Risk Factors

Several factors influence the risk of developing kidney cancer:

• Smoking: Cigarette smoking is a major risk factor of kidney cancer. Cigarette smokers are twice as likely as nonsmokers to develop the disease. Cigar smoking also may increase the risk of this disease.
• Obesity: People who are obese are at increased risk of kidney cancer.
• High blood pressure: High blood pressure also increases the risk of kidney cancer.
• Long-term dialysis: Dialysis is a treatment for people whose kidneys do not work well. It removes wastes from the blood. Being on dialysis for many years is a risk factor for kidney cancer.
• Von Hippel-Lindau (VHL) syndrome: VHL is a rare disease that runs in some families. It is caused by changes in the VHL gene. An abnormal VHL gene increases the risk of kidney cancer. It also can cause cysts or tumors in the eyes, brain, and other parts of the body. Family members of those with this syndrome can have a test to check for the abnormal VHL gene. For people with the abnormal VHL gene, doctors may suggest ways to improve the detection of kidney cancer and other diseases before symptoms develop.
• Occupation: Some people have a higher risk of getting kidney cancer because they come in contact with certain chemicals or substances in their workplace. Coke oven workers in the iron and steel industry are at risk. Workers exposed to asbestos or cadmium also may be at increased risk.
• Gender: Males are more likely than females to be diagnosed with kidney cancer.

Symptoms

Common symptoms of kidney cancer include the following:

• A lump or mass in the side or the abdomen
• Blood in the urine (making the urine slightly rusty to deep red)
• Feeling very tired or having a general feeling of poor health
• Fever
• Pain in the side that does not go away
• Weight loss

Most often, these symptoms do not mean cancer. An infection, a cyst, or another problem also can cause the same symptoms. A person with any of these symptoms should see a health care provider so the problem can be diagnosed and treated as early as possible.

Screening and Diagnosis

Currently, there are no screening methods for kidney cancer.

If symptoms suggest kidney cancer, the doctor may perform one or more of the following procedures:

• Physical exam: The doctor checks general signs of health and tests for fever and high blood pressure. The doctor also feels the abdomen and side for tumors.
• Urine tests: Urine is checked for blood and other signs of disease.
• Blood tests: Doctors check for specific substances in the blood such as creatinine. A high level of creatinine may mean the kidneys are not doing their job.
• Intravenous pyelogram (IVP): The doctor injects dye into a vein in the arm. The dye travels through the body and collects in the kidneys. The dye makes the kidneys show up on x-rays. A series of x-rays then tracks the dye as it moves through the kidneys to the ureters and bladder. The x-rays can show a kidney tumor or other problems.
• CT scan: Doctors often use CT scans to take pictures of tissue inside the body. An x-ray machine linked to a computer takes several pictures. The pictures may show a tumor, abnormal fluid, swollen lymph nodes, or if the cancer has spread to other parts of the body.
• Ultrasound: This procedure uses high-energy sound waves bounced off internal tissues or organs in the abdomen to make echoes. The echoes form a picture called a sonogram. The picture can be printed to be looked at later.
• Biopsy: The doctor removes tissue to look for cancer cells. A biopsy is the only way to know for sure if cancer is present.
• Surgery: The doctor may recommend surgery to remove part or all of the kidney. A pathologist makes the final diagnosis by examining the tissue under a microscope.

Staging

To plan the best treatment, the doctor needs to know the stage (extent) of the disease. The stage is based on the size of the tumor, whether the cancer has spread and, if so, to what parts of the body. The following tests and procedures may be used in the staging process:

• CT scan: Doctors often use CT scans to take pictures of tissue inside the body. An x-ray machine linked to a computer takes several pictures. The pictures may show a tumor, abnormal fluid, swollen lymph nodes, or if the cancer has spread to other parts of the body.
• Magnetic resonance imaging (MRI): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body.
• X-ray: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
• Bone scan: Doctors inject a small amount of a radioactive substance into a blood vessel. It travels through the bloodstream and collects in the bones. A machine called a scanner finds and measures the radiation. The scanner makes pictures of the bones. The pictures may show cancer that has spread to the bones.

