Kidney Cancer

Definition

Kidney cancer is a disease in which cancer cells grow in the kidneys. The kidneys are two bean-shaped organs. They are located just above the waist, on each side of the spine. Their main function is to filter the blood and produce urine.

Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissue and spread to other parts of the body. A benign tumor does not invade or spread.

There are two main types of kidney cancer: Wilms tumor, which occurs mainly in children, and renal cell carcinoma in adults. The cells that line the ureter may also give rise to transitional cell cancer, and the connective tissues of the kidney may produce sarcomas, which are rare.

Cancer Cell Growth
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Causes

The cause of kidney cancer is unknown.

Risk Factors

Factors that increase your risk for kidney cancer include:

  • Smoking
  • Family history of certain hereditary forms of kidney cancer
  • Age: 50 years or older
  • Sex: male
  • Certain occupational exposures such as asbestos and aniline
  • Tanning products
  • Exposure to some toxins, such as astrolachia, which is an herb that is common in some Chinese herbal preparations
  • Balkan nephritis
  • Chronic renal stones
  • Phenacetin abuse
  • Tuberous sclerosis
  • Dialysis treatment
  • Von Hippel Lindau syndrome

Symptoms

Symptoms may include:

  • Blood in the urine
  • Lower back pain or new pain elsewhere
  • Shortness of breath or cough
  • A lump in the abdomen
  • Unplanned, significant weight loss
  • Fever
  • Swelling of ankles, legs, and/or abdomen

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Your bodily fluids and tissues may be tested. This can be done with:

Your bodily structures may need to be viewed. This can be done with:

Treatment

Staging tests will be done. The purpose of these tests is to find out if the cancer has spread and, if so, to what extent. Treatment depends on the stage.

Surgery is the most important component of any approach to cure kidney cancer. There is some information suggesting immunotherapies may be of some benefit. Radiation can be used to treat kidney cancer that has spread to the lung, bones, or brain, but it is not a cure. Chemotherapy is not a very effective form of treatment.

Surgery

Surgery involves the removal of a cancerous tumor, nearby tissue, and possibly nearby lymph nodes. Surgeries to treat kidney cancer include:

  • Radical nephrectomy—removal of the entire kidney, adrenal gland, and nearby fatty tissue and lymph nodes
  • Partial nephrectomy—removal of the cancerous part of the kidney only to treat smaller tumors that have not spread locally
  • Removal of metastases—removal of cancerous tissue that has spread to other parts of the body, particularly when causing symptoms

Radiation Therapy (or Radiotherapy)

This is the use of radiation to kill cancer cells and shrink tumors. External radiation therapy is directed at the tumor from a source outside the body.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including pill, injection, and through a tube called a catheter. The drugs enter the bloodstream and travel through the body destroying mostly cancer cells but also some healthy cells.

Immunotherapy

This procedure involves the use of drugs like interleukin-2 and interferon alpha to help the immune system fight and destroy cancer cells.

Targeted Therapy

Targeted therapy includes using medications called tyrosine kinase inhibitors. These medications have been shown to increase the survival rate in people with kidney cancer. Another class of drugs called mammalian target of rapamycin (mTOR) inhibitors may also help people with kidney cancer live longer.

Medication

These medicines may be prescribed to adults with advanced kidney cancer:

  • Everolimus
  • Pazopanib

Prevention

Measures to prevent kidney cancer are limited:

  • Avoid using tobacco products.
  • Avoid occupational exposures.

Revisions

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