Kidney Cancer Health Channel

Definition

Renal cell carcinoma is a type of kidney cancer in which the cancerous cells are found in the lining of very small tubes (tubules) in the kidney.

Alternative Names

Renal cancer; Kidney cancer; Hypernephroma; Adenocarcinoma of renal cells; Cancer - kidney

Causes, incidence, and risk factors

Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in men ages 50-70.

The exact cause is unknown.

Risk factors include:

• Dialysis treatment
• Family history of the disease
• Genetics
• Smoking
• Von Hippel-Lindau disease (a hereditary disease that affects the capillaries of the brain, eyes, and other body parts)

Symptoms

• Abdominal pain
• Abnormal urine color (dark, rusty, or brown)
• Back pain
• Blood in the urine
• Emaciated, thin, malnourished appearance
• Enlargement of the veins around a testicle (varicocele)
• Flank pain
• Swelling or enlargement of the abdomen
• Unintentional weight loss of more than 5% of body weight

Other symptoms that can occur with this disease:

• Constipation
• Cold intolerance
• Excessive hair growth in females
• Paleness
• Vision abnormalities

Sometimes both kidneys are involved. The cancer spreads easily, most often to the lungs and other organs. In about one-third of patients, the cancer has already spread (metastasized) at the time of diagnosis.

Signs and tests

Pressing with the fingers (palpation) on the abdomen may show a mass or organ enlargement, particularly of the kidney or liver. Men may have a varicocele in the scrotum (a varicocele that is only on the right side is especially suspicious.)

Tests include:

• Abdominal CT scan
• Complete blood count (CBC)
• Intravenous pyelogram (IVP)
• Liver function tests
• Renal arteriography
• Serum calcium
• Ultrasound of the abdomen and kidney
• Urine cytology
• Urine test (urinalysis)

The following tests may be performed to see if the cancer has spread:

• Abdominal CT scan
• Abdominal MRI
• Bone scan
• Chest x-ray
• PET scan

Treatment

Surgical removal of all or part of the kidney (nephrectomy) is recommended. This may include removing the bladder or surrounding tissues or lymph nodes.

Radiation therapy does not usually work for renal cell carcinoma so it is not often used. Hormone treatments may reduce the growth of the tumor in some cases.

Chemotherapy is generally not effective for treating renal cell carcinoma. The drug interleukin-2 (IL-2) is effective in a small percentage of patients, but it is very toxic.