Kidney Cancer

Signs & symptoms

In its early stages, kidney cancer usually causes no obvious signs or troublesome symptoms. As a kidney tumor grows, symptoms may occur. These may include:

• Blood in the urine. In some cases, blood is visible. In other instances, traces of blood are detected in a urinalysis, a lab test often performed as part of a regular medical checkup.
• A lump or mass in the kidney area.

Other less common symptoms may include:

• Fatigue
• Loss of appetite
• Weight loss
• Recurrent fevers
• Pain in the side that doesn't go away
• General feeling of poor health

High blood pressure or a lower than normal number of red cells in the blood (anemia) may also signal a kidney tumor. These symptoms occur less often.

Diagnosis

To find the cause of symptoms, your doctor may ask about your medical history and perform a physical exam. In addition to checking for general signs of health, your doctor may perform blood and urine tests. Your doctor also may carefully feel the abdomen for lumps or irregular masses.

Other tests that produce pictures of the kidneys and nearby organs are often recommended. These pictures can often show changes in the kidney and surrounding tissue. For example, an intravenous pyelogram (IVP) is a series of X-rays of the kidneys, ureters, and bladder after the injection of a dye into the veins. The pictures produced can show changes in the shape of these organs.

Another test, arteriography, is a series of X-rays of the blood vessels. Dye is injected into a large blood vessel through a catheter. X-rays show the dye as it moves through the network of smaller blood vessels in and around the kidney.

Kidney cancer, however, is most commonly detected with either computed tomography (CT) scan, ultrasound or magnetic resonance imaging (MRI).

• Abdominal Ultrasound Sound waves, called ultrasound, that cannot be heard by humans, are sent into the abdomen. The waves bounce off the kidneys and a computer uses the echoes to create a picture called a sonogram.
• Computed Tomography (CT) Scan A series of detailed pictures of areas inside the body, taken from different angles. The pictures are created by a computer linked to an X-ray machine. This also is called computerized tomography and computerized axial tomography (CAT) scan.
• Magnetic Resonance Imaging (MRI) A procedure in which a magnet linked to a computer is used to create detailed pictures of areas inside the body.

Treatments

Treatment for kidney cancer depends on the stage of the disease, the patient's general health and age, and other factors. Our doctors develop a treatment plan to fit each patient's needs.

At UCSF Health patients with kidney cancer often are treated by a team of specialists, including urologists, oncologists and radiation oncologists. Kidney cancer usually is treated with surgery or biological therapy, also called immunotherapy. Doctors may decide to use one treatment method or a combination of methods.

Surgery

Surgery is the most common treatment for kidney cancer. An operation to remove the kidney is called a nephrectomy. Most often, the surgeon removes the whole kidney along with the adrenal gland and the tissue around the kidney. Some lymph nodes in the area also may be removed. This procedure is called a radical nephrectomy. Very often, the surgeon is able to remove just the part of the kidney that contains the tumor. This procedure, called a partial nephrectomy, is best suited for patients with small tumors or tumors on the edge of the kidney.

Radiation Therapy

Radiation therapy, also called radiotherapy, uses high-energy rays to kill cancer cells. Doctors sometimes use radiation therapy to relieve pain (palliative therapy) when kidney cancer has spread to the bone.

Radiation therapy for kidney cancer involves external radiation, which comes from radioactive material outside the body. A machine aims the rays at a specific area of the body. Most often, treatment is given on an outpatient basis in a hospital or clinic five days a week for several weeks. This schedule helps protect normal tissue by spreading out the total dose of radiation. You don't need to stay in the hospital for radiation therapy, and you're not radioactive during or after treatment.

Biological Therapy

Biological therapy, also called immunotherapy, is a form of treatment that uses the body's natural ability or immune system, to fight cancer. Interleukin-2 and interferon are types of biological therapy used to treat advanced kidney cancer.

Clinical trials continue to examine better ways to use biological therapy while reducing the side effects patients may experience. Many people receiving biological therapy stay in the hospital during treatment so that these side effects can be monitored.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Although useful in the treatment of many other cancers, chemotherapy has shown only limited effectiveness against kidney cancer. Researchers continue to study new drugs and new drug combinations that may prove to be more useful.

Hormone Therapy

Hormone therapy is used in a small number of patients with advanced kidney cancer. Some kidney cancers may be treated with hormones to try to control the growth of cancer cells. More often, it is used as palliative therapy or therapy to relieve pain.