Kidney cancer, also called “renal cell carcinoma,” is a malignant (cancerous) tumor that develops within the kidney itself. Other types of cancer (breast, lung, colon and lymphoma) may “metastasize” to the kidney. Their treatment and prognosis are different from renal cell carcinomas.
More common risk factors for renal cell carcinoma include older age, male gender, tobacco smoking, obesity and, to a lesser extent, genetics.
Symptoms of Kidney Cancer
Individuals may experience “painless gross hematuria” (blood in urine that is seen by the individual without associated pain) or “microscopic hematuria” (blood in the urine identified through a lab test).
Flank or back pain may be present along with unintentional weight loss; however, this is rare and usually associated with very large kidney tumors.
More commonly, individuals undergo diagnostic imaging such as a CT scan, MRI, or ultrasound of the abdomen for some other condition or symptom (such as abdominal pain), at which point, a tumor is identified “incidentally” within the kidney.
With widespread use of advanced diagnostic imaging, kidney tumors are diagnosed when they are smaller in size “before” they cause symptoms, thus allowing treatment earlier resulting in better treatment outcomes and improved survival rates.
Evaluation and Treatment
Individuals who experience either “painless gross hematuria” or “microscopic hematuria” should undergo a thorough evaluation by a urologist including diagnostic imaging (CT scan, MRI or ultrasound) as well as cystoscopy (a small camera is inserted in to the bladder to visually inspect the bladder for tumors).
If kidney cancer is suspected based on diagnostic tests, surgery is usually warranted to remove either the entire kidney (radical nephrectomy), or part of the kidney including the cancerous tumor (partial nephrectomy).
The decision to remove either the entire kidney or just part of the kidney depends on the size of the cancer as well as the location of the cancer within the kidney. The most important consideration in this decision is “effective” removal of the cancer.
With advances in surgical equipment and training, even large kidney cancers can be removed with minimally invasive surgery such as laparoscopic surgery or robot-assisted laparoscopic surgery.
When only part of the kidney is removed, robot-assisted laparoscopic surgery, or laparoscopic surgery, may be offered to allow for quicker recovery and similar cancer cure outcomes compared to open surgery. However, traditional open surgery may be the best option for some individuals based on the size and location of the cancer within the kidney.
Cryosurgery (freezing the cancer) or radiofrequency ablation (heating the cancer) are also “minimally invasive” surgical therapies and offer effective cancer cure rates in smaller kidney cancers (less than 3 centimeters in size). These treatments are usually reserved for individuals who are too ill to undergo surgical removal of the tumor or those with compromised kidney function.
It is important to discuss all treatment options with your urologist once a kidney cancer is suspected to develop the most effective treatment option for you.