What is renal cell cancer?

Renal cell cancer (or renal cell carcinoma) is the most common type of kidney cancer. It is a life-threatening tumor found mostly in adults in their 50s and 60s. It affects twice as many men as women.

How does it occur?

The actual cause of this disease is unknown. Smoking and work-related cadmium exposure are known risk factors. A growth of cancer cells within the kidney forms an enlarging mass that may spread outside the kidney. The symptoms may occur as a result of effects on kidney function or effects on neighboring organs.

What are the symptoms?

Symptoms vary, depending on how advanced the tumor is when it is found. Symptoms can include:

• blood in the urine (most common symptom)

• pain in the lower back or sides

• a lump that can be felt in the abdomen. Other more general symptoms can include:

• fever

• weight loss

• fatigue.

How is it diagnosed?

Kidney cancer can be difficult to diagnose. Many kidney tumors are found when x-rays are taken for other reasons.

The physical exam is critical to look for direct and indirect evidence of a tumor. Recent symptoms are very important as well. The findings of the recent medical history and physical will direct the lab and x-ray evaluation. The tumor can be felt during abdominal exam only 20% of the time. For this reason, one or more ways to view the kidney and its function are used. Diagnostic studies may include:

• blood work to check for infection, anemia, kidney and liver function

• urinalysis to check kidney function

• IV pyelogram (a kidneys x-ray study)

• ultrasound scan of the kidneys

• CT scan of the kidneys

• MRI scan of the kidneys

• arteriogram (a special x-ray of your arteries).

To look for possible spread of kidney cancer, other studies may include:

• chest x-ray

• bone scan.

How is it treated?

The treatment for renal cell cancer depends on how large the tumor is, whether the tumor has spread to other parts of the body, and your overall physical condition.

The best treatment for kidney cancer is usually surgical removal of the kidney. If the cancer has not spread to nearby lymph nodes or other tissues, the long-term survival rates are good. Most people can live on just one kidney if the other is removed. A person can live without both kidneys if he or she is on dialysis. If the disease has spread to other organs, surgery is not as likely to be helpful.

Kidney cancer is not very responsive to either chemotherapy or radiation therapy. It has, however, shown some sensitivity to immunotherapy. One type of immunotherapy, interleukin-2, is now approved by the FDA for use in some cases of renal cell cancer. This is currently only available through major medical centers participating in kidney cancer research.

The doctor may also do a renal artery embolization, in which the blood flow through the artery that leads to the affected kidney is blocked. This decreases blood flow to the cancer and may cause the tumor to decrease in size, helping to make the patient more comfortable.

How long will the effects last?

The chances of being cured vary depending on how large the tumor is, whether it affects the surrounding tissue, and whether it has spread to other parts of the body.

Most of the symptoms of renal cell cancer occur when the cancer is fairly advanced. Because the chance for cure depends on finding the disease early, it is important to have regular medical checkups. It is also important to report symptoms such as blood in the urine or abdominal pain to the doctor as soon as possible.

After treatment the doctor will recommend regular checkups to see if the cancer has returned or spread. It is important to follow the doctor's recommendations so that any recurrence can be found early. It is possible to have recurrences even 10 years or more after treatment. In addition, similar cancer may appear in the other kidney.

How can I help prevent renal cell cancer?

Limit or prevent, if possible, your exposure to cigarette smoke and cadmium, which are associated with increased risk for this disease.