Kidney Cancer: Symptoms, Risk Factors, Treatment & Prevention

What is Kidney Cancer?

Kidney cancer is a disease where cancer cells develop in your kidney tissue. The kidneys are two bean-shaped organs, responsible for cleaning your blood, eliminating waste products, and creating urine.

This disease is more common in men than women, with some studies citing the higher levels of androgen (e.g., testosterone) in men as the reason. However, there are other risk factors as well.

Unfortunately, this cancer is usually discovered in its advanced stages, when the disease may have spread beyond the kidney. This is because it often shows no symptoms early on, and the kidney’s location in the abdomen makes it hard to detect small tumours during check-ups.

Types of Kidney Cancer

Here are a few common types of kidney cancer:

Renal Cell Carcinoma (RCC)

Renal Cell Carcinoma (RCC) develops when malignant (cancer) cells form in the lining of the tubules of the kidney. It usually affects only one kidney, but in some cases, tumours can form in both kidneys.

This disease is the most common type of kidney cancer, where 9 out of 10 of kidney cancers are diagnosed as RCC. The most prevalent subtype of RCC is clear cell renal cell carcinoma (ccRcc).

This cancer has been linked to smoking, long-term use of certain pain medications, obesity, high blood pressure, family history of RCC, and certain genetic conditions (e.g., von Hippel-Lindau disease).

Transitional Cell Cancer (TCC)

Transitional cell cancer (TCC) develops when malignant cells form in transitional cells, which are cells that can change stretch and shrink. These cells form the lining of the renal pelvis, ureters, and bladder.

This cancer has been linked to risk factors such as older age, being male, smoking, exposure to certain chemicals, aristolochic acid, Lynch syndrome, and personal history of bladder cancer.

Renal Sarcoma

Renal sarcoma develops in the connective tissues of your kidneys. This includes muscles, nerves, fat, blood vessels, and fibrous tissue.

This disease is a rare form of kidney cancer. If left untreated, it can spread to other parts of the body, such as nearby organs and bones.

This cancer has been linked to risk factors such as older age, radiotherapy treatment, exposure to chemicals, family history, and specific genetic diseases and syndromes (e.g., neurofibromatosis).

Wilms Tumour (Kidney Cancer in Children)

Wilms Tumour is the most common type of kidney cancer in young children. It develops in immature cells called nephroblasts, during the growth of the baby in the womb.

This disease usually only affects one kidney, but in rare cases, tumours can form in both kidneys.

This cancer has been linked to mutations in specific genes (e.g., associated with WAGR syndrome, Beckwith-Wiedemann syndrome), although research is still ongoing to understand the exact cause.

In rare cases, cancer can spread from another cancer to the kidney. This is known as secondary cancer, not kidney cancer. Learn more about cancer types in this article on the 9 Most Common Cancers.

Stages of Kidney Cancer

The two common ways of staging kidney cancer are the TNM and number system. Your doctor will use either one of these staging systems to describe the spread of cancer, and decide the best treatment.

The TNM System

Most doctors will use the TNM staging system. TNM stands for Tumour, Node, and Metastasis:

• Tumour (T): Indicates the size of the tumour. Grading from T1 to T4, with a higher grade denoting a bigger size of cancer.
• Node (N): Indicates whether the cancer has spread to lymph nodes. Grading from N0 to N1, with N1 meaning that cancer is affecting 1 or more nearby lymph nodes.
• Metastasis (M): Indicates whether the cancer has spread to other body parts. Grading from M0 to M1, with M1 meaning that cancer has spread to other parts of the body (e.g., lungs).

The Number System

The system comprises 4 main stages, from stage 1 to stage 4:

• Stage I: Cancer size is 7cm (across) and below, and confined to the kidney.
• Stage II: Cancer is larger than 7cm, and still confined to the kidney.
• Stage III: Cancer has spread to the surrounding tissue, main blood vessels, and / or nearby lymph nodes.
• Stage IV: Cancer has spread to surrounding tissue, the adrenal gland, and / or nearby lymph nodes. It has also spread to other parts of the body (e.g., lungs).

Symptoms

As mentioned earlier, the symptoms of kidney cancer are not that noticeable during its early stages. Therefore, this disease is usually only diagnosed once it has started to spread.

Here are a few symptoms of kidney cancer:

• Blood in your urine
• Pain in your lower back (not caused by injury)
• A lump in your side or lower back
• Fatigue
• Unexplained weight loss
• Loss of appetite
• Fever
• Night sweats
• Bone pain
• High blood pressure
• Anaemia
• High calcium

Do note that these symptoms could be caused by other medical conditions. If you notice any of these signs, schedule an appointment with your doctor immediately and obtain a proper diagnosis.

