Kidney Cancer

Renal Cell Carcinoma (RCC)

RCC, also known as renal cell cancer or renal cell adenocarcinoma, makes up about 90% of kidney cancers. It usually beings as a single tumor in one kidney, but in some cases, there may be multiple tumors in one or both kidneys. Subtypes of RCC include:
 

• Clear cell renal cell carcinoma
• Papillary renal cell carcinoma
• Chromophobe renal cell carcinoma
• Unclassified renal cell carcinoma
• Rare types of renal cell carcinoma

Transitional Cell Carcinoma (TCC)

Also known as urothelial cancer or renal pelvis carcinoma, TCC is a rare form of kidney cancer that affects the transitional cells in the urinary system. Because transitional cells are found throughout the urinary system, TCC is a common form of bladder cancer. When TCC affects the kidney, it often targets the renal pelvis in the center of the kidney. 
 

Wilms Tumor (Nephroblastoma)

Wilms tumor is a rare type of kidney cancer that is the most often found in children around 3-4 years old. It usually forms in only one kidney. 
 

Renal Sarcoma

Another type of rare kidney cancer, renal sarcoma forms in the renal veins (the veins that carry filtered blood back up to the heart for circulation). This type of kidney cancer is more likely to recur and spread than other forms.

As with most cancers, the earlier kidney cancer is diagnosed, the more likely it can be successfully treated. Signs of kidney cancer include:

• Blood in your urine
• Persistent back pain below the ribs
• Fever that won’t go away, and has no known cause
• Weight loss
• Fatigue
• Swelling of legs and ankles

Many causes of kidney cancer are unknown. However, the known kidney cancer risk factors include:
 

Workplace exposure

Certain substances like asbestos, trichloroethylene or herbicides have been shown to increase kidney cancer risk.
 

Advanced kidney disease

A strong family history of renal cancer, especially among siblings, can increase risk.
 

Dialysis

Kidney disease and prolonged dialysis treatment can increase the risk of kidney cancer.
 

Inherited risk factors

Some rare inherited conditions that can cause kidney cancer include Cowden syndrome, tuberous sclerosis and hereditary leiomyoma RCC.
 

Age

People over age 45 are more likely to be affected.
 

Gender

RCC affects about twice as many men as it does women.
 

Tobacco use

Smoking raises the risk of cancer.
 

Obesity

Being obese or overweight may cause changes in some hormones that increase the risk of RCC.
 

High blood pressure

People with high blood pressure have an increased risk of kidney cancer.

Unfortunately, there are no screenings or exams to detect kidney cancer in people of average risk. However, the following preventive factors may help reduce the risk:
 

• Avoid tobacco
• Maintain a healthy weight
• Avoid exposure to harmful substances in the workplace

Imaging Tests

Imaging tests are used to diagnose kidney cancer as well as determine whether it has spread or not.

Imaging tests used in kidney cancer diagnosis are:

• Ultrasound - a diagnostic ultrasound uses sound waves to show any growths or tumors on the kidney
  
• MRI - MRI scans will be performed if a patient can't have a CT scan or if it is suspected that kidney cancer has spread into major blood vessels
• Intravenous Pyelogram (IVP) - IVP involves injecting an iodine-based dye into a vein before taking a series of x-rays. The dye provides contrast on the x-ray so your doctor can look for any abnormal growths in the kidneys.
• CT scan - a CT scan can provide precise information regarding the size, shape and location of a kidney tumor

Biopsy

During a biopsy, a small tissue sample is removed from the kidney to be examined under a microscope to determine if cancer is present.

Renal cancer staging indicates how far cancer may have grown beyond the kidneys to other parts of the body. The stage of kidney cancer helps Mercy doctors determine the best course of treatment.
 

Kidney Cancer Stage I

Stage I of kidney cancer indicates that the tumor is approximately 7 cm across or smaller and has not spread beyond the kidney.
 

Kidney Cancer Stage II

Stage II of kidney cancer indicates that either the tumor is larger than 7 cm across but has not spread beyond the kidney. Or that the tumor is growing into a major vein or into the tissue around the kidney but isn't growing into the adrenal gland or Gerota's facia (the fibrous tissue that surrounds the kidney) In stage II, kidney cancer has not spread to the lymph nodes or to distant organs.
 

Kidney Cancer Stage III

Stage III of kidney cancer indicates that the main tumor can be any size and can be outside the kidney, however, it has not spread beyond Gerota's facia. It may have spread to nearby lymph nodes but not to distant lymph nodes or to other organs.
 

Kidney Cancer Stage IV

The main tumor is growing outside Gerota's facia and may be growing into the adrenal gland in stage IV of kidney cancer. The main tumor can be any size and may have grown outside the kidney.

Kidney Cancer Surgery

Surgery is often the main treatment for most types of kidney cancer. Mercy offers a full team of specialists and advanced surgical technologies and techniques such as robot-assisted and video-assisted surgery for easier procedures and recoveries. Surgical treatments of kidney cancer include the following:
 

Radical Nephrectomy

Radical nephrectomy, or complete nephrectomy, involves removing the entire kidney along with nearby lymph nodes, adrenal gland and surrounding tissues. It is often recommended for kidney cancers that have grown into surrounding tissues but have not yet spread. Radial nephrectomies are performed laparoscopically, with robot-assisted technologies or through an open incision.
 

Partial nephrectomy

Partial nephrectomy, also known as nephron-sparing surgery or kidney-sparing surgery, involves removing the tumor and sparing the remainder of the kidney. This type of surgery is preferred for early-stage kidney cancer.
 

Regional Lymphadenectomy

A regional lymphadenectomy, also known as a lymph node dissection, is a procedure to remove nearby lymph nodes to see if they contain cancer. Sometimes this is performed during a radical nephrectomy.
 

Kidney Transplant 

A kidney transplant replaces a nonfunctional kidney with a new kidney, although many people can live with just one kidney.

Other Local Therapy Treatments
 

Radiation Therapy

Radiation therapy may be part of your kidney cancer treatment plan to eliminate cancer cells. Radiotherapy may be used before or after surgery for kidney cancer. Advanced radiation treatments for kidney cancer include intensity-modulated radiation therapy (IMRT). 
 

Cryoablation

Cryoablation, also known as cryotherapy, is an outpatient procedure used to kill kidney cancer cells using extreme cold. 
 

Radiofrequency Ablation (RFA)

RFA uses high-frequency electrical energy to heat the kidney tumor and kill the cancer cells.

Immunotherapy

Part of your treatment plan for kidney cancer may include immunotherapy. Also known as targeted therapy or biologic therapy, immunotherapy is designed to use the body's immune system to fight kidney cancer.

Chemotherapy

Chemotherapy may be used as a part of a kidney cancer treatment plan if targeted therapies are unsuccessful.