Najma Farah BSc Biochemistry, Queen Mary University of London
Overview
Kidney cancer, also referred to as renal cancer, is a common form of cancer which begins in the kidneys. It occurs when cells grow uncontrollably in the kidneys. If the cancer spreads further than the kidneys, it becomes known as metastatic cancer. People living with kidney cancer may experience symptoms like pain, high blood pressure, and blood in their urine. Kidney cancer treatments include surgery and radiation therapy.1 Early detection is key for successful treatment and recovery.
The diagnosis and treatment of kidney cancer can significantly impact your physical and mental well-being, including your sleep. Maintaining normal sleep is essential for your overall health, as it supports the immune system and improves quality of life. However, kidney cancer and its treatments can lead to sleep disturbances, such as insomnia, pain and discomfort. It may also lead to sleep anxiety, impacting your mental and emotional well-being. Sleep disturbances can worsen overall health for people living with kidney cancer. Understanding the relation between kidney cancer and sleep is important not only for relieving pain and discomfort but also for potentially improving cancer outcomes. This article will explore how kidney cancer affects sleep and discuss possible strategies to help manage sleep-related issues for patients during kidney cancer treatment.
Understanding kidney cancer
Kidney cancer occurs due to the abnormal growth of the cells in your kidneys. The disease most commonly affects people between the ages of 65 and 74, with people assigned male at birth being twice as likely as people assigned female at birth to develop the disease. Kidney cancer is much less frequent in children and young adults, although a small proportion of children are diagnosed with a Wilms tumour, a type of kidney cancer.
There are several different types of kidney cancer. Renal cell carcinoma is the most common form, making up 85% of all kidney cancers.2 Renal cell carcinoma usually begins as a single tumour in one kidney, however, it can affect both kidneys. The cancer begins in the cells lining your kidney’s tubules - the parts of the kidney that return nutrients and fluid to your blood. The most commonly diagnosed form of renal cell carcinoma is clear cell renal cell carcinoma (ccRCC).2,3
The second most common form of kidney cancer is transitional cell carcinoma, which is observed in approximately 6-7% of kidney cancer cases. This cancer typically develops in the area where your ureter connects to the main part of your kidney, called your renal pelvis. It can also occur in your ureters or bladder. Another type of kidney cancer is Wilms’ tumour. This is the most observed type of kidney cancer in children, accounting for about 5% of kidney cancers.
Renal carcinoma is the least common form of kidney cancer, accounting for only 1% of cases. This type of kidney cancer develops in the connective tissues of your kidneys and, without any treatment, can spread to nearby organs and bones.
What are the symptoms of kidney cancer?
Symptoms of kidney cancer may not be noticeable in the early stages of its development, with most people not noticing symptoms. However, as the tumour becomes larger, several symptoms may appear. Therefore, kidney cancer is often not diagnosed until it is in its later stages and has begun to spread.
Common kidney cancer symptoms include:
- Blood in your urine
- Flank pain (pain or discomfort below your ribcage)
- Fatigue
- A mass in your kidney area
- Loss of appetite
- Weight loss
- High blood pressure
- Anaemia (low iron)
- High calcium levels
- Bone pain
There are several risk factors which increase your chances of developing kidney cancer. For example, smokers are at a higher risk of developing kidney cancer. High blood pressure, also called hypertension, and obesity are directly linked to kidney cancer as well. Other risk factors include having a family history of kidney cancer, radiation therapy and long-term dialysis treatment for kidney disease.
How is kidney cancer diagnosed?
Diagnosis of kidney cancer typically includes a full medical history and physical exam. Urinalysis may be carried out, meaning that a sample of your urine will be tested for any traces of blood. Blood tests can be used to check if you have a low number of red blood cells, indicating anaemia, and whether your kidneys are functioning correctly. Additionally, imaging tests, such as CT scans, ultrasounds and MRI, can be used to produce diagnostic images of your kidneys and detect tumours.2
How is kidney cancer treated?
Kidney cancer treatment is dependent on the stage of the tumour, as well as your age and overall health and wellbeing. Common treatment options include surgery, radiation therapy, ablation, targeted drug therapy, immunotherapy and often chemotherapy. Surgery is typically used to treat most stages of kidney cancer. The most frequently used surgical options are partial nephrectomy, where part of the kidney is removed, and radical nephrectomy, where the entire kidney is removed, as well as some of the tissue surrounding the kidney.3
Radiation therapy may be recommended if you are not able to undergo surgery or if you only have one kidney. This may relieve some symptoms of kidney cancer, including pain.
The treatment of kidney cancer, particularly chemotherapy, immunotherapy and radiotherapy, may have a significant impact on sleep.
Impact of kidney cancer on sleep
Kidney cancer and its treatments can significantly impact your ability to get restful and healthy sleep.4 Sleep disturbances are common and can be triggered by both the physical symptoms of kidney cancer and the emotional and physical side effects associated with its treatment.
