Kidney Cancer


General Information

What is renal cell cancer?

Renal cell cancer (also called cancer of the kidney or renal adenocarcinoma) is a disease in which cancer (malignant) cells are found in certain tissues of the kidney. Renal cell cancer is one of the less common kinds of cancer. It occurs more often in men than in women.

The kidneys are a "matched" pair of organs found on either side of the backbone. The kidneys of an adult are about 5 inches long and 3 inches wide and are shaped like a kidney bean. Inside each kidney are tiny tubules that filter and clean the blood, taking out waste products, and making urine. The urine made by the kidneys passes through a tube called a ureter into the bladder where it is held until it is passed from the body. Renal cell cancer is a cancer of the lining of the tubules in the kidney. Information on cancer that is found in the part of the kidney that collects urine and drains it to the ureters (the renal pelvis), or is found in the ureters, can be found in another summary (refer to Transitional Cell Cancer of the Renal Pelvis and Ureter Treatment for more information).

A doctor should be seen if one or more of the following symptoms appear: blood in the urine, a lump (mass) in the abdomen, or a pain in the side that doesn't go away. Tiredness, loss of appetite, weight loss without dieting, and anemia (too few red blood cells) may also be symptoms.

If there are signs of cancer, a doctor will usually feel the abdomen for lumps. A doctor may order a special x-ray called an intravenous pyelogram (IVP). During this test, a dye containing iodine is injected into the bloodstream. This allows the doctor to see the kidney more clearly on the x-ray. The doctor may also do an ultrasound, which uses sound waves to find tumors, or a special x-ray called a CT scan to look for lumps in the kidney. A special scan called magnetic resonance imaging (MRI), which uses magnetic waves to find tumors, may also be done.

The chance of recovery (prognosis) and choice of treatment depend on the stage of the cancer (whether it is just in the kidney or has spread to other places in the body) and the patient's general state of health.

Stage Information

Stages of renal cell cancer:

Once renal cell cancer has been found, more tests will be done to find out if cancer cells have spread to other parts of the body. This is called staging. A doctor needs to know the stage of the disease to plan treatment. The following stages are used for renal cell cancer:

Stage I
Cancer is found only in the kidney.

Stage II
Cancer has spread to the fat around the kidney, but the cancer has not spread beyond this to the capsule that contains the kidney.

Stage III
Cancer has spread to the main blood vessel that carries clean blood from the kidney (renal vein), to the blood vessel that carries blood from the lower part of the body to the heart (inferior vena cava), or to lymph nodes around the kidney. (Lymph nodes are small, bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells.)

Stage IV
Cancer has spread to nearby organs such as the bowel or pancreas or has spread to other places in the body such as the lungs.

Recurrent
Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the original area or in another part of the body.

Treatment Option Overview

How renal cell cancer is treated:

There are treatments for most patients with renal cell cancer. Five kinds of treatment are used:

-surgery (taking out the cancer in an operation)
-chemotherapy (using drugs to kill cancer cells)
-radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)
-hormone therapy (using hormones to stop cancer cells from growing)
-biological therapy (using the body's immune system to fight cancer)

Surgery is a common treatment of renal cell cancer. A doctor may take out the cancer using one of the following:

Partial nephrectomy removes the cancer and part of the kidney around the cancer. This is usually done only in special cases, such as when the other kidney is damaged or has already been removed.

Simple nephrectomy removes the whole kidney. The kidney on the other side of the body can take over filtering the blood.

Radical nephrectomy removes the kidney with the tissues around it. Some lymph nodes in the area may also be removed.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells throughout the body.

Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that contain radiation through thin plastic tubes (internal radiation therapy) in the area where the cancer cells are found. Radiation can be used alone or before or after surgery and/or chemotherapy.

Hormone therapy uses hormones (taken by pill or injected with a needle) to stop cancer cells from growing.

Biological therapy tries to get the body to fight cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body's natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy or immunotherapy.

