Kidney Cancer

Factors that contribute to an increased risk for developing kidney cancer include:

• Lifestyle:
  • Cigarette smoking
  • Obesity
  • High calorie diet with fried/sautéed meat
• Genetics and Hereditary:
  • Family history of kidney cancer
  • Von Hippel-Lindau syndrome
  • Heriditary papillary renal cell carcinoma
  • Heriditary leiomyoma-renal cell carcinoma
  • Birt-Hogg-Dube syndrome
  • Tuberous sclerosis
• Other:
  • Male
  • Hypertension
  • Chronic kidney failure and/or dialysis
  • Certain medications

While kidney cancer is often asymptomatic, the following are the most common symptoms:

• Blood in the urine
• Rapid, unexplained weight loss
• Low back pain
• Loss of appetite
• Swelling of ankles and legs
• Mass or lump on the side or lower back
• Fatigue
• Recurrent fever
• High blood pressure (less frequently)
• Anemia (less frequently)
• Unrelieved pain in the side

The survival rate for patients is good if kidney cancer is caught early. Your urologic surgeon will meet with you to discuss concerns and to conduct a thorough evaluation. Diagnostic tests and procedures may include:

• Medical history
• Physical examination
• Blood and urine tests
• Kidney imaging tests such as ultrasound, computerized tomography (CT) scan, magnetic resonance imaging (MRI).
• Biopsy to remove suspicious cells and view them under a microscope for cancer.

Your urologist will order additional tests to determine the size of the cancer and whether cancer cells have spread within the body. This is called staging. Tests may include additional CT-scans or other imaging tests. Kidney cancer stages include:

• Stage I. Tumor is confined to the kidney and is up to 2 3/4 inches (7 centimeters) in diameter.
• Stage II. Tumor is confined to the kidney but is larger than a stage I tumor.
• Stage III. Tumor extends beyond the kidney into surrounding tissue, major veins, nearby lymph nodes.
• Stage IV. Cancer has spread outside the kidney, to one or more lymph nodes, or other organs such as the bowel, pancreas, or lungs.

Treatment for kidney cancer depends on many factors including the stage of the cancer and where it is located. Your urologist will discuss the best treatment for your particular situation. Often a combination of therapies will be recommended. These include:

Surgery for kidney cancer:

• Laparoscopic or Robotic nephrectomy (partial or radical) is performed using telescopic instruments inserted in the abdomen through small incisions.
  • Partial nephrectomy removes part of the kidney with the tumor.
  • Radical nephrectomy removes the whole kidney, sometimes the adrenal gland, tissue around the kidney, and surrounding lymph nodes.
• Open nephrectomy (partial or radical) is performed through a flank or abdominal incision.
• Laparoscopic nephrectomy removes all or part of the kidney through a series of small incisions in the abdomen.
• Robot-assisted laparoscopic nephroureterectomy removes the entire kidney as well as the ureter down to the bladder using telescopic instruments inserted in the abdomen through small incisions.
• Tumor ablation destroys the tumor without surgically removing it. Ablative technologies include cryotherapy and radiofrequency ablation.

Radiation therapy for kidney cancer

• Radiation cannot cure kidney cancer, but it can alleviate symptoms such as bone pain. It may be used alone or in combination with other therapies.

Targeted therapy for kidney cancer

• Drugs that attack specific cancer cells, slowing down growth. Targeted therapy treats advanced kidney cancer.

Immunotherapy for kidney cancer

• Immunotherapy or biological therapy uses the body's own immune system to fight cancer.

You will receive a thorough diagnostic evaluation and receive clinically-proven treatment by a board-certified urologist who specializes in kidney cancer. Your experience post-treatment will vary depending upon the stage of your cancer. Early detection—and the involvement of an experienced urologist—are important to the successful outcome for kidney cancer treatment. After treatment, routine life-long surveillance is necessary.

Brigham and Women’s Faulkner Hospital practices a multidisciplinary approach to patient care, collaborating with colleagues in other medical specialties. Specialists also include radiologists, pathologists, nurse specialists, social workers, palliative care specialists and dietitians.