Kidney Cancer
What is Kidney Cancer?
The kidneys are bean-shaped organs that filter blood to remove excess water and waste products that are excreted in urine. Kidney cancer occurs when cells in the kidney start to grow out of control. The type of kidney cancer depends on which cells of the kidney became abnormal.
Renal cell carcinoma (RCC) is the most common type of kidney cancer and it can arise in the lining of small tubes in the kidneys. The term renal cell carcinoma actually includes several forms of cancer that are classified according to their appearance under the microscope. The three most common forms are: clear cell RCC, papillary RCC and chromophobe RCC.
Common Symptoms
There are often no obvious symptoms of kidney cancer until the cancer has grown to a large size.
Possible symptoms may include:
Blood in urine (Hematuria)
A lump in the lower back or the side of the waist
Low back pain on one side (not caused by injury)
Swelling of the legs and ankles
Unexplained loss of appetite, weight loss, night sweats, fever or fatigue
Anemia (low red blood cell count)
Other health conditions can cause the same symptoms as kidney cancer. Consult your health care provider if you are concerned about any of these symptoms.
Diagnosis
Most kidney cancers are found unexpectedly by imaging obtained for other medical conditions.
Tests used to help diagnose kidney cancer:
Blood tests: Blood tests on their own can’t diagnose kidney cancer but they can provide important information about how well kidneys are functioning.
Urinalysis: A urine sample is checked for blood, protein or infection.
Ultrasound: This imaging may be useful in helping decide if a mass in the kidneys is a fluid-filled cyst or a solid tumour.
CT scan or MRI: These imaging techniques often help diagnose and stage kidney tumours or show if it has spread beyond the kidney.
Bone scan or chest x-ray: These may help to find out if the cancer has spread.
Kidney mass biopsy: A biopsy is sometimes used to help find out what type of tumour is present and plan treatment.
Treatment
Surgery is one of the main treatment options for kidney cancer. The best treatment is often based upon the type of kidney cancer, its size and whether a patient has only one working kidney.
Active surveillance: Watching the cancer closely rather than giving treatment right away may be an option if surgery is not possible, if the cancer is small and slow growing, or if you don’t have symptoms. This involves regular blood tests and imaging to see if the cancer is progressing.
Ablation: Therapy to destroy the cancer by freezing or burning. Most often beneficial for small cancers
Partial nephrectomy: Surgery to remove only the cancer. This surgery aims to keep as much kidney as possible and maintain kidney function as normally as possible. It is offered for specific cancers that are of a certain size and location within a kidney
Radical nephrectomy: Surgery to remove the whole kidney, the ureter attached to the kidney and the layer of fat around the kidney. The adrenal gland is sometimes removed as well. A radical nephrectomy may be done if the cancer can’t be removed with a partial nephrectomy.
Other Resources
Canadian Urological Association: Kidney Tumours Brochure