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Renal cell carcinoma

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Renal cancer; Kidney cancer; Hypernephroma; Adenocarcinoma of renal cells; Cancer - kidney

Renal cell carcinoma is a type of kidney cancer that starts in the lining of very small tubes (tubules) in the kidney.

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  • Causes

    Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in men 50 to 70 years old.

    The exact cause is unknown.

    The following may increase your risk of kidney cancer:

    • Smoking
    • Obesity
    • Dialysis treatment
    • Family history of the disease
    • High blood pressure
    • Horseshoe kidney
    • Long-term use of certain medicines, such as pain pills or water pills (diuretics)
    • Polycystic kidney disease
    • Von Hippel-Lindau disease (a hereditary disease that affects blood vessels in the brain, eyes, and other body parts)
  • Symptoms

    Symptoms of this cancer may include any of the following:

    • Abdominal pain and swelling
    • Back pain
    • Blood in the urine
    • Swelling of the veins around a testicle (varicocele)
    • Flank pain
    • Weight loss
    • Excessive hair growth in females
    • Pale skin
    • Vision problems
  • Exams and Tests

    The health care provider will perform a physical exam. This may reveal:

    • Mass or swelling of the abdomen
    • A varicocele in the male scrotum

    Tests that may be ordered include:

    • Abdominal CT scan
    • Blood chemistry
    • Complete blood count (CBC)
    • Intravenous pyelogram (IVP)
    • Liver function tests
    • Renal arteriography
    • Ultrasound of the abdomen and kidney
    • Urine tests

    The following tests may be done to see if the cancer has spread:

    • Abdominal CT scan
    • Abdominal MRI
    • Bone scan
    • Chest x-ray
    • Chest CT scan
    • PET scan
  • Treatment

    Surgery to remove of all or part of the kidney (nephrectomy) is recommended. This may include removing the bladder, surrounding tissues, or lymph nodes. A cure is unlikely unless all of the cancer is removed with surgery. But even if some cancer is left behind, there is still benefit from surgery.

    Chemotherapy is generally not effective for treating kidney cancer. The immune system medicines interleukin-2 (IL-2) or nivolumab may help some people. Medicines that target the development of blood vessels that feed the tumor may be used to treat kidney cancer. Your provider can tell you more.

    Radiation therapy usually does not work for kidney cancer.

  • Support Groups

    You can ease the stress of illness by joining a support group whose members share common experiences and problems.

  • Outlook (Prognosis)

    Sometimes, both kidneys are involved. The cancer spreads easily, most often to the lungs and other organs. In about one third of people, the cancer has already spread (metastasized) at the time of diagnosis.

    How well someone with kidney cancer does depends on how much the cancer has spread and how well treatment works. The survival rate is highest if the tumor is in the early stages and has not spread outside the kidney. If it has spread to the lymph nodes or to other organs, the survival rate is much lower.

  • Possible Complications

    Complications of kidney cancer include:

    • High blood pressure (hypertension)
    • Too much calcium in the blood
    • High red blood cell count
    • Liver problems
    • Spread of the cancer
  • When to Contact a Medical Professional

    Call your provider any time you see blood in the urine. Also call if you have any other symptoms of this disorder.

  • Prevention

    Stop smoking. Follow your provider's recommendations in the treatment of kidney disorders, especially those that may require dialysis.

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Related Information

  RenalCancerMetastasisHigh blood pressur...   Kidney removal - d...   High blood pressur...

References

Campbell SC, Lane BR. Malignant renal tumors. In: Wein AJ, Kavoussi LR, Partin AW, et al, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 57.

National Cancer Institute: PDQ renal cell cancer treatment. Bethesda, MD: National Cancer Institute. Date last modified: February 4, 2016. www.cancer.gov/types/kidney/hp/kidney-treatment-pdq.  Accessed: February 1, 2016.

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: kidney cancer. Version 2. 2016. www.nccn.org/professionals/physician_gls/pdf/kidney.pdf. Accessed: March 17, 2016.

Pili R, Kauffman E, Rodriguez R. Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 82.

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Review Date: 2/1/2016  

Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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