What is it?
Kidney cancer is now the seventh most common cancer in the UK, accounting for three per cent of all new cancer cases.
It can come in several different forms:
- Renal cell cancer is the most common type in adults (accounting for 85-90 per cent of all kidney cancers and usually develops in the lining of the tubules (the tiny tubes within the kidney). The average age at diagnosis is 64. There are three main sub-groups,
- clear cell
- Transitional cell cancer is a much rarer form of kidney cancer that affects the central area of the kidney (known as the renal pelvis) or the ureter (the tube that takes urine from the kidney down to the bladder).
- Wilm’s tumour is the most common kidney cancer in children. It is rarely inherited and is usually caused by disruption to normal kidney development.
Some people may develop benign kidney tumours, the most common of which is known as an oncocytoma. These can have a similar appearance to kidney cancers on scans and removal of the tumour or a kidney biopsy may be required to confirm the diagnosis.
One particular form of benign tumour, made up of blood vessel tissue, fat or muscle tissue is known as an angiomyolipoma. Usually these are of no significance when small but if large or multiple tumours occur then specialist assessment is required.
Kidney cancer is caused by genetic mutations in kidney cells which make the cells multiply out of control. We don’t yet know what triggers these mutations but some things can increase your risk of developing kidney cancer. These include:
- Being overweight or obese
- Having high blood pressure
- Having a family history of kidney cancer
- Working with or being exposed to some workplace chemicals such as asbestos, cadmium and some solvents
- Being on long-term dialysis
At first, kidney cancer may cause no obvious symptoms but you should see your GP if you have:
- Blood in your urine
- A lump or swelling in your side
- Persistent pain in your lower back or side
- No energy
- Sudden weight loss
- Recurrent fevers
- A general feeling of poor health
Most of these symptoms could have other less serious causes. But if you do have kidney cancer, the earlier diagnosis is made and treatment started, the better the chances of slowing down progression or even curing the cancer.
Imaging tests (such as ultrasound, CT or MRI scans) are normally used to detect kidney cancer and assess whether the cancer has spread to other parts of the body. Blood and urine tests are also used to gauge kidney function.
As the use of scans increases, a significant proportion of kidney tumours are now being identified during scans to investigate other issues.
Grades of kidney cancer
Cancerous cells taken from a kidney biopsy may also be examined under a microscope in order to grade the cancer from 1- 4. The more the cells look like normal cells the lower the grade and the lower the likelihood that the cancer will spread. This information may be useful in planning management, particularly for very small tumours where observation of the tumour is being considered as one of the treatment options.
Treatments will depend on the stage or extent of your kidney cancer, and your general health. These could be designed to cure, control or ease the symptoms of the disease. A treatment plan will be designed to fit your individual needs.
Treatments could include:
- Surgery – open or keyhole surgery can be used to remove part of the kidney or the entire kidney. Keyhole (laparoscopic) surgery delivers less post-operative pain, a quicker discharge from hospital and a faster return to normal activity and is feasible for the majority of small or medium sized tumours. Keyhole surgery can also be used to perform a partial nephrectomy (removal of the area of kidney containing the tumour) – which is feasible for many small tumours.
- Cryotherapy or radiofrequency ablation – where cancer cells are destroyed by freezing or heating. This can provide a minimally invasive treatment option for small kidney tumors.
- Arterial embolization – can occasionally be used to make surgery easier when removal of the kidney is not possible. In this technique a blood supply to the tumour is reduced, so that the tumour starves and shrinks.
- Radiation therapy (radiotherapy) – uses X-rays to kill the cancer. It is sometimes used to relieve pain (palliative therapy) if kidney cancer has spread to the bone.
- Drug therapy – a number of drugs are now available to treat kidney tumours that have spread beyond the kidney.
Help for you
If you have been diagnosed with kidney cancer and have any questions or concerns about your illness don’t hesitate to speak to your cancer specialist.
You can also find further information, advice and helpful tips in our Just diagnosed and How can I help myself? sections.
- Visit the NHS Choices webpage on kidney cancer
- Types of kidney cancer – Cancer Research UK
- Visit the Patient UK website
- Visit the Kidney Cancer UK website
Reviewed April 2019
The need for more research
Understanding why kidney cancer develops could lead to new treatments to prevent or cure this type of cancer. We also need to understand how best to treat kidney cancer in older, frail patients, and in those with pre-existing chronic kidney disease.
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