you are concerned, make an appointment with your general practitioner (GP).

Diagnosis

Most kidney cancers are found when people have an ultrasound or scan for an unrelated reason.

If your doctor suspects you have kidney cancer, you will have some of the following tests but you are unlikely to need them all. You will probably have urine and blood tests to see how well your kidneys are working and to check for changes that could be caused by kidney cancer, but these tests cannot provide a definitive diagnosis.

The main tests for diagnosing kidney cancer are imaging scans and tissue sampling (biopsy). Sometimes the doctor will also recommend an internal examination of the bladder, ureters and kidneys.

You will usually have at least one of the following imaging scans:

  • Ultrasound – uses soundwaves to produce pictures of your internal organs.
  • CT scan – uses x-rays to take many pictures of the inside of your body and then a computer compiles them into one detailed, cross-sectional picture.
  • MRI scan – uses a powerful magnet and radio waves to build up detailed, cross-sectional pictures of the inside of your body.
  • Radioisotope bone scan – a scan to see if any of the cancer has spread to the bones

Removing a tissue sample from the kidney for examination under a microscope is the only way to confirm a diagnosis of kidney cancer. This is known as a biopsy. The procedure used to check for kidney cancer is called a core needle biopsy.

You may not need a core needle biopsy if the doctor already knows enough from others tests, such as a CT scan, to immediately recommend surgery to remove the tumour. In this case, rather than testing the tissue sample, the removed tumour is tested to confirm that it is 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 stereotactic body radiation therapy (SBRT). In some cases, your doctor may recommend active surveillance.

Surveillance, also known as observation, refers to the process of watching small tumours using CT scans rather than treating immediately. When small tumours are found in the kidney, they are less likely to be aggressive and might not grow during a person’s lifetime.

Using the active surveillance method might help to avoid the loss of kidney function and other side effects you may experience after surgery. It is also a reasonable option if you are not well enough for an operation and the tumours are small.

You may feel anxious about not treating a cancer in your body right away. However, active surveillance is a common approach for early kidney cancer and will only be recommended if the doctor thinks it is the best thing to do.

Surgery is the main treatment for 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 of the cancer.

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. It is not possible for anyone to predict the exact course of the disease, but your medical team can give you an idea about common issues that affect people with kidney cancer.

In most cases, the earlier that kidney cancer is diagnosed, the better the chance of successful treatment. If the cancer is found after it has spread to other parts of the body, it is very unlikely that all of the cancer can be removed, but treatment can often keep it under control.

People who can have surgery to remove the cancer tend to have better outcomes. 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.