Cancer Care

Kidney Cancer

Urology of Indiana Kidney Cancer

There are several types of Kidney Cancer. As with most cancers, the earlier kidney tumors are discovered, the better a patient’s chances for survival.

There are several types of kidney cancer. Renal cell carcinoma (RCC), the most common form, accounts for the majority of all kidney cancers. In RCC, malignant (cancerous) cells develop in the lining of the kidney’s tubules and typically grow into a mass called a tumor. Single tumors are the norm, although more than one tumor can develop within one or both kidneys.

In order to provide high-quality care and excellent patient outcomes, the Urology of Indiana kidney cancer team references national guidelines to inform current and best practices. In addition, they offer access to clinical trials. This may allow a kidney cancer patient to be treated with new and promising medicines that are not yet available to all kidney cancer patients.

Risk Factors

People with a family history of kidney cancer appear to be at increased risk for RCC. It is suspected that inherited genetic mutations may be the cause, perhaps triggered by damage to the DNA that forms genes; cigarette smoke, for example, is known to contain chemicals that can damage the genes of kidney cells. Other risk factors include:

  • Age: particularly adults 50 – 70 years old
  • Diet and weight
  • Extended dialysis treatment
  • Gender: Men are twice as likely as women to develop kidney cancer

Symptoms

In early stages, kidney cancer typically does not have symptoms. As the disease progresses symptoms can include:

  • Abdominal mass or lump in the belly
  • Blood in the urine (hematuria)
  • Fever not caused by a cold or flu
  • High blood pressure
  • Pain in the flank (side) or lower back not associated with injury
  • Persistent feeling of fatigue
  • Rapid, unexplained weight loss
  • Swelling of the legs and ankles

While these symptoms are usually caused by other illnesses, they may indicate the presence of kidney cancer. People who have any of these symptoms should see their primary care doctor or urologist as soon as possible.

Early diagnosis is critically important. As with most cancers, the earlier kidney tumors are discovered, the better a patient’s chances for survival. Tumors discovered at an early stage often respond well to treatment.

Survival rates in such cases are high. Tumors that have grown large or metastasized (spread) through the bloodstream or lymphatic system to other parts of the body are much more difficult to treat and present a greatly increased risk for death from kidney cancer.

Once a diagnosis of renal cell cancer has been confirmed and the disease’s stage determined, the urologist and patient decide on a treatment plan. Factors to consider in this decision include the patient’s age and overall health, the extent to which the cancer has spread and any other physical conditions that might affect the patient’s survival.

Active Surveillance

When a small tumor (3 centimeters or less in size) is diagnosed, one of the first considerations is whether this can be safely watched without active treatment. This is true of many patients with small kidney tumors. While these tumors may still have a high probability of being cancer, many do not need to be treated right away, if at all. In fact, risk calculators (1) have been published that show many cases where no treatment (active surveillance) and watching with repeat scans over time results in the same outcome as surgery or other forms of invasive treatment.

Surgery

In general, surgical removal is the standard of care for kidney cancer. With smaller tumors, often the normal portion of the kidney is spared and only the tumor is removed. This is known as partial nephrectomy. With larger tumors the whole kidney is removed (radical nephrectomy). Both partial and radical nephrectomy can be done with open, laparoscopic or robotic surgical techniques depending on numerous factors.

Ablation

This refers to a technique where energy is delivered by placing needles directly into the tumor to destroy it. The main two types of energy are cryotherapy (freezing the tumor) and microwave (heating the tumor). These procedures are typically performed by an interventional radiologist. Discuss with your doctor the considerations for this form of treatment, as it may not be appropriate depending on an individual patient’s unique circumstance.

Immunotherapy

With tumors that have spread, surgical removal is often combined with biological or immunotherapy. Immunotherapy uses compounds produced by the body’s disease-fighting system (immune system), or laboratory-produced copies of them, to kill cancer cells. Unfortunately, kidney cancer is not responsive to most chemotherapy or radiation treatments. However, there currently are several promising treatments that are in development for the treatment of advanced kidney cancer.

1. Psutka SP et al., A Clinical Decision Aid to Support Personalized Treatment Selection for Patients with Clinical T1 Renal Masses: Results from a Multi-institutional Competing-risks Analysis. European Urology. DOI: https://doi.org/10.1016/j.eururo.2021.11.002