Renal cell carcinoma, or RCC, is also called hypernephroma, adenocarcinoma of renal cells, or renal or kidney cancer. It is the most common kind of kidney cancer found in adults.
The kidneys are organs in your body that help get rid of waste. There are tiny tubes in the kidneys called tubules. These help filter the blood, aid in excreting waste, and help make urine. RCC occurs when cancer cells start growing uncontrollably in the lining of the tubules of the kidney.
Medical experts do not know the exact cause of RCC. It is most commonly found in men between the ages of 50 and 70, but can be diagnosed in anyone.
There are some risk factors for the disease, including:
- family history of RCC
- dialysis treatment
- smoking cigarettes
- polycystic kidney disease (an inherited disorder that causes cysts to form in the kidneys)
- the genetic condition Von Hippel-Lindau disease (characterized by cysts and tumors in various body organs)
- chronic abuse of certain prescribed and over-the-counter medications such as non-steroidal anti-inflammatory drugs used to treat arthritis and medications for fever and pain relief such as acetaminophen
When RCC is in its early stages, patients may be symptom-free. As the disease progresses, symptoms that may appear include:
- a lump in the abdomen
- blood in the urine
- unexplained weight loss
- loss of appetite
- vision problems
- persistent pain in the side
- excessive hair growth (in women)
If your doctor suspects that you may have renal cell carcinoma, he or she will ask about your (and your family’s) medical history. He or she will then perform a physical exam. Findings that can indicate RCC include swelling or lumps in the abdomen, or, in men, enlarged veins in the scrotal sac (this is called “vericocele”).
If RCC is suspected, to get an accurate diagnosis, your doctor will order a number of tests.
- A complete blood count, a blood test conducted by drawing blood from your arm and sending it to a lab for evaluation.
- A CT scan, an imaging test that will allow your doctor to take a closer look at your kidneys to detect any abnormal growth.
- Abdominal and kidney ultrasounds, a test that uses sound waves to create a picture of your organs, allowing your doctor to look for tumors and problems within the abdomen.
- Urine examination, tests used to detect blood in the urine and to analyze cell in the urine looking for evidence of cancer.
Your doctor may also perform a biopsy to get a small piece of kidney tissue. This is done by inserting a needle into the tumor and drawing out a tissue sample. The sample is then sent to a pathology lab to rule out or confirm the presence of cancer.
If you are found to have RCC, more tests will be done to find out if and where the cancer has spread. This is called staging, and RCC is staged from stage I to stage IV, in order of ascending severity. Staging tests can include a bone scan, PET scan, and chest X-ray (all imaging tests).
According to the National Institutes of Health, one-third of individuals with RCC have cancer that has spread at the time of diagnosis (Dugdale, 2012).
Surgery can include different types of procedures. Part of the kidney or the entire kidney may be removed; this is a partial nephrectomy, or a simply nephrectomy, respectively. Depending on how far the disease has spread, more extensive surgery may be needed to remove surrounding tissue, lymph nodes, and the adrenal gland. This is a radical nephrectomy.
If both kidneys are removed, dialysis—the use of a machine to perform the functions of the kidneys—or a transplant is necessary.
Radiation therapy involves using high-energy X-rays to kill cancer cells. The radiation can be given externally by a machine, or placed internally using seeds or wires.
Chemotherapy uses drugs to kill cancer cells. It can be given orally or intravenously, depending on what medication is chosen. This allows the drugs to go through the bloodstream and reach cancer cells that may have spread to other parts of the body.
Biologic therapy, also called immunotherapy, works with the individual’s immune system to attack the cancer. Enzymes or substances made by the body are used to defend your body against the cancer.
Targeted therapy is a newer kind of cancer drug therapy. These drugs attack certain cancer cells without damaging healthy cells. Some drugs work on blood vessels to prevent blood flow to the tumor, “starving” and shrinking it.
Clinical trials may be an option for some patients with RCC. Clinical trials test new treatments to see if they are effective in treating the cancer. They are closely monitored, and you can leave the trial at any time. Talk with your treatment team to see if a clinical trial is a viable option for you.
The outlook after being diagnosed with RCC depends largely on whether or not the cancer has spread and how soon treatment is started. Obviously, the sooner it is caught, the more likely you will have a full recovery. If the cancer has spread to other organs, the survival rate is much lower than if it is caught before spreading.
According to the National Cancer Institute, the 5-year survival rate for RCC is around 70 percent. This means that over two-thirds of those diagnosed with RCC will live at least five years after their diagnosis (NCI, 2012).
If the cancer is cured, you may still have to live with long-term effects of the disease, which can include poor kidney function. Chronic dialysis may be required and long-term drug therapy, if a kidney transplant is performed.