Kidney Cancer (Renal Cancer)
Kidney cancer usually affects adults in their 60s or 70s and is rare in people under 50.
What is kidney cancer?
When to get medical advice
Kidney cancer, also called renal cancer, is one of the most common types of cancer in the UK. It usually affects adults in their 60s or 70s and is rare in people under 50. It can often be cured if it’s caught early. But a cure may not if it’s not diagnosed until after it has spread beyond the kidney.
There are several types of kidney cancer. This page will focus on the most common type – renal cell carcinoma.
See your GP if you have symptoms of kidney cancer. Although it’s unlikely you have cancer, it’s important to get your symptoms checked out. Your GP will ask about your symptoms and may test a sample of your urine to see if it contains blood or an infection. If necessary, they can refer you to a hospital specialist for further tests to find out what the problem is.
Your GP will ask about your symptoms and may test a sample of your urine to see if it contains blood or an infection.
Diagnostic tests for kidney cancer
Causes of kidney cancer
In addition to a physical examination, the following tests may be used to diagnose kidney cancer:
The doctor may recommend having a blood test to check the number of red blood cells and a urine test to find blood, bacteria, or cancer cells. These tests may suggest that kidney cancer is present, but they cannot be used to make a definite diagnosis.
A biopsy is usually performed as an outpatient procedure using local anesthesia by an interventional radiologist. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. However, in some cases, a biopsy may not be diagnostic and is therefore unabe to confirm kidney cancer. Therefore, if imaging tests show a solid and growing mass, then surgeons may remove the tumor first and then the pathologist will later provide the definitive tumor type and stage.
The patient should carefully discuss with their doctor whether a biopsy is needed before treatment.
For patients being evaluated for a renal mass, a non-contrast CT scan is done before a contrast medium is injected. A contrast medium is a special dye that provides better detail on the images taken by CT scans. This dye is injected into a patient’s vein. If the renal mass is found to have fat in it during a CT scan without contrast medium, then the diagnosis of benign angiomyolipoma can be made, and nonsurgical treatment options may be recommended. Renal cysts will not take up the contrast medium, but renal tumors will. If patients have severe chronic kidney disease or kidney failure, then the contrast medium cannot be safely used. A CT scan of the urinary tract is called a CT urogram.
An MRI can be used to measure the tumor’s size and to look for features which be suggestive of cancer. A special dye called gadolinium is given before the scan to create a clearer picture. This dye is injected into a patient’s vein.
Occasionally, special tests called a cystoscopy and uretero-renoscopy may be done for suspected cancer in the renal pelvis, or in the ureter. They are not often used for renal cell carcinoma unless imaging also finds a mass or stone in the bladder. During these procedures, the patient is anaesthetised, while a tiny, lighted tube is inserted into the bladder through the ureter and up into the kidney. This procedure can be used to obtain tumor cells for examination under a microscope, to perform a biopsy, and sometimes to completely destroy small tumors.
The exact cause of kidney cancer is unknown, but some things can increase your chances of developing it:
These include:
- obesity – a body mass index (BMI) of 30 or more; use the healthy weight calculator to work out your BMI
- smoking – the more you smoke, the greater the risk
- high blood pressure (hypertension)
- family history – you’re more likely to get kidney cancer if you have a close relative with it
- genetic conditions – some inherited genetic conditions increase the risk of kidney cancer, such as Von Hippel-Lindau syndrome
- long-term dialysis – a treatment for kidney disease where a machine replicates some of the jobs of the kidneys
After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer. This is called staging.
Treatments for kidney cancer
The treatment for kidney cancer depends on the size of the cancer and whether it has spread to other parts of the body.
The main treatments are:
- surgery to remove part or all of the affected kidney – this is the main treatment for most people
- cryotherapy or radiofrequency ablation – where the cancerous cells are destroyed by freezing or heating
- biological therapies – medications that help stop the cancer growing or spreading
- embolisation – a procedure to cut off the blood supply to the cancer
- radiotherapy – using high-energy radiation to target cancer cells and relieve symptoms
