Overview

Kidney cancer, also called renal cell carcinoma (RCC), is one of the most common malignancies of the urinary tract. Over the past two decades, the incidence rate has increased rapidly at a rate of 2% per year.¹ It is the sixth most common cancer, causing 5% of malignancies - or cancer incidences - in people assigned male at birth (AMAB). It is also the tenth most common cancer in people assigned female at birth (AFAB), causing 3% of malignancies in them. It predominates in European and North American populations, with a lower occurrence rate in Asia.²

Where are the kidneys present in the body? How does it work?

Bean-shaped organs called kidneys are placed on either side of the backbone, above the waist. Tiny tubules in the kidneys take out waste products and make urine by filtering and cleaning the blood that enters the kidneys. The urine from each kidney passes through a long tube called a ureter into the bladder, which holds the urine until it passes through the urethra and leaves the body.³

What is kidney cancer?

Kidney cancer is a type of cancer that starts in the kidney when cells grow abnormally and out of control. As more cancer cells develop, they can form a tumour and, with time, might spread to other body parts.

Surgery options for kidney cancer

Renal cell cancer is often treated by removing part of the kidney or the organ entirely. 

Types of surgeries commonly used include:

• Partial nephrectomy - This surgery is performed to remove the tumour within the kidney and some of the tissue around it. It is also called ‘nephron-sparing surgery’ or ‘kidney-sparing surgery’. This is usually done in case of smaller tumours in healthy patients. It can also be performed for larger tumours in cases where the other kidney may not be healthy and able to function independently. The surgeon removes the tumour and spares the remainder of the kidney in this technique
• Simple nephrectomy - In this surgery, the kidney is removed as a whole
• Radical nephrectomy - This surgery involves the removal of the kidney, the adrenal gland, surrounding tissue, and usually nearby lymph nodes. It is performed through an open incision, laparoscopically, or with robot-assisted laparoscopic technologies. This surgery removes the tumours that are larger and/or those that appear to extend outside the tumour capsule or infiltrate into the kidney
• Surgery for recurrent renal cancer - Kidney cancer may recur after an initial surgery. In this case, you may require a surgical removal of the recurrences. Structures adjacent to the kidney would also be removed here. This surgery involves a multidisciplinary surgical team that includes vascular (blood and lymphatics), hepatobiliary (liver and pancreas), colorectal (colon and rectum), interventional radiologists, and thoracic (lung) surgeons to completely eradicate the disease
• Surgery for patients with metastatic kidney cancer (Cytoreductive Nephrectomy) - Metastatic cancers are cancers which have spread to other parts of the body from their origin. Sometimes systemic medications and not surgery can treat most cancers that have spread to other organs, including kidney cancer. To improve certain symptoms of kidney cancers, nephrectomy can also be performed, keeping the patients off the medications, thus offering a better chance at a cure

You can survive with a portion of one working kidney, but if both kidneys are removed or not working, you will need dialysis (a procedure to clean the blood using a machine outside of the body) or a kidney transplant (replacement with a healthy donated kidney).

A kidney transplant may be done when the disease is present only within the kidney and a well-matched donated kidney is found.

After the removal of all the cancer cells visible during the surgery, you may receive radiation therapy to kill any remote cancer cells that were inaccessible during the surgery. Treatment given after surgery to lower the risk of recurrence of cancer is called adjuvant therapy.^3,5

FAQs

What are the risk factors for renal cell cancer?

The risk factors for renal cell cancer are:

• Long-term smoking of tobacco
• Misusing certain pain medicines, including over-the-counter pain medicines, for a long time
• Having excess body weight
• High blood pressure
• A family history of renal cell cancer
• Genetic conditions, such as von Hippel-Lindau disease or hereditary papillary renal cancer³

What are the signs of renal cell cancer?

The signs of renal cell cancer are:

• Blood in the urine
• A lump in the abdomen
• A constant irritating pain in the side of the body
• Loss of appetite
• Weight loss for no known reason
• Anaemia⁴

What are the stages of renal cell cancer, and what do they mean?

Renal cell cancer has 1-4 stages. The cancer stage describes the extent of cancer in the body, such as:

• The size of the tumour
• It's spread to other parts of the body, and 
• The extent of the spread from its place of origin³

What tests are used to diagnose renal cell cancer?

• Ultrasound exam
• Blood-chemistry study
• Urinalysis
• CT scan (CAT scan)
• MRI
• Biopsy
• Chest x-ray and bone scan to check for the spread of cancer³

What are the treatment options for renal cell cancer?

The treatment options for renal cell cancer are:

• Surgery
• Radiation therapy
• Immunotherapy
• Targeted therapy³

What are the factors affecting prognosis (chance of recovery) and treatment options available to me?

The factors affecting prognosis (chance of recovery) and treatment options depend on

• The stage of the disease
• Your age and the general health of the patient

Summary

Kidney cancer does not respond to radiotherapy and chemotherapy, and surgery is the ultimate mode of treatment for kidney cancer. Cancer may develop metastasis in the initial stage in 30% of patients, and local cancers may develop recurrence or distant metastasis after surgery in approximately 25% of patients.¹

Clinical trials are underway to explore new types of treatment in this field. There may be side effects during the treatment for renal cell cancer, and so you may need follow-up care post-surgery.