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Kidney cancer

Published by Bupa's health information team, February 2008.

This factsheet is for people who have kidney cancer, or who would like information about it.

A kidney tumour is a lump created by an abnormal and uncontrolled growth of cells. It can either be malignant (cancerous) or benign. Kidney cancer is rare in people under 40, but the rate then increases with age.

• Animation - How cancer develops
• About kidney cancer
• Types of kidney cancer
• Symptoms
• Causes
• Diagnosis
• Treatment
• Help and support
• Further information
• Questions and answers
• Related topics
• Sources

How cancer develops

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About kidney cancer

The kidneys

Most people have two kidneys, which are found towards the back of the abdomen (tummy). They "clean" the blood by filtering out water and waste products to make urine, which is then passed out of the body via the bladder.

The position of the kidneys and surrounding structures

What is kidney cancer?

A kidney tumour is a lump created by an abnormal and uncontrolled growth of cells. It can either be malignant (cancerous) or benign.

Cancerous tumours can grow through your kidney and spread to other parts of your body (through the bloodstream or the lymph system) where they may grow and form secondary tumours. This spread of cancer is called metastasis.

Benign tumours don't spread to other parts of the body.

Kidney cancer usually only affects one kidney. Kidney cancer is also sometimes referred to as renal cancer.

In the UK, it's the eighth most common cancer in men and the fourteenth most common cancer in women. More than 7,000 people are diagnosed with kidney cancer each year.

Types of kidney cancer

There are several types of kidney cancer.

• Renal cell cancer (RCC) is the most common form of kidney cancer and affects the area of the kidney called the renal parenchyma. There are a number of different types of RCC, depending on the type of cell affected. Some of these are clear cell (the most common type), papillary, chromophobic, oncocytic, collecting duct and sarcomatoid.
• Transitional cell cancer (TCC) mainly affects the area of the kidney called the renal pelvis.
• Wilms tumour generally occurs in children when they are about four. It can affect the whole kidney.

This factsheet will focus on renal cell cancer (RCC).

Symptoms

The most common symptom of kidney cancer is blood in the urine (haematuria). This may come and go. Sometimes blood clots may form and cause spasms in the ureters or bladder which causes pain (renal colic). The ureters are tubes that take urine from the kidneys to the bladder. Other symptoms include:

• lower back pain from just below the ribs
• fever
• tiredness
• swelling in your lower back
• anaemia
• weight-loss

Although not necessarily a result of kidney cancer, if you have these symptoms you should visit your GP. Kidney cancer may also cause high blood pressure.

Causes

The causes of kidney cancer aren't fully understood at present. But there are certain factors that make kidney cancer more likely, including:

• age - middle aged and older people are more likely to get kidney cancer
• smoking - this doubles the risk of renal cell cancer
• environmental factors - this includes exposure to industrial materials such as cadmium and asbestos
• chronic renal failure needing long-term dialysis
• obesity
• diabetes
• high blood pressure
• genetics - some rare genetic (linked to certain genes in the family) conditions, such as von hippel-lindau syndrome and papillary renal carcinoma syndrome, can lead to kidney cancer. Most kidney cancer isn't passed through families.

However, the risk is four times higher if a close relative (eg mother, father, sibling) has had kidney cancer.

Diagnosis

Your doctor will ask you about your symptoms and will examine you. He or she may test a sample of your urine with a "dipstick" to look for blood and infection. He or she may also take a blood sample. Your doctor may then refer you to an urologist - a doctor specialising in conditions that affect the urinary system for further tests which may include the following.

• An ultrasound scan uses high-frequency sound waves to produce an image of the kidney to look for any changes.
• An intravenous pyelogram (or IVP urogram) is used to examine the urinary system. A dye is injected into a vein. This dye is removed from the bloodstream (excreted) by the kidney as part of urine production. By taking X-ray pictures while the kidneys are excreting the dye, the urologist can see any abnormalities in the outline of your urinary system.
• A CT (computerised tomography) scan uses X-rays to make a three-dimensional picture of the body which can help your doctor see if the cancer has spread.
• An MRI (magnetic resonance imaging) scan uses magnets and radiowaves to produce two- and three-dimensional pictures of the inside of the body which can help your doctor see how far the cancer has spread (if at all).
• Your doctor may also use the ultrasound or CT scan to guide a needle to the kidney to take a biopsy. A biopsy is a small sample of tissue. This will be sent to a laboratory for testing.

Treatment

The treatment for kidney cancer depends on the type of cancer you have, and the stage and grade of cancer that you may have.

• If the cancer has not spread outside of the kidney, a part of or the whole kidney (nephrectomy) may be removed. Surgery is the most likely treatment to offer a complete cure.
• Biological treatments include immunotherapy medicines such as interferon alpha and interleukin-2 that aim to encourage the body's defence system to attack the tumour. These are generally only given if you are taking part in a research trial.
• In some people, where surgery is not possible, the cancer cells in the kidney can be injected and killed with heat. This is called radiofrequency ablation (RFA).
• Cryotherapy is a treatment which uses liquid nitrogen to freeze cancer cells in the kidney. People with small tumours who are unable to have surgery are the most likely to benefit from this treatment.
• Radiotherapy uses radiation to destroy cancer cells. It's only helpful to a small number of people with kidney cancer, but may be used if the cancer has spread to the bones, for example.
• Chemotherapy medicines to attack cancer cells are given to some people with certain types of cancer. These are rarely used in kidney cancer but may be used if other treatments have not helped.
• There are a number of new medicines such as sunitinib and sorafenib that may benefit some people with kidney cancer. Currently they are not routinely provided by the NHS.
• Kidney cancer that has spread outside the kidney is difficult to treat and so sometimes you may be offered new medicines that are under investigation in clinical trials.

Help and support

Being diagnosed with cancer can be distressing for you and your family. Specialist cancer doctors and nurses are experts in providing the care and support you need. There may be support groups so you can meet people who may have similar experiences to you. Ask your doctor for advice.

Further information

• Cancerbackup
  0808 800 1234
  www.cancerbackup.org.uk
• Cancer Research UK
  www.cancerresearchuk.org

Related topics

• Chemotherapy
• CT scan
• MRI scan
• Radiotherapy
• Abdominal ultrasound

Sources

• British National Formulary 53 (BNF) March 2007. BMJ Publishing Group
• Cassidy J, Bissett D and Spence RAJ Obe, Oxford Handbook of Oncology: Oxford University Press, 2002:390-393
• Improving outcomes in urological cancers. National Institute of Health and Clinical Excellence (NICE). 2002.
  http://guidance.nice.org.uk
• Kidney cancer. UK kidney cancer statistics. Cancer Research UK.
  info.cancerresearchuk.org
  accessed 18 May 2007
• Kidney cancer. Cancerbackup.
  www.cancerbackup.org
  accessed 17 July 2007
• Renal Cell Carcinoma - bevacizumab, sarofenib and sunitinib: Draft Scope. National Institute of Health and Clinical Excellence (NICE).
  http://guidance.nice.org.uk
  14 August 2007
• Souhami R, Tobias J. Cancer and its management. 5th ed. Oxford, 2005:411-415
• What's new in kidney cancer? Cancer Research UK.
  www.cancerhelp.org.uk
  accessed 21 September 2007

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: February 2008