Cancer of the Kidney (Renal Cell Cancer)
Definition: There are many types of growths or masses that can occur in the kidney. Renal cell cancer is a malignant growth that originates in the tubules of the kidney. There are usually two kidneys. They are located above the waist on either side of the backbone. The tubules are tiny tubes in the kidney that help filter the blood to remove waste products.

Overview: There has been an increase in the incidence of renal cell cancer since the 1970's. This is due to the introduction of newer, more advanced diagnostic technology such as ultrasound and CT scans. In fact, over 50% of newly diagnosed renal cell cancer is found incidentally or when not suspected. Most patients have no symptoms. There are 30,000 new cases of this disease diagnosed in the USA each year. It is slightly more common in males than females.

Causation: The cause of renal cell cancer (RCC) is not entirely clear. Some experts feel that it may be due in part to a virus. Certain known risk factors include cigarette smoking, misuse of certain pain medicines, and genetic conditions.

Symptoms / When to call your doctor: Although many individuals who develop RCC are without symptoms, there are some possible signs and symptoms that should alert you to contact your physician. Keep in mind that other conditions other than RCC may cause similar symptoms. Possible signs and symptoms include: a lump in the abdomen, pain in the flank or side, decreased appetite, low blood count (anemia), weight loss, or blood in the urine (hematuria).

Diagnosis of RCC: When a physician is confronted with the possibility a patient may have RCC, he or she may order various diagnostic tests in addition to doing a complete history and physical examination. Testing usually includes blood work, urinalysis, CT scan (CAT scan), MRI, or rarely a biopsy. The most common way that the diagnosis is confirmed currently is by CT scan. A CT scan can not only identify a growth in the kidney but with great accuracy can determine if a growth is malignant or not. The accuracy of the scan is close to 90%. Once the diagnosis is confirmed, it is important to determine if the cancer cells have spread beyond the kidney or not. This is called the staging process. The stage of the disease is important to know because it determines the plan created to treat the disease. Tests, in addition to those already mentioned, to determine the stage may include blood tests to check the health of the liver, chest x ray, and a bone scan

Stages of RCC: Stages include I through IV:

  • Stage I: growth or tumor is no larger than 7 centimeters and found in the kidney only


  • Stage II: tumor is larger than 7 centimeters and found in the kidney only


  • Stage III: cancer is found in the kidney and in one nearby lymph node; or in an adrenal gland or in the fatty tissue layer around the kidney, and may be found in one nearby lymph node; or in the main blood vessels of the kidney and may be found in one nearby lymph node


  • Stage IV: cancer has spread beyond the layer of fatty tissue around the kidney and may be found in one nearby lymph node; or to 2 or more nearby lymph nodes; or to other organs, such as the bowel, pancreas, or lungs, and may be found in nearby lymph nodes
Treatment of RCC: There are four different types of treatment available for RCC, surgery is by far the most common, but treatment is based on the stage of the disease and the overall condition of the patient, In addition to standard treatments, many clinical trials are being conducted to help improve current treatments or to obtain information on new treatments. The four standard treatments include: surgery, radiation therapy, chemotherapy, and biological therapy

  1. Surgery: Surgery is used frequently to treat RCC. Surgery can now be performed in certain situations using minimally invasive techniques instead of the standard large incision. Laparoscopy alone or in combination with a smaller incision has been used to diminish hospitalization time and shorten recovery overall. Surgery can be done to remove the entire kidney or just the part with the tumor to save kidney function in certain situations.


  2. Radiation Therapy: This treatment method sometimes plays a role in the treatment of RCC.


  3. Chemotherapy: This form of treatment currently has a limited role in the treatment of RCC.


  4. Biologic Therapy: This form of treatment utilizes the patient's immune system to kill cancer cells. It is used mostly in advanced stages of the disease