Kidney cancer is not often talked about, but it’s more common than you might think. Every year, hundreds of thousands of people worldwide are diagnosed, often without any warning signs until the disease has already progressed. Knowing the signs to look for can help, but too often it can fly under the radar. The good news is that medical advancements have made it easier to detect and treat than ever before. From cutting edge imaging techniques that make diagnosis straightforward, to targeted therapies that specifically attack cancer cells, solutions for coping with kidney cancer have come a long way.
Understanding Kidney Cancer
Your kidneys are small but mighty. These two bean-shaped organs, located at your lower back, do much more than just filter waste from your blood. They help to regulate blood pressure, balance fluids and even produce hormones. But like any other part of the body, they’re vulnerable to cancerous growths.
What is Kidney Cancer?
Kidney cancer happens when cells inside the kidneys grow uncontrollably, forming a tumor. The most common type of kidney cancer in adults is renal cell carcinoma (RCC), accounting for about 85% of cases. RCC usually develops as a single tumor in one kidney, but it can affect both kidneys. Within RCC there are different subtypes, but the most frequently diagnosed is clear-cell renal-cell carcinoma.
Other, less common types of kidney cancer include the following.
Urothelial or Transitional Carcinoma
This begins in the urinary system and affects the lining of the kidney’s draining system.
Wilms Tumor
Mostly found in children.
Renal Sarcoma
A rare form which affects connective tissues, but can spread to nearby organs and bones.
What Puts You at Risk?
There is no single causes of kidney cancer, but some factors can increase the risk.
- Smoking: The use of tobacco significantly increases the risk of developing kidney cancer.
- Obesity: Excess weight can lead to hormonal imbalances that can trigger many different types of cancer.
- High blood pressure: Hypertension is a known contributor.
- Family history: If kidney cancer runs in your family, then your risk is likely to be higher.
- Certain medications and toxins: Extended use of painkillers such as acetaminophen has been linked to kidney cancer. Similarly, exposure to chemicals such as asbestos or cadmium can increase your risk.
While you cannot change your family history or genetics, healthy lifestyle choices can significantly lower your risk of developing this type of cancer.
Recognizing the Symptoms
One of the most frustrating things about kidney cancer is that it often doesn’t cause noticeable symptoms in its early stages. Many cases are found by accident when someone has an imaging test for an unrelated issue. But when symptoms do appear, they can include the following.
Common Signs to Watch Out For
- Blood in the urine (hematuria): Any amount of blood in your pee should be noted, whether it is pinkish discoloration or bright red blood.
- Persistent lower back pain: This is important only if unrelated to any injury, and often will occur just on one side.
- A lump or mass in the side of the abdomen: A lump in your side may not always be noticeable, but this is something that can be picked up during a physical exam.
- Unexplained weight loss: Dropping pounds without trying to or making any significant changes to your diet or activity level could be a red flag.
- Fatigue and weakness: Feeling drained or low on energy, even when you have had adequate rest, could be a symptom of kidney cancer.
- Fever and night sweats: Some kidney cancer cases cause recurrent fevers, or fluctuations in body temperature.
If you notice any of these signs, especially blood in your urine, it’s worth getting checked out by a doctor sooner rather than later.
How Kidney Cancer is Diagnosed
Kidney cancer diagnosis isn’t always straightforward. Because the early stages often lack symptoms, many cases are discovered accidentally when a patient undergoes imaging for something unrelated, like back pain or digestive issues. However, if kidney cancer is suspected, doctors use a combination of medical history, imaging tests, laboratory analyses, and sometimes biopsies to confirm the diagnosis.
Step 1: Medical History and Physical Examination
Before jumping into tests, a doctor will start by asking about a couple of things.
- Any symptoms you’ve noticed, even if they seem minor,
- Your personal and family history of cancer,
- Lifestyle factors like smoking, alcohol consumption, or exposure to harmful chemicals,
- Other medical conditions, such as high blood pressure or kidney disease.
They’ll also conduct a physical examination. Your doctor will feel for any lumps or swelling in the abdomen and check for signs of anemia (which could indicate kidney dysfunction).
Step 2: Imaging Tests – Getting a Closer Look
If kidney cancer is suspected, imaging tests are the next step. These allow doctors to visualize the kidney and any abnormal growths.
- Ultrasound: A quick and painless scan that uses sound waves to detect tumors. It’s often the first imaging test done if a kidney problem is suspected.
- CT Scan (Computed Tomography): The most common and reliable method for diagnosing kidney cancer. It provides detailed images of a cross-section of the kidney which helps to distinguish between a benign cyst and a solid tumor. A contrast dye will usually be injected to enhance the image.
- MRI (Magnetic Resonance Imaging): These are used when CT scans aren’t sufficient, particularly if more detail is needed to assess soft tissues or if the patient has an allergy to the contrast dye.
