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  • Kidney cancer

    n the UK about 5,000 people are diagnosed with kidney cancer each year. There are several types of kidney cancer. Renal cell carcinoma (RCC) is the most common type in adults and is, responsible for approximately 80 per cent of cases. Top
    Symptoms

    Many people with kidney cancer have no symptoms at first, especially when the cancer is small. The affected kidney will become larger and in time, the tumour may grow through the wall of the kidney and invade nearby tissues and organs such as the muscles around the spine, liver and nearby large blood vessels.
    As the cancer develops, the following may occur:
    • In 60 per cent of cases, the first symptom is to pass blood in the urine which is usually painless, and may 'come and go' as the tumour bleeds.
    • Pain in the back or side.
    • Swelling in the abdomen.
    • High blood pressure.
    • Feeling generally unwell or tired.
    • Loss of appetite.
    • Polycythaemia (too much blood in body) or anaemia (too little).
    • Varicocele (tangled network of veins in the scrotum).
    • Hip fracture due to spread of the cancer to bone.
    • Excessive hair growth in females.
    • Feeling thirsty.
    • Night sweats.
    • Severe weight loss.

    Top
    Causes and risk factors

    Although kidney cancer is more common in men over the age of 60, many people develop it for no apparent reason. However, certain risk factors increase the chance of it developing, including:
    • Smoking.
    • Obesity.
    • Hypertension.
    • Family history of the disease.
    • Dialysis patients with cysts in their kidneys.
    • Inherited disorders such as von Hippel-Lindau disease.

    Top
    Diagnosis and treatment

    About half of kidney cancers are diagnosed before any symptoms develop. They are usually seen 'by chance' when a scan or other investigation is done for another reason.
    If your doctor suspects kidney cancer they will arrange an ultrasound scan. A CT scan, which gives a more detailed view of sections of the body, may be used if there is doubt about the diagnosis - or to assess if the cancer has spread.
    Treatment options which may be considered include:
    • Surgery to remove all (or part) of the affected kidney. This is the most common treatment and can sometimes be done as a keyhole operation in some cases. If the cancer is at an early stage and has not spread then surgery alone may be enough. If the cancer has spread to other parts of the body, surgery to remove the affected kidney may still be advised, often in addition to further surgery to remove a ‘secondary’ kidney tumour (one which has spread to another part of the body).
    • Radiotherapy may be advised to kill any cancerous cells left behind following an operation.
    • Arterial embolisation may be used instead of surgery, where the artery to the kidney tumour is blocked. The blood supply to the tumour is then cut off, and the tumour dies.
    • Medications such as sunitinib, temsirolimus, bevacizumab, interferon-alpha have improved the outlook for kidney cancer patients. Speak to your specialist about what may be best for you.

    Chemotherapy doesn’t work as well as it does for other types of cancer. The type of treatment depends on the type and how large the cancer is, whether it has spread and general health.
    If a cure is not realistic, in some cases treatment aims to control the cancer, limiting the growth or spread so it progresses less rapidly. This may limit the amount of symptoms for some time.
    If the cancer is confined to the kidney without spreading, and the patient is in otherwise good general health, the outlook is good; with around 95 per cent of patients surviving five years after diagnosis (if the tumour is less than 4 cm). Surgical removal of an affected kidney in this situation gives a good chance of cure.
    However, many people with kidney cancer are diagnosed when the cancer has already spread, so a cure is less likely. However, treatment can often slow down the progression of the cancer.
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