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Renal cell carcinoma

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

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 50 to 70 years old.

The exact cause is unknown.

The following may increase your risk of kidney cancer:

  • Smoking
  • Obesity
  • Dialysis treatment
  • Family history of the disease
  • High blood pressure
  • Horseshoe kidney
  • Long-term use of certain medicines, such as pain pills or water pills (diuretics)
  • Polycystic kidney disease
  • Von Hippel-Lindau disease (a hereditary disease that affects blood vessels in the brain, eyes, and other body parts)

Symptoms

Symptoms of this cancer may include any of the following:

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 that may be ordered include:

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, there is still benefit from surgery.

Chemotherapy is generally not effective for treating kidney cancer. The immune system medicines interleukin-2 (IL-2) or nivolumab may help some people. Medicines that target the development of blood vessels that feed the tumor may be used to treat kidney cancer. Your provider 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 people, the cancer has already spread (metastasized) at the time of diagnosis.

How well someone with kidney cancer 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

Complications of kidney cancer include:

  • 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 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 provider's recommendations in the treatment of kidney disorders, especially those that may require dialysis.

References

Campbell SC, Lane BR. Malignant renal tumors. In: Wein AJ, Kavoussi LR, Partin AW, et al, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 57.

National Cancer Institute: PDQ renal cell cancer treatment. Bethesda, MD: National Cancer Institute. Date last modified: February 4, 2016. www.cancer.gov/types/kidney/hp/kidney-treatment-pdq. Accessed: February 1, 2016.

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: kidney cancer. Version 2. 2016. www.nccn.org/professionals/physician_gls/pdf/kidney.pdf. Accessed: March 17, 2016.

Pili R, Kauffman E, Rodriguez R. Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 82.

    • Kidney anatomy

      Kidney anatomy - illustration

      The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and stimulating red blood cell production.

      Kidney anatomy

      illustration

    • Kidney tumor - CT scan

      Kidney tumor - CT scan - illustration

      This CT scan of the abdomen shows a tumor in the left kidney (called hypernephroma, or renal cell carcinoma). It is located on the lower right side of the picture.

      Kidney tumor - CT scan

      illustration

    • Kidney metastases, CT scan

      Kidney metastases, CT scan - illustration

      A CT scan of the middle abdomen showing metastasis (cancer that has spread) in the left kidney in a patient with carcinoma of the lung. Note the large dark circular tumor in the kidney on the right side of the picture.

      Kidney metastases, CT scan

      illustration

    • Kidney - blood and urine flow

      Kidney - blood and urine flow - illustration

      This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.

      Kidney - blood and urine flow

      illustration

      • Kidney anatomy

        Kidney anatomy - illustration

        The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and stimulating red blood cell production.

        Kidney anatomy

        illustration

      • Kidney tumor - CT scan

        Kidney tumor - CT scan - illustration

        This CT scan of the abdomen shows a tumor in the left kidney (called hypernephroma, or renal cell carcinoma). It is located on the lower right side of the picture.

        Kidney tumor - CT scan

        illustration

      • Kidney metastases, CT scan

        Kidney metastases, CT scan - illustration

        A CT scan of the middle abdomen showing metastasis (cancer that has spread) in the left kidney in a patient with carcinoma of the lung. Note the large dark circular tumor in the kidney on the right side of the picture.

        Kidney metastases, CT scan

        illustration

      • Kidney - blood and urine flow

        Kidney - blood and urine flow - illustration

        This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.

        Kidney - blood and urine flow

        illustration

      A Closer Look

       

      Tests for Renal cell carcinoma

       

      Review Date: 2/1/2016

      Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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