- PET Scan (Positron Emission Tomography): Generally not a routine test for kidney cancer but can be helpful in detecting whether cancer has spread to other organs.
Step 3: Laboratory Tests – Checking for Clues
Although blood and urine tests can’t directly diagnose kidney cancer, they can provide important clues.
Urine Tests
To detect blood, abnormal proteins, or cancer cells in the urine.
Blood Tests
- Creatinine and eGFR: Measures kidney function. If kidney function is impaired, it might indicate a tumor affecting filtration.
- Complete Blood Count (CBC): Checks for anemia, which can be a symptom of kidney cancer.
- Liver Function Tests: If elevated, they may indicate that the cancer has spread to the liver.
Step 4: Biopsy – Is it Always Necessary?
Unlike some cancers where a biopsy is the standard diagnostic tool, kidney cancer can often be diagnosed without a biopsy because imaging tests are usually conclusive. However, a biopsy might be performed in the following circumstances.
- Imaging results are inconclusive,
- A small mass is detected, and doctors want to confirm whether it’s cancerous,
- There’s a suspicion of an infection or another type of kidney disease.
A kidney biopsy involves inserting a thin needle into the tumor to extract a small tissue sample. While generally safe, there’s a small risk of bleeding or infection.
Staging and Prognosis
Determining the Cancer Stage
Once kidney cancer is confirmed, doctors can determine its stage. This helps to guide treatment decisions. Most commonly, doctors use the TNM staging system.
- T (Tumor Size): Measures how large the tumor is and whether it has invaded nearby tissues.
- N (Lymph Nodes): Checks if cancer has spread to nearby lymph nodes.
- M (Metastasis): Determines if the cancer has spread to other parts of the body, like the lungs or bones.
By using these measures, the kidney cancer can be categorized into stages 1 to 4.
- Stage 1: The tumor is no more than 7cm across and is only in your kidney – no metastasis.
- Stage 2: The tumor is larger than 7cm across but has not metastasized.
- Stage 3: The tumor has spread to the major blood vessels, surrounding tissue or nearby lymph nodes.
- Stage 4: The tumor has spread outside the kidney to the adrenal gland, or to distant lymph nodes or other organs.
Why Early Diagnosis Matters
Like most cancers, early detection will drastically improve the outcome. If kidney cancer is caught in Stage 1 (when the tumor is small and confined to the kidney), the survival rate after five years is over 90%. However, if it has already spread to distant organs by the time it’s detected (Stage 4), survival rates are significantly lower.
Because kidney cancer can often go undetected with few symptoms, regular check-ups and screenings are crucial. This is especially important for those with risk factors like smoking, high blood pressure, or a family history of the disease.
Treatment Options for Kidney Cancer
Once kidney cancer has been diagnosed and staged, the next step is to determine the best treatment plan. The most appropriate approach depends on several factors, including the tumor’s size, stage and how the cancer has spread beyond the kidney. The main treatment options include surgery, targeted therapy, immunotherapy, radiation therapy and, in some cases, chemotherapy.
Surgery – The First Line of Defense
For early-stage kidney cancer, surgery is usually the primary and most-effective treatment. Depending on the location and size of the tumor, one of the following surgeries might be most appropriate for you.
Partial Nephrectomy (Kidney-Sparing Surgery)
In early stage kidney cancer, the cancerous portion of the kidney alone can be removed. This preserves as much of the healthy kidney tissue as possible, allowing for continued function of the kidney. This is preferred for smaller tumors, or people with only one functional kidney.
Radical Nephrectomy
The entire kidney is removed along with surrounding tissues, lymph nodes, and sometimes the adrenal gland. This is done for larger or more aggressive tumors.
In some cases, minimally invasive surgery is an option, such as laparoscopic or robotic assisted surgery. This offers faster recovery times and smaller incisions.
Ablation – An Alternative to Surgery
For some who aren’t candidates for surgery, heat and cold treatment can destroy cancer cells.
Cryoablation
During this procedure, a needle is inserted through your skin and into the kidney tumor. The cancerous cells are frozen with cold gas.
Radiofrequency Ablation
Similarly, a needle is inserted into the tumor through the skin, but an electrical current is passed through the cancer cells to destroy them.
Targeted Therapy – Precision Medicine
Unlike traditional chemotherapy, targeted therapy specifically attacks cancer cells while minimizing harm to nearby normal cells. These drugs work by blocking proteins and pathways that fuel tumor growth.
Sunitinib (Sutent) and Pazopanib (Votrient)
These medicines block blood vessel growth that feeds the tumor.
Cabozantinib (Cabometyx)
Helps inhibit tumor growth and metastasis.
Targeted therapy is often used for advanced kidney cancer or when surgery isn’t an option.
Immunotherapy – Harnessing the Immune System
Immunotherapy helps the body’s immune system recognize and fight cancer cells more effectively. Cancer cells usually survive by hiding from the immune system, immunotherapy helps to prevent this from happening successfully.