Curious to learn about other urological conditions? Read this in-depth article on Recognising the Symptoms of Common Urological Diseases.

Causes and Risk Factors

The exact causes of kidney cancer are unknown. However, doctors have identified several factors that increase your risk of this disease:

• Obesity
• High blood pressure
• Smoking
• Exposure to certain chemicals (e.g., asbestos, cadmium)
• Having dialysis treatment for advanced kidney disease
• Using certain pain medication long-term
• Being male
• Family history of kidney cancer
• Genetic diseases (e.g., von Hippel-Lindau disease, Birt Hogg Dube syndrome)

If you have a higher risk of kidney cancer, consult your doctor to find out your next step. We also recommend getting regular health screenings to ensure early detection.

Interested to know more? We provide a further discussion of the risk factors in this section.

Diagnosis

If a doctor suspects you have kidney cancer, here are a few diagnosis methods they may use:

• Urinalysis: A sample of your urine is collected and tested for the presence of blood, a sign of kidney disease. Overall, this method can detect levels of various chemicals and proteins, red and white blood cells, and other matters which are invisible to the naked eye.
• Blood Tests: Measures the number of each type of blood cell and electrolyte in your body, which can indicate problems with your kidney. For instance, blood tests can show if there is a low level of red blood cells (anaemia), reveal high levels of chemicals like calcium, and assess kidney function.
• Computed Tomography (CT) Scan*: Uses X-rays to create a detailed picture of your kidneys and abdomen. It can show whether the tumour is cancerous. It can also reveal if the cancer has spread to nearby lymph nodes or other parts of the body.
• Magnetic Resonance Imaging (MRI): Uses radio waves and strong magnets to produce a detailed picture of your kidneys and abdomen. It can show the presence of tumours, or the spread of cancer to areas like the brain and spinal cord.
• Ultrasound: Uses sound waves to create a detailed picture of your kidneys and abdomen. It can reveal whether a kidney mass is a fluid-filled cyst or solid tumour. In certain cases, some ultrasound patterns can help doctors determine whether the tumour is benign or malignant.
• Biopsy: A small piece of the kidney is removed, and the sample is sent to a laboratory to be checked for cancer. This diagnosis method is generally not recommended for kidney cancer, as the results are not always accurate.

Presently, there are no recommended screening tests for individuals with an average risk for kidney cancer. However, urinalysis and ultrasound are a good way for these individuals to screen for kidney problems, as they are usually a part of routine checkups.

*Note: In CT scans, a contrast dye is typically injected to create a clearer image. As this chemical may be unsuitable for those with impaired kidney function, an MRI or ultrasound will be recommended instead.

How is Kidney Cancer Treated?

Here are some treatments your doctor may recommend:

• Surgery: A nephrectomy is able to cure kidney cancer at its early stage. The tumour can be removed by either only removing the part of the kidney where the tumour is (partial nephrectomy) or removing the whole kidney along with the tumour (radical nephrectomy).
• Ablation: Kills the tumour through the process of burning (radiofrequency ablation) or freezing (cryoablation) the cancer cells. This treatment is suitable if you have a small tumour and are unable to undergo surgery.
• Radiation Therapy: Uses high-powered energy beams to kill cancer cells. This therapy is mostly used to control symptoms and slow down the growth of cancer, as kidney cancer is less responsive to radiation compared to other cancer types.
• Targeted Therapy: Uses drugs which block the pathways and signals needed for cancer cells to grow. Essentially, it attacks the mutations in these cells, causing them to die. It may be used when surgery is not possible, or used after surgery to reduce the risk of recurring kidney cancer.
• Immunotherapy: Uses medicines which help the immune system find and attack the cancer cells. It may be used alone, or in combination with treatments like surgery to improve outcomes. It is usually used to treat advanced and recurrent cases of kidney cancer.

Living with Kidney Cancer

Fom the diagnosis to treatment to post-treatment stages, kidney cancer can cause drastic changes to your daily life. Here are a few ways to cope during this period:

Regular Follow-Ups

After treatment, it’s important to attend follow-up appointments with your healthcare provider. This enables them to monitor your condition and evaluate whether the treatment was effective.

The doctors may use imaging tests or lab tests to check for cancer or treatment side effects. These appointments also provide an opportunity for you to:

• Voice any concerns.
• Highlight any symptoms you have noticed.

Aside from checkups, we recommend making lifestyle changes to care for your kidney health. This includes managing your weight, keeping active, eating healthy, and avoiding smoking and drinking alcohol.

We discuss this further in the following section.

Mental Health and Support

Living with kidney cancer can take a toll on your mental health. You may experience feelings of depression, uncertainty, anxiety, or worry throughout this period – which are perfectly normal.

