Kidney Cancer: Symptoms, Diagnosis, Treatment, and FAQs

What is Kidney Cancer? 

Kidney cancer (Renal Cancer) is a condition where cells in the kidney tissue grow and divide abnormally and rapidly, uncontrollably. These cancer cells cluster together to form a malignant tumor, which can spread to surrounding tissues such as the fat tissue around the kidney, the major blood vessels connected to the kidney, and nearby organs.

 

Importantly, kidney cancer can also spread through the bloodstream or lymphatic system to distant organs such as the lungs, bones, liver, or brain, making treatment more complex and challenging.

 

How Many Types of Kidney Cancer Are There?

There are several types of kidney cancer, with the most common being renal cell carcinoma (RCC), which originates from cells in the small kidney tubules. It accounts for about 80–90% of all kidney cancer cases.

 

The most common subtype of RCC is clear cell renal cell carcinoma (Clear Cell RCC), found in more than 70% of RCC cases. Other subtypes include papillary RCC and chromophobe RCC.

 

Another less common type is transitional cell carcinoma (TCC), which occurs in the renal pelvis. In young children, Wilms tumor is often found, which is a type specific to children only.

 

Symptoms or Warning Signs of Kidney Cancer That Should Not Be Overlooked

Early-stage kidney cancer often has no clear symptoms, causing many people to be unaware they have the disease. However, as the disease progresses, there may be warning signs to watch for as follows:

 

     ๐ Blood in urine: This is the most common symptom and should be diagnosed immediately. The urine color may be pink, red, or dark brown. Sometimes blood clots may be present. The blood may appear intermittently or occasionally.

     ๐ Back or flank pain: Usually occurs on one side, especially from under the ribs down to the waist. This may be caused by a growing tumor pressing on nearby tissues, organs, or nerves. The pain can be dull and chronic or sharp and sudden.

     ๐ A palpable lump in the abdomen or flank: You may feel a hard lump in the abdomen or flank, indicating the tumor has grown larger.

     ๐ Other symptoms that may be present include:

     ๐ Fatigue, easy tiredness, or unusual exhaustion without a known cause

     ๐ Unintentional continuous weight loss

     ๐ Chronic low-grade fever from inflammatory substances secreted by cancer cells or from infection

     ๐ Possible anemia symptoms

     ๐ High blood pressure that is difficult to control even with medication

 

Guidelines for Diagnosing Kidney Cancer

Detecting kidney cancer at an early stage increases the chance of a complete cure. However, currently, there are no screening guidelines for kidney cancer in asymptomatic patients. Many patients are diagnosed incidentally during annual health check-ups, ultrasound, or CT scans performed to investigate other unrelated symptoms such as back pain, chronic fever, or abnormal urination. Finding abnormalities related to the kidney leads to further diagnostic tests using various methods at the physician’s discretion, such as:

 

     ๐ Urine test: To detect substances in the urine, especially hematuria (blood in urine), which is the most common symptom of kidney cancer, and to check for proteinuria (protein in urine).

     ๐ Blood test: To assess kidney function, such as creatinine levels, eGFR, and to check for anemia, which is often found in advanced kidney cancer due to chronic blood loss.

     ๐ Ultrasound: A preliminary test that does not use radiation, helping to visualize kidney structure and detect abnormal masses.

     ๐ CT Scan: Using contrast-enhanced CT helps clearly show the size, location, and spread of the tumor. It is the standard method commonly used for treatment planning and staging of kidney cancer.

     ๐ MRI: Used in some cases requiring additional detail, such as assessing tumor invasion into the major veins or in patients with kidney impairment who cannot receive contrast agents used in CT scans.

     ๐ Biopsy: A pathological examination in the laboratory to confirm the cancer type and severity. Doctors consider biopsy only when imaging results are inconclusive or when planning treatments other than surgery, such as targeted therapy or immunotherapy. Generally, if CT or MRI clearly indicates the disease, surgery may be chosen without biopsy.

 

In cases where assessment of metastasis to other organs such as lungs, bones, or lymph nodes is needed, additional tests may be performed, such as chest X-rays, bone scans, or PET/CT scans as appropriate.

 

Treatment Options for Kidney Cancer

Treatment of kidney cancer depends on several factors such as cancer type, disease stage, overall patient health, and disease severity. Doctors will consider the most appropriate treatment plan for each patient, with the main methods as follows:

     ๐ Surgery: The primary treatment for kidney cancer that has not spread, with two main types:

                      ๐ Partial nephrectomy: Removing only the tumor and surrounding kidney tissue while preserving as much healthy kidney tissue as possible to maintain kidney function. Suitable for small tumors.

                      ๐ Radical nephrectomy: Removing the entire affected kidney, usually for large tumors to control spread. This may include removal of surrounding tissues, adrenal gland, and lymph nodes.

     ๐ Targeted Therapy: Drugs that specifically act on cancer cell growth mechanisms to inhibit growth and spread, often used in advanced kidney cancer.

     ๐ Immunotherapy: Such as immune checkpoint inhibitors that stimulate the body’s immune system to fight and eliminate cancer cells, commonly used in advanced or metastatic kidney cancer.

     ๐ Chemotherapy: Renal cell carcinoma, the most common type, often does not respond well to chemotherapy, so this method is used in some cases or for other types of kidney cancer.

     ๐ Radiation Therapy: Using high-energy radiation to destroy cancer cells, relieve pain, or control tumor spread to bones or brain.

 

Q&A: Frequently Asked Questions About Kidney Cancer

 

Q: Is kidney cancer hereditary?

A: Most kidney cancers are not hereditary. However, some types are associated with genetic abnormalities, such as von Hippel-Lindau (VHL) Syndrome, a hereditary condition that increases the risk of kidney cancer and other tumors in various organs. If there are multiple family members with kidney cancer or if kidney cancer occurs at a young age, genetic counseling and testing should be considered.

 

Q: Do I need dialysis after kidney surgery?

A: If only one kidney is removed and the remaining kidney functions well, dialysis is not necessary because one kidney can adequately filter waste and maintain fluid and electrolyte balance. However, if the remaining kidney does not function fully or acute kidney failure occurs after surgery, temporary or permanent dialysis may be required depending on kidney function and patient condition.

 

Q: How should I take care of myself if I have only one kidney?

A: If you have only one kidney, it is very important to take care of the remaining kidney to ensure it functions efficiently and reduce the risk of future problems.

     ๐ Drink enough clean water to help kidney function and prevent dehydration.

     ๐ Reduce intake of very salty, very sweet, and high-fat foods; choose healthy foods such as vegetables, fruits, and lean protein.

     ๐ If you have chronic diseases such as diabetes or high blood pressure, keep them well controlled as these can harm the kidneys.

     ๐ Avoid medications that affect the kidneys and always inform your doctor or pharmacist that you have only one kidney to avoid harmful drugs.

     ๐ Exercise regularly to maintain a healthy weight and overall health.

     ๐ Avoid smoking and limit alcohol consumption as they negatively affect kidney health.

     ๐ Have regular health check-ups and kidney function tests.

 

Kidney cancer, if detected early, increases the chance of successful treatment. If you experience symptoms or have concerns about kidney cancer, you can consult a doctor for appropriate diagnosis at Phyathai Phaholyothin Hospital, which has a specialized team in kidney and cancer diseases, along with advanced diagnostic and treatment technologies to meet all your needs.

 

Dr. Suppawat Sirikupt

Urology Specialist

Phyathai Phaholyothin Hospital

Source : Phyathai Phaholyothin Hospital