Nivolumab (Opdivo) and Pembrolizumab (Keytruda)
Checkpoint inhibitors that prevent cancer from being invisible to the immune system.
Ipilimumab (Yervoy)
Sometimes combined with nivolumab for aggressive cases.
These treatments are particularly useful for advanced kidney cancer and have been shown to improve survival rates.
Radiation Therapy – Limited but Useful
Radiation isn’t generally used to treat kidney cancer directly, but can sometimes be used to help manage symptoms. This is particularly helpful if the cancer has spread to bones or other organs. It’s mainly used for pain relief and palliative care in later-stage cases.
Chemotherapy – Rarely Used
Traditional chemotherapy is not very effective against kidney cancer, as tumors often don’t respond well to chemo drugs. However, in rare cases, chemotherapy might be considered.
Clinical Trials – Exploring New Frontiers
For patients with advanced or treatment-resistant kidney cancer, clinical trials offer the opportunity to access experimental therapies that might become the next big advancement. These trials test new drugs, combinations or treatment approaches to improve survival and quality of life.
Which treatment you choose is highly personal, and often, a combination of therapies will suit you best and provide the best possible outcomes.
Managing Life After Diagnosis and Treatment
Surviving kidney cancer is a huge victory, but life after treatment comes with its own challenges. Recovery doesn’t stop once the tumor is removed or treatment ends, it requires ongoing care, monitoring, and lifestyle adjustments to maintain your health and prevent the cancer from coming back.
Follow-up Care – Staying One Step Ahead
Regular follow ups are crucial after kidney cancer treatment. Depending on the stage of your cancer and the treatment that you have received, doctors will schedule certain follow-ups.
- Routine imaging (CT or MRI scans) to check for recurrence or new tumors.
- Blood and urine tests to monitor kidney function.
- Physical exams and symptom tracking to catch any early warning signs of recurrence.
If you only had one kidney removed, monitoring your kidney function becomes even more important. Doctors may recommend avoiding certain medications (like NSAIDs) that can strain the remaining kidney.
Adopting a Kidney-Friendly Lifestyle
Maintaining long-term health after kidney cancer depends on you making a few healthy lifestyle changes. Keeping your body (and your kidneys!) healthy reduces the risk of recurrence of cancer as well as improving your overall well-being.
- Staying hydrated: Drinking lots of water supports your kidney function and helps to flush out toxins.
- Maintaining a healthy weight: Obesity is a key risk factor for kidney cancer, so keeping a healthy weight is important.
- Eating a balanced diet: A kidney-friendly diet includes more fresh fruits, vegetables, whole grains, and lean proteins, and less processed foods, excess salt, red meat, and alcohol.
- Regular exercise: Staying active helps maintain a healthy weight, improves circulation, and boosts immune function.
Managing Emotional and Mental Health
A diagnosis of cancer and the journey through treatment affect you in many ways. Many survivors experience common post-diagnosis symptoms.
- Anxiety about recurrence: The fear of cancer coming back is common and natural.
- Depression or PTSD: The trauma of dealing with a life-threatening illness can remain even after treatment.
- Fatigue or brain fog: Lingering effects from treatment can make daily tasks feel more exhausting.
Seeking support is key. There are a few options you should consider.
- Therapy or counseling: Speaking with a mental health professional can help manage stress and fear.
- Support groups: Connecting with other kidney cancer survivors can provide emotional reassurance.
- Mindfulness practices: Activities like meditation, yoga, and journaling can improve mental well-being.
Understanding the Risk of Recurrence
The risk of kidney cancer returning depends on multiple factors. This includes tumor size, stage, treatment success, and lifestyle. For early-stage kidney cancer, recurrence rates are lower, but for advanced cases, continued vigilance is crucial.
You might be classified by your doctor in one of these stages.
- Low risk: Less frequent follow-ups are required, but still need regular monitoring.
- Moderate to high risk: More frequent imaging and lab tests to detect any signs of return.
If cancer does come back, it can often still be treated with surgery, targeted therapy, or immunotherapy, depending on how and where it reappears.
Looking Forward – Life After Cancer
A kidney cancer diagnosis changes life in ways big and small, but many survivors go on to live long, healthy lives. The key is staying proactive by attending follow-ups, maintaining a healthy lifestyle, and prioritizing mental well-being.
For many, surviving cancer leads to a shift in perspective—an increased appreciation for life, a focus on wellness, and a deeper connection with loved ones. While the journey may have been tough, it often leaves survivors stronger and more resilient.
Kidney cancer may not always give obvious warning signs, but arming yourself with information about risk factors and early symptoms can make your journey easier. Early detection and the right treatment allow for promising survival rates. The sooner that kidney cancer is caught, the more options you have for treatment and the better your chances of a full recovery. To give yourself the best chance, pay attention to your body, get regular check-ups and don’t ignore any symptoms!
