Kidney cancer

What is kidney cancer?

There are several types of kidney cancer. Renal cell carcinoma (RCC) is the most common type in adults, responsible for approximately 80 per cent of cases.

Kidney cancer symptoms

Many people with kidney cancer have no symptoms at first, especially when the cancer is small. The affected kidney will become larger and in time, the tumour may grow through the wall of the kidney and invade nearby tissues and organs, such as the muscles around the spine, liver and nearby large blood vessels.

As the cancer develops, the following may occur:

• Blood in the urine, which is usually painless and may 'come and go' as the tumour bleeds (the first symptom in 60 per cent of cases)
• Pain in the back or side
• Swelling in the abdomen
• High blood pressure
• Feeling generally unwell or tired
• Loss of appetite
• Polycythaemia (too much blood in body) or anaemia (too little)
• Varicocele (tangled network of veins in the scrotum)
• Hip fracture, owing to spread of the cancer to bone
• Excessive hair growth in females
• Feeling thirsty
• Night sweats
• Severe weight loss

Kidney cancer causes

Although kidney cancer is more common in men over the age of 60, many people develop it for no apparent reason. However, certain risk factors increase the chance of it developing, including:

• Smoking
• Obesity
• High blood pressure
• Family history of the disease
• Dialysis patients with cysts in their kidneys
• Inherited disorders such as Von Hippel-Lindau disease

Diagnosing kidney cancer

About half of kidney cancers are diagnosed before any symptoms develop. They are usually seen by chance when a scan or other investigation is done for another reason.

If your doctor suspects kidney cancer, they will arrange an ultrasound scan. A CT scan, which gives a more detailed view of sections of the body, may be used if there is doubt about the diagnosis or to assess if the cancer has spread.

Kidney cancer treatments

Treatment options which may be considered include:

• Surgery to remove all (or part) of the affected kidney. This is the most common treatment and can be done as a keyhole operation in some cases. If the cancer is at an early stage and hasn't spread, surgery alone may be enough. If the cancer has spread, surgery to remove the affected kidney may still be advised, often in addition to further surgery to remove a secondary kidney tumour (one which has spread to another part of the body).
• Radiotherapy may be advised to kill any cancerous cells left behind following an operation.
• Arterial embolisation may be used instead of surgery, where the artery to the kidney tumour is blocked. The blood supply to the tumour is then cut off, and the tumour dies.
• Medications such as sunitinib, temsirolimus, bevacizumab, interferon-alpha have improved the outlook for kidney cancer patients. Speak to your specialist about what may be best for you.

Chemotherapy doesn't work as well as it does for other types of cancer. The type of treatment depends on the type and how large the cancer is, whether it has spread and general health.

If a cure is not realistic, in some cases treatment aims to control the cancer, limiting the growth or spread so it progresses less rapidly. This may limit the amount of symptoms for some time.

If the cancer is confined to the kidney without spreading, and the patient is in otherwise good general health, the outlook is good, with around 95 per cent of patients surviving five years after diagnosis (if the tumour is less than 4 cm). Surgical removal of an affected kidney in this situation gives a good chance of cure.

However, many people with kidney cancer are diagnosed when the cancer has already spread, so a cure is less likely. However, treatment can often slow down the progression of the cancer.