There are several types of kidney cancer. Renal cell cancer (RCC) is the most common type in adults. More than eight in 10 people who get kidney cancer in the UK have this type. In RCC, the cancerous cells develop in the lining of tubes inside your kidneys that help to filter your blood and make urine.
Other types of kidney cancer include the following.
- Transitional cell cancer (TCC) affects part of your kidney called the renal pelvis. About 10 in 100 people who get kidney cancer in the UK have TCC.
- Wilms’ tumour can affect children, most often those under five. Only about 70 children in the UK develop Wilms’ tumour each year in the UK.
This topic will focus on RCC.
In the early stages of kidney cancer, you probably won’t have any symptoms. As the cancer grows, the most common symptom is blood in your urine. It’s possible that you might feel a lump in your back too, although most kidney cancers are too small to feel. You might also have some pain in your back or side.
Other symptoms of kidney cancer include:
- feeling tired
- swollen ankles
- a fever
- pain in your bones
- weight loss
If you have any of these symptoms, go and see your GP.
Your GP will ask about your symptoms and examine you. They may ask you about your medical history too.
Your GP may test a sample of your urine with a dipstick to check if there’s any blood in it. They may need to take a sample of your blood to test too.
If your GP thinks you might have kidney cancer, they will refer you to see a urologist – a doctor who specialises in the urinary system. You’ll then be offered further tests, which may include the following.
- CT scan. This uses X-rays to make a three-dimensional image of your kidneys and other organs.
- Ultrasound scan. This uses sound waves to produce an image of your kidneys and can show any growths.
- MRI scan. This uses magnets and radio waves to produce images of the inside of your kidneys.
- An image-guided biopsy. In this test, your doctor will take a sample of tissue from your kidney. They will use an ultrasound or CT scanner to find the right area. The sample will be sent to a laboratory to be tested to see if the cells are cancerous.
If these tests find that you have kidney cancer, you may need further tests to find its size and exact position. This is called staging.
The type of treatment you have will depend on the type and size of your cancer, and whether it has spread. You may have treatment to:
- cure kidney cancer
- shrink or slow down the growth of kidney cancer to prolong your life
- reduce the symptoms caused by kidney cancer – this is called palliative therapy
Surgery is the main treatment for kidney cancer. If you’re diagnosed when it’s at an early stage, it may be possible to cure kidney cancer with surgery.
You can have open surgery, in which your surgeon will make one large cut in your abdomen (tummy). Or you may be able to have keyhole surgery.
Your surgeon may remove your whole kidney and nearby lymph nodes in what’s called a radical nephrectomy. Or, they may just remove the part of your kidney with cancer in a partial nephrectomy.
If your kidney tumour is small, or you aren’t healthy enough to have surgery, you might need to have another type of procedure. These other procedures include the following.
- Percutaneous radiofrequency ablation. Your surgeon will place one or more needle-like electrodes through your skin and into the cancer and pass an electrical current into it. This will heat the cancer cells and destroy them.
- Cryotherapy. Your surgeon will place one or more probes into the cancer and pass liquid nitrogen through them to freeze and destroy cancer cells.
- High-intensity focused ultrasound. Your surgeon will use sound waves to produce high temperatures inside cancer cells to destroy them. This treatment is newer than other treatments, so it’s not widely used – ask your doctor or surgeon if it’s an option for you.
Targeted therapy (also called biological therapy) uses medicines that are designed to stop cancer cells growing. Your doctor may offer you targeted therapy if your kidney cancer has spread, or after surgery to help kill any remaining cancer cells. Targeted medicines include:
Chemotherapy uses medicines to destroy cancer cells. Chemotherapy isn’t often used to treat kidney cancer. But your doctor might offer it to you if other treatments haven’t worked for you, or in combination with another treatment.
Radiotherapy uses radiation to destroy cancer cells. It isn’t used much in kidney cancer but your doctor may offer you this treatment to shrink your cancer if it’s causing you pain. You may also have it to treat cancer that has spread to other parts of your body.
The exact reasons why you may develop kidney cancer aren’t fully understood at present. But doctors do know that your risk of developing kidney cancer is higher if you:
- smoke – the longer you smoke for and the more you smoke, the greater your risk
- are overweight or obese
- have a family history of kidney cancer
- have kidney disease (dialysis treatment means you’re more likely to develop kidney cysts, which increase your risk of kidney cancer)
- have high blood pressure – the risk may be due to the condition, the medicines used to treat it or both
- take lots of over-the-counter painkillers – for more information see: FAQ: Do over-the-counter painkillers cause kidney cancer?
