Renal Cell Carcinoma

Definition

Renal cell cancer (also called kidney cancer, renal cell adenocarcinoma or RCC) is a disease in which malignant (cancer) cells are found in the lining of tubules (very small tubes) in the kidney, which filter and clean the blood. There are 2 kidneys, one on each side of the backbone, above the waist. They take out waste products and make urine. The urine passes from each kidney through a long tube (ureter) into the bladder. The bladder holds the urine until it passes through the urethra and leaves the body.

A recent study lead at the National Cancer Institute and published in the Cancer Journal, researchers found that Blacks tend to have a poorer 5-year survival rate than whites regardless of clinical data and patient demographics.

The study revealed the 5-year relative survival rate for whites diagnosed with invasive kidney cancer was 72.6 percent as compared to 68 percent for Blacks regardless of age, sex, tumor size or stage, type of RCC and surgical procedures performed.

Risk Factors

Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in men 60 to 70 years old, however, the exact cause of renal cell carcinoma is unknown.

The following may increase your risk of kidney cancer:

• Smoking
• Obesity
• Dialysis treatment
• Family history of the disease
• High blood pressure
• Horseshoe kidney
• Long-term use of certain medicines, such as pain pills or water pills (diuretics)
• Polycystic kidney disease
• Von Hippel-Lindau disease (a hereditary disease that affects blood vessels in the brain, eyes, and other body parts)
• Birt-Hogg-Dube syndrome (a genetic disease associated with benign skin tumors and lung cysts)

Symptoms

Symptoms of renal cell carcinoma may include any of the following:

• Abdominal pain and swelling
• Back pain
• Blood in the urine
• Swelling of the veins around a testicle (varicocele)
• Flank pain
• Weight loss
• Fever
• Liver dysfunction
• Elevated erythrocyte sedimentation rate (ESR)
• Excessive hair growth in females
• Pale skin
• Vision problems

Diagnosis

Your healthcare provider will perform a physical exam that may reveal a mass or swelling of the abdomen.

Tests that may be ordered include:

• Abdominal CT scan
• Blood chemistry
• Complete blood count (CBC)
• Intravenous pyelogram (IVP)
• Liver function tests
• Renal arteriography
• Ultrasound of the abdomen and kidney
• Urinalysis

The following additional tests may be ordered by your doctor to see if the cancer has spread:

• Abdominal MRI
• Biopsy
• Bone scan
• Chest x-ray
• Chest CT scan
• PET scan

Complications

Complications of kidney cancer include:

• High blood pressure (hypertension)
• Too much calcium in the blood
• High red blood cell count
• Liver and spleen problems
• Spread of the cancer

Treatment

• Surgery. Surgery to remove all or part of the kidney (nephrectomy) is usually recommended. This may include removing the bladder, surrounding tissues, or lymph nodes. A cure is unlikely unless all of the cancer has been removed with surgery. However, even if some of the cancer is left behind, there is still benefit from surgery.
• Chemotherapy. Chemotherapy is generally not effective for treating kidney cancer in adults.
• Medicine. Medicines that target the development of blood vessels that feed the tumor may be used to treat kidney cancer.
• Radiation therapy. Radiation therapy is usually done when the cancer spreads to the bone or brain.

Prognosis

In about one-fourth of people, the cancer has already spread (metastasized) at the time of diagnosis.

How well someone with kidney cancer does depends on how much the cancer has spread and how well the treatment works. The survival rate is highest if the tumor is in the early stages and has not spread outside the kidney. If it has spread to the lymph nodes or to other organs, the survival rate is much lower.

Prevention

The best way to prevent renal cell carcinoma is to stop smoking and follow your provider’s recommendations in the treatment of kidney disorders, especially those that may require dialysis.

When to See a Doctor

You should call your provider if you see blood in your urine or if you have any other symptoms of this disorder.