What is renal cell carcinoma?

Kidney cancer occurs when cancer cells form in the kidneys. Over 90 percent of kidney cancers are renal cell carcinomas (RCC), which start in the tubules of the kidneys. Tubules are tiny tubes in the kidneys that help filter waste products from the blood in order to make urine. The remaining 10 percent of kidney cancers start in the renal pelvis in the center of the kidney, which is where urine collects.

In the United States, kidney cancer is the seventh most common cancer in men and the ninth most common cancer in women, according to the Cleveland Clinic.

Risk factors for developing renal cell carcinoma include:

  • smoking
  • hypertension
  • obesity
  • workplace chemical exposures
  • family history
  • advanced kidney disease
  • genetic factors
  • hepatitis C

One of the first symptoms of kidney cancer is the appearance of blood in the urine. Sometimes, a lump can be felt in the abdomen.

To diagnose kidney cancer, a doctor will perform a physical exam, and they may order blood work, a urinalysis, and imaging tests, such as:

  • ultrasound
  • CT scan
  • MRI

If the imaging tests reveal a suspicious mass, your doctor will do a biopsy to check for malignant cells.

Once kidney cancer is confirmed, your medical team will determine the stage of the cancer. The stage is based on how much or how little the cancer has spread.

  • Stage 1 means the cancer is only in the kidney, and the tumor is 7 centimeters long or smaller.
  • Stage 2 means the cancer is still contained to the kidney, but the tumor is larger than 7 centimeters.

Stages 3 and 4 indicate that the cancer has metastasized, or spread to other parts of your body. Kidney cancer spreads through blood, lymph nodes, or by direct extension of the original cancerous tumor into nearby tissue or structures.

  • Stage 3 means the cancer is also present in a lymph node near the kidney, or in a main kidney blood vessel or fatty tissue around the kidney.
  • Stage 4 means the cancer has spread to the adrenal gland on top of the kidney or to another organ or distant lymph nodes.

Local treatment

Treatment for kidney cancer depends on the stage of the cancer. If the tumor is small and you are eligible for surgery, a partial nephrectomy may be possible. This operation spares the kidney, but removes the tumor and some of the surrounding tissue. A full nephrectomy, in which an entire affected kidney is removed, may be necessary in more advanced cases.

In some cases, where surgery is not an option, cryoablation may be a solution if the tumor is solid and in a contained area. Cryoablation is a procedure that involves the freezing of cancer cells. Another nonsurgical local therapy option is radiofrequency ablation, which heats the tumor with high-energy radio waves. Radiation therapy is another option, though not as commonly used for kidney cancer.

Targeted therapies, which are medications that target kidney cancer cells, may be used if the cancer has spread. According to the American Cancer Society, there are several targeted therapy medications for kidney cancer. Targeted therapies are drugs that target specific receptors or molecules along the cancer cell growth pathways that slow or halt cancer growth.

Immunotherapy drugs, which help boost your body’s immune system, are another option. However, these drugs may have many side effects.

Your overall health is a key factor for predicting your outlook after being diagnosed with kidney cancer. People with kidney cancer tend to be older, which also affects survival rates.

The biggest factor affecting a kidney cancer outlook is the stage of the disease when it’s diagnosed. Chances of survival are much better when the disease is diagnosed before it has spread and can be removed surgically.

Survival rates for renal cell carcinoma are sometimes based on the percentage of people who live at least five years after the cancer is discovered. The percentages differ by the stage of the cancer at the time of diagnosis.

Renal cell carcinoma occurs when cancer cells form in the tubules of the kidney. The biggest factor affecting the outlook for kidney cancer is the stage of the disease when it’s diagnosed. People with early diagnoses have five-year survival rates up to 10 times greater than those with late-stage diagnoses.

Among the first symptoms of kidney cancer is blood in the urine. Sometimes you may feel a lump in the abdomen. If you experience any of these symptoms, see your doctor as soon as possible.

The American Cancer Society reports the following five-year survival rates for renal cell carcinoma:

  • Stage 1: 81 percent
  • Stage 2: 74 percent
  • Stage 3: 53 percent
  • Stage 4: 8 percent
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