Kidney Cancer



Renal cell carcinoma is cancer or a mass that grows in the solid portion of the kidney.   
Affecting about 32,000 people in the US each year, kidney cancer is most often curable when caught early.

Risk Factors

The more common risk factors associated with RCC are:

  • Smoking 
  • Age, Sex and race - being older than 60, male or African American puts you at higher risk 
  • Obesity or High blood pressure 
  • Exposure to environmental toxins and carcinogenic substances 
  • Family history 
  • Long term hemodialysis 
  • Certain genetic disorders such as Von Hippel-Lindau disease 


Symptoms

Most patients who have kidney cancer do not have symptoms.  The majority of kidney tumors are discovered incidentally on CT scans, ultrasound, MRIs performed for another reason.  

The symptoms of more advanced RCC are:

Blood in the urine (hematuria) which is the most common sign, a mass in the abdominal area, fever, high blood pressure,  pain in the side, flank or lower back,  swelling in the legs and ankles. Late symptoms include anemia, persistent fatigue and rapid weight loss.


Diagnosis

Following a thorough history and physical examination, your doctor may order additional imaging and lab tests, including:   MRI or ultrasound, urinalysis, blood tests, a CT Urogram - an X-ray with dye to look at the structure of the kidneys, ureters and bladder X-ray or bone scan - to determine if cancer has spread to the lungs or bones. Needle biopsy of the mass in rare circumstances.
Staging your cancer will be assigned to one of four stages that describe how advanced and how aggressive the cancer is. 
Earlier stages have a better prognosis. 

Stage 1 - the tumor is less than or equal to 7 centimeters and     confined to the kidney
    
Stage 2 - the tumor is larger than 7 centimeters but still confined to the kidney
    
Stage 3 - the tumor has spread to nearby lymph nodes or tissues
    
Stage 4 - the tumor has spread more extensively (liver, lungs, bone and/or brain)


Treatment

Treatment will depend on a number of factors, including your age and overall health, and the extent to which the cancer has spread.

When appropriate, your urologist will collaborate with other specialized urologic surgeons to provide state of the art care.

Minimally invasive surgery is the standard of care for treatment of RCC. The following procedures often can be performed laparoscopically and or robotically, . 
  
  • Simple nephrectomy - removing the whole kidney

  • Radical nephrectomy - total removal of the kidney, nearby adrenal gland and lymph nodes

  • Partial nephrectomy - studies have shown that this approach, removing only the tumor and a portion of surrounding tissue, can be just as effective as a radical nephrectomy for many patients with early stage disease

  • RCC Cryosurgery - freezing cancer cells to destroy them

  •  Radiofrequency ablation - using heat to destroy cancer cells 

  • Radiation therapy - using high energy X-rays to destroy cancer cells and shrink tumors; used to reduce pain if cancer has spread to your bones

  •  Biologic therapy - using substances to boost the immune system and fight cancer

  •  Chemotherapy - using medications to treat cancer cells that have spread throughout the body


Follow Up Surveillance

Since RCC may recur, your urologist will recommend follow-up care at varying intervals.