Stages of Kidney Cancer

Stage I: The tumor is no bigger than 7 centimeters. The cancer is found only in the kidney and is considered early stage.

Stage II: The tumor measures more than 7 centimeters. The cancer is found only in the kidney and is still considered early stage.

Stage III: The tumor has started to invade nearby tissues or lymph nodes.

Stage IV: The tumor has invaded deeper into nearby tissues, or has spread to many lymph nodes other places in the body.

Recurrent cancer is cancer that has come back (recurred) after treatment. It may come back in the kidney or in another part of the body.

Treatment

At Huntsman Cancer Institute, kidney cancer is treated by a team of specialists, including urologists (doctors who specialize in diseases of the urinary system), surgeons, medical oncologists, radiation oncologists, nurses, social workers, dietitians, and other professionals.

Kidney cancer treatment options include the following:

• Surgery
• Arterial embolization
• Radiation therapy
• Chemotherapy
• Biological therapy
• Clinical trials

A patient may receive more than one type of treatment. The treatment that's right for each patient depends on the stage of the cancer and the patient's overall health before diagnosis.

Surgery

Treatment to remove the kidney is called a nephrectomy. There are several types of nephrectomies. The type depends mainly on the stage of the tumor. The doctor can explain each operation and discuss which is most suitable for the patient:

• Radical nephrectomy: Kidney cancer is usually treated with radical nephrectomy. The surgeon removes the entire kidney along with the adrenal gland and some tissue around the kidney. Some lymph nodes in the area also may be removed.
• Simple nephrectomy: The surgeon removes only the kidney. Some people with stage I kidney cancer may have a simple nephrectomy.
• Partial nephrectomy: The surgeon removes only the part of the kidney that contains the tumor. This type of surgery may be used when the person has only one kidney, or when the cancer affects both kidneys. Also, a person with a small kidney tumor (less than 4 centimeters) may have this type of surgery.

Arterial embolization

This is a type of local therapy that shrinks the tumor. Sometimes it is done before an operation to make surgery easier. When surgery is not possible, embolization may be used to help relieve the symptoms of kidney cancer.

Radiation therapy

This treatment uses high-energy rays to kill cancer cells. A large machine directs radiation only to a specific area to kill cancer cells.

Chemotherapy

This treatment uses drugs to destroy or control cancer throughout the body. Learn more about this treatment in our introduction to chemotherapy video.

Biological therapy

This treatment helps the body fight cancer. The doctor may suggest a biological therapy called interferon alpha or interleukin-2 (also called IL-2 or aldesleukin). The body normally produces these substances in small amounts in response to infections and other diseases.

Clinical trials

These studies discover and evaluate new and improved cancer treatments. Patients are encouraged to talk with their doctors about participating in a clinical trial or any questions regarding research studies. For more information, also visit HCI's clinical trials website.

Support

When you or someone you love is diagnosed with cancer, concerns about treatments and managing side effects, hospital stays, and medical bills are common. You may also worry about caring for your family, employment, or how to continue normal daily activities.

Here's where you can go for support:

• Your health care team can answer your questions and talk to you about your concerns. They can help you with any side effects and keep you informed of all your treatments, test results, and future doctor visits.
• The Cancer Learning Center has hundreds of free brochures and more than 3,000 books, DVDs, and CDs available for checkout. You can browse the library, perform Internet research, or talk with a cancer information specialist. Call 801-581-6365 or toll free 1-888-424-2100, or e-mail This e-mail address is being protected from spambots. You need JavaScript enabled to view it .
• Our Patient and Family Support Services professionals offer HCI patients and their families emotional support and resources for coping with cancer and its impact on daily life.
• The Linda B. and Robert B. Wiggins Wellness-Survivorship Center offers support groups, classes, and activities aimed to increase the quality of life and well-being of HCI patients and their families.