Sometimes a special treatment called arterial embolization is used to treat renal cell cancer. A narrow tube (catheter) is used to inject small pieces of a special gelatin sponge into the main blood vessel that flows into the kidney to block the blood cells that feed the tumor. This prevents the cancer cells from getting oxygen or other substances they need to grow.

Treatment By Stage

Treatment of renal cell cancer depends on the type and stage of the disease, and the patient's age and general health.

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in most parts of the country for most stages of renal cell cancer. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Stage I Renal Cell Cancer
Treatment may be one of the following:

1. Surgery to remove the kidney and the tissues around it (radical
nephrectomy). Lymph nodes in the area may also be removed.
2. Surgery to remove only the kidney (simple nephrectomy).
3. Surgery to remove the part of the kidney where the cancer is found
(partial nephrectomy).
4. External beam radiation therapy to relieve symptoms in patients who
cannot have surgery.
5. Injection of small pieces of a special gelatin sponge into the main
artery that flows to the kidney to block blood flow to the cancer cells
(arterial embolization). This is usually done only in patients who
cannot have surgery.
6. Clinical trials.

Stage II Renal Cell Cancer
Treatment may be one of the following:

1. Surgery to remove the kidney and the tissues around it (radical
nephrectomy). Lymph nodes in the area may also be removed.
2. External beam radiation therapy before or after radical nephrectomy.
3. Surgery to remove the part of the kidney where the cancer is found
(partial nephrectomy).
4. External beam radiation therapy to relieve symptoms in patients who
cannot have surgery.
5. Injection of small pieces of a special gelatin sponge into the main
artery that flows to the kidney to block blood flow to the cancer cells
(arterial embolization). This is usually done only in patients who
cannot have surgery.
6. Clinical trials.

Stage III Renal Cell Cancer
Treatment may be one of the following:

1. Surgery to remove the kidney and the tissues around it (radical
nephrectomy). Lymph nodes in the area may also be removed. If the
cancer has spread to the main blood vessels that carry blood to and from
the kidney (the renal vein or vena cava), part of the blood vessel may
also be removed.
2. Injection of small pieces of a special gelatin sponge into the main
artery that flows to the kidney to block blood flow to the cancer cells
(arterial embolization) followed by radical nephrectomy.
3. External beam radiation therapy to relieve symptoms.
4. Arterial embolization to relieve symptoms.
5. Surgery to remove the kidney (simple or radical nephrectomy) to relieve
symptoms.
6. External beam radiation therapy before or after radical nephrectomy.
7. Clinical trials of biological therapy in addition to other therapy.

Stage IV Renal Cell Cancer
Treatment may be one of the following:

1. Biological therapy.
2. External radiation therapy to relieve symptoms.
3. Surgery to remove the kidney (nephrectomy) to relieve symptoms.
4. If cancer has spread only to the area around the kidney, surgery to
remove the kidney and the tissue around it (radical nephrectomy). If the
cancer has spread to a limited area, surgery to remove the cancer where
it has spread (metastasized) in addition to radical nephrectomy.
5. Clinical trials.

Recurrent Renal Cell Cancer
Treatment may be one of the following:

1. Biological therapy.
2. External radiation therapy to relieve symptoms.
3. Chemotherapy.






The information on this page was obtained from the National Cancer Institute. The National Cancer Institute provides accurate, up-to-date information on many types of cancer, information on clinical trials, resources for people dealing with cancer, and information for researchers and health professionals.

The National Cancer Institute is in no way affiliated with the Mary Stolfa Cancer Foundation.

The information on this web site is provided for general information only. It is not intended as medical advice, and should not be relied upon as a substitute for consultations with qualified health professionals who are familiar with your individual medical needs. The MSCF disclaims all obligations and liabilities for damages arising from the use or attempted use of the information, including but not limited to direct, indirect, special, and consequential damages, attorneys' and experts' fees and court costs. Any use of the information will be at the risk of the user.





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