Common sleep disturbances for someone living with kidney cancer include pain, discomfort, fever, anxiety and depression. Surgery can cause chronic pain, particularly in the lower back or side, which makes it harder to fall asleep. In some cases of kidney cancer, patients experience fever due to the body’s response to the disease and its treatments. Pain and fever may interrupt your sleep. Living with kidney cancer often causes anxiety and emotional distress, leading to difficulty staying asleep. Cancer treatments, particularly chemotherapy, radiotherapy and immunotherapy, are linked to a decrease in sleep quality. Their side effects, including fatigue, nausea and insomnia, can affect your sleep cycle and result in irregular sleep.
Which sleep disorders are associated with kidney cancer?
People living with kidney cancer often experience sleep disorders that can significantly impact their quality of life and overall health. Insomnia is the most common sleep disorder associated with kidney cancer.5 This may be caused by pain, anxiety or other side effects of cancer treatments and leads to difficulty falling and staying asleep.4
Sleep apnoea, a condition where breathing stops and starts during sleep, is also related to kidney cancer. This can cause further fatigue during the day, headaches and affect your cardiovascular health. Other sleep disorders associated with kidney cancer include restless leg syndrome, sleep fragmentation and circadian rhythm disorders. It is important to find strategies to improve your quality of sleep, not only to improve emotional well-being, but also to potentially improve kidney cancer patient outcomes.
Strategies for improving sleep in kidney cancer patients
Improving sleep quality is essential to improve your overall health and support the recovery of kidney cancer patients. Effective strategies to overcome sleep disturbances typically involve a combination of medical treatments, behavioural techniques and lifestyle adjustments.4
Medications
Medical interventions may be recommended if you are experiencing insomnia or other sleep disorders. For example, sleeping aids such as zolpidem and melatonin may be prescribed to help you fall asleep. Pain killers, which help to manage chronic pain resulting from kidney cancer treatment, may also improve your quality of sleep. If a sleep disorder is caused by depression and anxiety, antidepressants may help to maintain a healthy sleep cycle.
It is important to speak with your healthcare provider to ensure that your medications are safe and effective to take while undergoing kidney cancer treatment.
Behavioural techniques
These sleep hygiene tips may improve your sleep quality:
- Sleeping and waking up at the same time every day
- Avoiding bright screens before bedtime
- Limiting caffeine late in the day
- Keeping your bedroom dark and quiet
- Avoiding heavy meals before bedtime
Additionally, cognitive behavioural therapy for insomnia may effectively change thoughts and behaviours surrounding sleep.5 This may help manage worry and stress, improving sleep quality.
Lifestyle changes
Several lifestyle adjustments can help to better manage your sleep. For example, regular exercise early in the day can help to support your sleep and reduce anxiety.
Staying hydrated and maintaining a healthy diet by avoiding spicy or heavy food before bedtime is important to improve your sleep quality. Furthermore, practising mindfulness and meditation before bed can help reduce stress and anxiety, contributing to healthy sleep.
Summary
Kidney cancer can have a significant impact on your sleep and overall well-being. Sleep disturbances may result from physical symptoms of kidney cancer, including pain and night sweats, anxiety and depression and side effects of treatments. Common sleep problems include insomnia, sleep apnoea, restless legs syndrome and general sleep fragmentation. These can worsen fatigue, reduce quality of life and potentially affect kidney cancer outcomes.
Understanding and addressing the link between kidney cancer and sleep is essential to improving your sleep and overall health. A combination of medical interventions, behavioural therapies like cognitive behavioural therapy for insomnia and lifestyle adjustments, such as improving sleep hygiene, managing stress and incorporating regular exercise, can significantly help to manage your sleep. By combining these strategies, kidney cancer patients can improve their sleep quality and overall health.
References
- Pandey J, Syed W. Renal cancer. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. [cited Apr 10]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK558975/.
- Rose TL, Kim WY. Renal cell carcinoma: A review. JAMA. 2024 Sep;332(12):1001–10. [cited Apr 10]. Available from: https://doi.org/10.1001/jama.2024.12848.
- Gray RE, Harris GT. Renal cell carcinoma: Diagnosis and management. Am Fam Physician. 2019 Feb;99(3):179–84. [cited Apr 10].
- Mogavero MP, et al. Sleep disorders and cancer: State of the art and future perspectives. Sleep Med Rev. 2021 Apr;56:101409. [cited Apr 10]. Available from: https://doi.org/10.1016/j.smrv.2020.101409.
- Dopheide JA. Insomnia overview: Epidemiology, pathophysiology, diagnosis and monitoring, and nonpharmacologic therapy. Am J Manag Care. 2020 Mar;26(4 Suppl):S76–84. [cited Apr 10]. Available from: https://doi.org/10.37765/ajmc.2020.42769.