Therefore, it’s important to create a good support system. Whether it’s a professional counsellor, trusted friend and family, or cancer support group, talking with others can help you cope with these changes.

If you’re not sure where to start, reach out to your doctor. They can share valuable resources and direct you to the right professional.

Furthermore, most people, especially those with advanced kidney cancer, find that learning more about their condition helps them to cope with the situation better and decide on the next step.

With that in mind, here are a few questions to ask your doctor:

1. What type of kidney cancer do I have?
2. Has the cancer spread to other parts of my body?
3. What stage is my kidney cancer?
4. What treatments are available for me?
5. What is my outlook?
6. How will these treatments benefit me?
7. What side effects might I experience from the treatments?

At Island Hospital, our team of experienced doctors and nurses are ready to answer every question, and offer you the best care. Schedule an appointment today to explore your diagnosis and treatment options.

Measures to Prevent Kidney Cancer

Here are a few ways to reduce your risk of kidney cancer, and enhance overall wellbeing:

1. Regular kidney cancer screenings

If you notice any symptoms or are at higher risk, schedule regular screenings with your doctor. This ensures early intervention, which leads to a better outlook.

2. Maintain a healthy weight

Obesity has been linked to a higher risk of kidney cancer. Studies have found that obesity could create ideal conditions for cancer cell growth by providing extra energy and nutrients to these cells.

Therefore, adhere to a balanced diet-meal plan and regular exercise routine to achieve a healthy weight. You may consult a doctor or dietician to help create an effective weight management plan.

3. Prioritise kidney health

Keeping your kidneys healthy can prevent complications which could lead to cancer. To protect these organs, we recommend exercising regularly, eating balanced meals, and limiting intake of alcohol. It’s also important to maintain hydration by drinking at least 2 litres of fluids a day.

4. Manage your high blood pressure

High blood pressure or hypertension can increase your risk of kidney cancer. It is unknown whether the disease itself or hypertension medication is the reason behind this. Therefore, take measures, such as eating less sugar and managing your weight, to control your blood pressure.

5. Stop smoking

Smoking can increase your risk of getting kidney cancer. This is because carcinogenic chemicals from tobacco smoke are absorbed into the bloodstream and then filtered by the kidney.

We recommend consulting your doctor for effective ways to quit smoking. They may recommend nicotine replacement products and medicines to help make the transition easier.

6. Avoid exposure to certain chemicals

Chemicals such as cadmium and asbestos can increase the risk of kidney cancer. Therefore, check if you are exposed to these toxins at your workplace or home, and take proactive measures to remove or reduce contact with them.

Island Hospital – Your Trusted Partner For Kidney Cancer Solutions

At Island Hospital, our renowned oncologists, experienced nurses, and dedicated paramedical support are always here to guide you throughout your kidney cancer journey.

From precise diagnostic testing to cutting-edge treatments and compassionate support services, our Clinical Oncology and Haemato-Oncology Centre is equipped to help you fight back against cancer.

Moreover, our Nephrology Centre specialises in managing kidney-related conditions, with a focus on kidney transplant procedures. Rest assured that we will provide the best treatment for you.

Start your journey to recovery with Island Hospital.

FAQ

Is kidney cancer curable?

Kidney cancer is treatable, but curability depends on various factors such as stage, type, and response to treatment. In every case, the best course of action is to consult  your doctor for a proper diagnosis and staging. Then, you may discuss outlook and treatment options with them.

What are the first signs of kidney cancer?

Common signs of kidney cancer include blood in urine, persistent back pain, a lump or mass in the abdomen, unexplained weight loss, and fatigue.

Do note that symptoms are usually not noticeable until the advanced stages. Therefore, we recommend meeting with your doctor and getting regular health screenings, especially if you are at risk.

Learn more about the symptoms here.

What is the survival rate of kidney cancer?

The survival rate of kidney cancer depends on factors like stage, type, and treatment. Generally, the five-year survival rate (whether a patient is still alive within five years of diagnosis) ranges from 15% to 93%.

Do note that every case is unique, and early detection is a crucial part of successful treatment.

Is kidney cancer aggressive?

Kidney cancer can be aggressive, especially in advanced stages. However, the aggressiveness differs among individuals and depends on factors like tumour size, location, and type.

For a better understanding of your condition, consult your doctor for a proper diagnosis and staging.

How painful is kidney cancer?

Kidney cancer can cause varying degrees of pain, from mild discomfort to severe pain, depending on factors such as tumour size, growth rate, and spread to nearby tissues.

Patients at an advanced stage of cancer may experience more pain. However, there are treatments and medications available to alleviate these symptoms.

Can kidney cancer return after removal?

Yes, kidney cancer can return after surgical removal. This is why regular follow-up appointments and monitoring are important to detect any recurrence early.

Learn more about living with kidney cancer here.