What is papillary renal cell carcinoma?

Papillary renal cell carcinoma (PRCC) is a type of cancer that forms inside the lining of the kidney’s tubules (the very small tubes that do the filtering). Commonly referred to as “renal cell cancer,” PRCC is the second most common type of kidney cancer.

The kidneys are a pair of bean-shaped organs that are located in your lower back, on either side of your spine. They are normally about 4 1/2 inches long. Kidneys are part of the urinary tract, and act as a “purification plant” for the circulatory system. They filter blood and remove waste.

It’s unclear why one person might develop kidney cancer while another won’t. However, obesity, high blood pressure, and smoking are known to be contributing factors. Your risk rises based on how long and how much you’ve smoked.

The average age of someone diagnosed with kidney cancer is 64, with most cases occurring in people 55 and older. According to a study published in 2005, between 3,500 and 5,000 new cases of PRCC are diagnosed in the United States each year.

Some common symptoms of PRCC include:

  • blood in the urine
  • pain in the side
  • unexplained weight loss
  • excessive fatigue
  • a lump or mass in the side
  • unexplained fever

These symptoms can also be due to other conditions, however, and don’t automatically mean you have cancer. See your doctor if you have any of these symptoms. Your doctor can order diagnostic tests and refer you to a specialist.

If your doctor suspects that something is wrong with your kidneys, he or she may order several tests, including:

  • urinalysis
  • blood test
  • ultrasound
  • CT scan
  • MRI

If these tests indicate that you have a tumor suspicious for PRCC, the next step is to take a biopsy. In a biopsy, your doctor will remove a small piece of tissue in order to study it further.

Once your doctor diagnoses PRCC based on biopsy results, the next step is to “stage” your cancer. Staging is the process of determining the extent of the cancer. The stage of the tumor depends on its size and whether it has spread to your lymph nodes or invaded surrounding tissue. The stages are as follows:

  • Stage 1: The tumor is smaller than a tennis ball and no cells are found outside the kidneys.
  • Stage 2: The tumor has grown larger than a tennis ball but no cells have travelled outside of the kidneys.
  • Stage 3: The tumor can be any size, but cells are found in a lymph node, or it has spread to nearby organs.
  • Stage 4: The tumor has spread to several lymph nodes or has travelled to the lungs, liver, or other organs.

Staging determines what type of treatment you’ll receive. There are five types of standard treatment options. They are:

  • Surgery: A surgeon may remove your tumor or the kidney, adrenal gland, and nearby lymph nodes.
  • Radiation therapy: Radiation may kill the tumor. It may be administered externally by a machine that delivers X-rays or gamma rays. Radioactive medication can also be delivered internally with needles, seeds, wires, or catheters.
  • Chemotherapy: These drugs may kill the cancer cells or stop them from dividing. You can take them orally or by injection.
  • Biologic therapy: This option makes use of the patient’s immune system to target the cancer.
  • Targeted therapy: Leaving normal cells alone, targeted therapy identifies and destroys cancer cells.

If none of the treatment options appeal to you, or if you want to expand your choices, you might consider a clinical trial. Having access to cutting-edge treatments or therapies not yet FDA-approved can improve your prognosis.

Speak with your doctor about what studies you qualify for. Be sure to weigh the risks and benefits of any trial before you sign on. You can usually participate while undergoing standard therapy, and you can stop a clinical trial whenever you want, for any reason.

Once your treatment is complete, your doctor will follow up with you often. Your doctor may monitor your health with some of the same tests used to diagnose you.

Keeping an eye on your results is an important part of the overall treatment process. It helps make certain your treatment is working and the cancer doesn’t come back.

Survival rates are often determined by the stage of cancer at the time of your diagnosis. For those with PRCC diagnosed in stage 1, the odds of surviving five years or longer are better than 80 percent. In more advanced stages, survival rates decline. By the time PRCC reaches stage 4, the five-year survival rate drops to 8 percent.

Taking care of your kidneys and leading a healthy lifestyle could help prevent PRCC. These tips can help protect your kidneys:

  • Maintain a healthy weight.
  • Treat high blood pressure and keep your cholesterol in check.
  • Exercise regularly.
  • Limit your salt intake and eat a balanced diet rich in fresh fruits and vegetables.
  • Stop smoking.
  • Limit your alcohol intake and drink plenty of water.

The important thing is not to wait until you have been diagnosed with PRCC. Living a healthy lifestyle now is great advice for everyone.