Renal cell carcinoma

Alternative Names

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

Definition

Renal cell carcinoma is a type of kidney cancer that starts in the lining of very small tubes (tubules) in the kidney.

Causes

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

The exact cause is unknown.

The following may increase your risk of kidney cancer:

Dialysis treatment
Family history of the disease
High blood pressure
Horseshoe kidney
Polycystic kidney disease
Smoking
Von Hippel-Lindau disease (a hereditary disease that affects blood vessels in the brain, eyes, and other body parts)

Symptoms

Abdominal pain and swelling
Back pain
Blood in the urine
Swelling of the veins around a testicle (varicocele)
Flank pain
Weight loss

Other symptoms that can occur with this disease:

Exams and Tests

The health care provider will perform a physical exam. This may reveal:

Mass or swelling of the abdomen
A varicocele in the male scrotum

Tests include:

Abdominal CT scan
Blood chemistry
Complete blood count (CBC)
Intravenous pyelogram (IVP)
Liver function tests
Renal arteriography
Ultrasound of the abdomen and kidney
Urine tests

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

Treatment

Surgery to remove of all or part of the kidney (nephrectomy) is recommended. This may include removing the bladder, surrounding tissues, or lymph nodes. A cure is unlikely unless all of the cancer is removed with surgery. But even if some cancer is left behind, patients can still benefit from surgery.

Hormone treatments may make the tumor smaller in some cases.

Chemotherapy is generally not effective for treating kidney cancer. The immune system medicine interleukin-2 (IL-2) may help some patients. Medicines that target the development of blood vessels that feed the tumor may be used to treat kidney cancer. Your doctor can tell you more.

Radiation therapy usually does not work for kidney cancer.

Support Groups

You can ease the stress of illness by joining a support group whose members share common experiences and problems.

Outlook (Prognosis)

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.

How well a patient does depends on how much the cancer has spread and how well treatment works. The survival rate is highest if the tumor is in the early stages and has not spread outside the kidney. If it has spread to the lymph nodes or to other organs, the survival rate is much lower.

Possible Complications

High blood pressure (hypertension)
Too much calcium in the blood
High red blood cell count
Liver problems
Spread of the cancer

When to Contact a Medical Professional

Call your health care provider any time you see blood in the urine. Also call if you have any other symptoms of this disorder.

Prevention

Stop smoking. Follow your health care provider's recommendations in the treatment of kidney disorders, especially those that may require dialysis.

References

National Cancer Institute: PDQ Renal Cell Cancer Treatment. Bethesda, Md: National Cancer Institute. Date last modified: Feb. 21, 2014. Available at: http://cancer.gov/cancertopics/pdq/treatment/renalcell/HealthProfessional. Accessed: March 23, 2014.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Kidney cancer. Version 2.2014. Available at: http: //www.nccn.org/professionals/physician_gls/pdf/kidney.pdf. Accessed: March 23, 2014.

Pili R, Kauffman E, Rodriguez R. Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2013:chap 82.