Renal cell carcinoma
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.
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production.
This CT scan of the abdomen shows a tumor in the left kidney (called hypernephroma, or renal cell carcinoma). It is located on the lower right side of the picture.
A CT scan of the middle abdomen showing metastasis (cancer that has spread) in the left kidney in a patient with carcinoma of the lung. Note the large dark circular tumor in the kidney on the right side of the picture.
This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.
Causes
Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in men 60 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)
- Birt-Hogg-Dube syndrome (a genetic disease associated with benign skin tumors and lung cysts)
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
- Fever
- Liver dysfunction
- Elevated erythrocyte sedimentation rate (ESR)
- Excessive hair growth in females
- Pale skin
- Vision problems
Exams and Tests
The health care provider will perform a physical exam. This may reveal a mass or swelling of the abdomen.
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
- Urinalysis
The following tests may be done to see if the cancer has spread:
- Abdominal MRI
- Biopsy
- Bone scan
- Chest x-ray
- Chest CT scan
- PET scan
Treatment
Surgery to remove all or part of the kidney (nephrectomy) is usually 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 may be a benefit from surgery.
Chemotherapy is generally not effective for treating kidney cancer in adults. Newer immune system medicines 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 is usually done when the cancer spreads to the bone or brain.
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 fourth 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
- Spread of the cancer
When to Contact a Medical Professional
Contact your provider any time you see blood in the urine. Also contact 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.
References
National Cancer Institute website. Renal cell cancer treatment (PDQ) -- health professional version.
National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology: kidney cancer. Version 2.2022.
Weiss RH, Jaimes EA, Hu SL. Kidney cancer. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 41.
Version Info
Last reviewed on: 1/25/2022
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, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