- have an inherited condition, such as von Hippel-Lindau disease
If you make some changes to your lifestyle, it may help to reduce your risk of getting kidney cancer.
- Stop smoking. If you smoke, you double your risk of kidney cancer, and the longer you smoke for and the more you smoke, the greater your risk. See our smoking information for tips on quitting.
- Lose weight if you’re overweight or obese. For tips, see our information on losing weight safely.
- Eat a healthy, balanced diet. Some studies have shown that eating lots of fruit and vegetables can reduce your risk of kidney cancer.
There’s a link between taking some over-the-counter painkillers and kidney cancer. But this is probably only in people who take a lot of painkillers over a long period of time.
Research into painkillers and kidney cancer risk is still at an early stage. But some painkillers, such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) – excluding aspirin – have been found to increase the risk of developing kidney cancer. This risk probably increases if you take a lot of these painkillers over a long period of time. It’s unlikely to be harmful if you only take them occasionally, or take a low dose.
If you take painkillers regularly and are concerned that you may be increasing your risk of getting kidney cancer, speak to your pharmacist.
- Cancer registration statistics, England, 2013. Office for National Statistics. www.ons.gov.uk, published 10 July 2015
- Renal cell carcinoma. BMJ Best Practice. www.bestpractice.bmj.com, published 5 March 2015
- Renal cancer. PatientPlus. www.patient.info/patientplus, reviewed 8 April 2013
- Kidney anatomy. Medscape. www.emedicine.medscape.com, published 4 October 2013
- Kidney cancer: survival report. National Cancer Intelligence Network. www.ncin.org.uk, published April 2014
- Wilms’ tumour. BMJ Best Practice. www.bestpractice.bmj.com, published 2 November 2015
- Map of Medicine. Kidney cancer. International View. London: Map of Medicine; 2015 (Issue 3)
- Laparoscopic partial nephrectomy. National Institute for Health and Care Excellence (NICE), 25 January 2006. www.nice.org.uk
- Percutaneous cryotherapy for renal cancer. National Institute for Health and Care Excellence (NICE), 27 July 2011. www.nice.org.uk
- Percutaneous radiofrequency ablation for renal cancer. National Institute for Health and Care Excellence (NICE), 28 July 2010. www.nice.org.uk
- Ritchie RW, Leslie TA, Turner GDH, et al. Laparoscopic high-intensity focused ultrasound for renal tumours: a proof of concept study. BJU International 2011; 107:1290–96. doi: 10.1111/j.1464-410X.2010.09620.x
- High intensity focused ultrasound (HIFU). Cancer Research UK. www.cancerresearchuk.org, reviewed 20 August 2015
- Coppin C, Kollmannsberger C, Le L, et al. Targeted therapy for advanced renal cell cancer (RCC): a Cochrane systematic review of published randomised trials. BJU International 2011; 108:1556–63. doi: 10.1111/j.1464-410X.2011.10629.x
- Axitinib for treating advanced renal cell carcinoma after failure of prior systemic treatment. National Institute for Health and Care Excellence (NICE), 25 February 2015. www.nice.org.uk
- Pazopanib for the first-line treatment of advanced renal cell carcinoma. National Institute for Health and Care Excellence (NICE), 23 February 2011. www.nice.org.uk
- Everolimus for the second-line treatment of advanced renal cell carcinoma. National Institute for Health and Care Excellence (NICE), 19 April 2011. www.nice.org.uk
- Bevacizumab (first-line), sorafenib (first- and second-line), sunitinib (second-line) and temsirolimus (first-line) for the treatment of advanced and/or metastatic renal cell carcinoma. National Institute for Health and Care Excellence (NICE), August 2009. www.nice.org.uk
- Risks and causes of kidney cancer. Cancer Research UK. www.cancerresearchuk.org, reviewed 14 January 2014
- Choueiri TK, Je Y, Cho E. Analgesic use and the risk of kidney cancer: a meta-analysis of epidemiologic studies. Int J Cancer 2014; 134(2):384–96. doi:10.1002/ijc.28093
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Reviewed by Rachael Mayfield-Blake, Bupa Health Content Team, January 2016.
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