Understanding Kidney Cancer: From Diagnosis to Treatment

Kidney cancer occurs when abnormal cells within the kidney tissue grow uncontrollably and form a lump or tumor. This tumor can affect how the kidney works and, in some cases, spread to other organs.  

Kidney cancer is among the ten most common cancers in the United States. According to the American Cancer Society, approximately 81,800 new cases of kidney cancer will be diagnosed by the end of 2023.  

In this blog post, we will provide detailed insights into the signs of kidney cancer, its diagnosis, stages, and treatment options. Read on to learn more.  

Types of Kidney Cancer

1. Renal cell carcinoma (RCC)

It is the most prevalent form of kidney cancer among adults that typically begins in the cells lining the kidney tubules.  

2. Transitional cell cancer

This form of kidney cancer generally initiates where the ureter connects to the main portion of the kidney and accounts for approximately 6% to 7% of all kidney cancer cases.   

3. Renal sarcoma

This rare variant of kidney cancer starts in the connective tissues of the kidneys.  

4. Wilms tumor

It is the most prevalent type of kidney cancer among children, accounting for approximately 5% of all kidney cancer cases.   

Kidney Cancer Signs and Symptoms

In the early stages of kidney cancer, there are typically no noticeable signs or symptoms. However, as the tumors grow larger, they may show a few signs and symptoms, which are as follows:  

• Blood in urine or hematuria  

• Lower back pain, which is not related to injury  

• A mass or lump on the side or lower back  

• Fatigue  

• Decreased appetite  

• Unexplained weight loss 

• Persistent fever   

• Anemia   

While these symptoms may indicate kidney cancer, they can also be associated with non-malignant conditions. For instance, urinary tract infections or kidney stones may also lead to hematuria. Nevertheless, those experiencing any of these symptoms should consult a healthcare provider for a thorough evaluation and accurate diagnosis. 

Diagnosis of Kidney Cancer

1. Medical evaluation and physical examination

If signs or symptoms indicate kidney cancer, healthcare providers will review your complete medical history to assess risk factors and understand your symptoms. Then, they will do a physical examination and recommend additional tests if they suspect any abnormalities.  

2. Blood tests

While blood tests alone cannot definitively diagnose kidney cancer, they can provide initial indications of kidney issues.   

3. Urinalysis

This test examines urine for microscopic blood and other substances not visible to the naked eye. About half of renal cell cancer patients have blood in their urine. In the case of transitional cell carcinoma, urine cytology can reveal the presence of abnormal cells.  

4. Imaging tests for kidney cancer

Imaging techniques employ X-rays, magnetic fields, sound waves, or radioactive substances to create internal body images. The following are some common imaging tests that healthcare providers order to detect kidney cancer:  

• Computed tomography (CT) scan  

• Magnetic resonance imaging (MRI) scan  

• Ultrasound  

• Angiography  

• Bone scan  

 5. Biopsy

While biopsies are not mandatory in kidney tumor diagnosis, healthcare professionals may recommend them in cases where the results of other tests are inconclusive. Biopsies not only confirm the diagnosis but also help assess tissue when surgery is not the primary treatment option for kidney cancer.   

Fine needle aspiration (FNA) and needle core biopsy are two types of biopsies commonly done for kidney cancer.  

Staging of Kidney Cancer

The primary staging system used for kidney cancer is the American Joint Committee on Cancer (AJCC) TNM system. This system relies on three crucial pieces of information:  

• Tumor size and extent (T) refers to the size of the tumor and whether it has invaded nearby areas.  

• Lymph node involvement (N) indicates whether the cancer has spread to nearby lymph nodes.  

• Metastasis to distant organs (M) assesses whether the cancer has spread to distant sites, such as bones, the brain, or the lungs.  

1. Stage I

T1, N0, M0  

The tumor measures 7 cm or smaller and is confined to the kidney. No spread to lymph nodes or distant organs.  

2. Stage II

T2, N0, M0  

The tumor is larger than 7 cm but still restricted to the kidney (T2). No spread to lymph nodes (N0) or distant organs (M0).  

3. Stage III

T3, N0, M0  

The tumor has extended into a major vein (e.g., renal vein or vena cava) or the surrounding kidney tissue but hasn't reached the adrenal gland or beyond Gerota's fascia (T3). No lymph node involvement (N0) or distant organ metastasis (M0).  

OR  

T1 to T3, N1, M0  

The primary tumor can be any size and may extend outside the kidney but hasn't breached Gerota's fascia. It has spread to nearby lymph nodes (N1) but hasn't metastasized to distant lymph nodes or other organs (M0).  

4. Stage IV

T4, any N, M0  

The primary tumor has infiltrated beyond Gerota's fascia and may involve the adrenal gland atop the kidney (T4). It may or may not have spread to nearby lymph nodes (any N) but hasn't metastasized to distant lymph nodes or other organs (M0).  

OR  

Any T, Any N, M1  

The primary tumor can be any size and may have grown beyond the kidney (any T). It may or may not have spread to nearby lymph nodes (any N) but has metastasized to distant lymph nodes or other organs (M1). 

Treatment Options for Kidney Cancer

In many cases, kidney tumors are non-cancerous (benign), and most small kidney cancers (about 75%) exhibit slow growth. If the kidney tumors are less than 4 cm in size, healthcare providers initially refrain from treatment and closely monitor the tumor's progression. If the tumor exhibits rapid growth, then they consider further treatments. Healthcare providers recommend active surveillance primarily for elderly patients.   

If the tumors are more than 4 cm or progress rapidly, providers may recommend the following treatment options.  

1. Surgical options 

Surgery is the first choice of treatment for most stages of kidney cancer. The following are some common surgical options for kidney cancer:  

• Partial nephrectomy: In this procedure, surgeons remove the part of the kidney that contains the tumor.  

• Radical nephrectomy: It involves the removal of the entire kidney and some of the tissue and lymph nodes in the area. When one kidney is removed, the remaining kidney usually performs the functions of both kidneys.  

Surgeons may also perform regional lymphadenectomy to remove nearby affected lymph nodes and adrenalectomy if cancer has affected the adrenal gland.   

2. Ablation

In some cases, healthcare professionals may consider the application of heat or cold to eliminate cancer cells. Oncologists have found cryoablation or radiofrequency ablation beneficial in cases where surgical intervention is not possible.  

• Cryoablation: In this procedure, a healthcare provider inserts a needle through the skin and into the kidney tumor to freeze cancer cells using cold gas.   

• Radiofrequency ablation: A healthcare provider inserts a needle into the kidney tumor and applies an electrical current to exterminate the cancer cells.  

3. Radiation therapy

Healthcare providers recommend it if an individual has only one kidney or if surgical intervention is not an option. In addition, radiation therapy is also a part of palliative care to alleviate kidney cancer symptoms, particularly pain.  

4. Targeted drug therapy

This new cancer treatment approach involves the use of certain drugs to halt the formation of new blood vessels or the production of proteins that nourish the cancer. Oncologists typically recommend targeted therapy for kidney cancer when surgery is not a viable option. In certain scenarios, these medications may be administered post-surgery to lower the risk of cancer recurrence.  

5. Immunotherapy

Although immunotherapy for kidney cancer is not common, healthcare providers may consider it in some advanced cases. Immunotherapy can be administered as a standalone treatment or in conjunction with surgery.  

6. Chemotherapy

While chemotherapy is not a standard course of treatment for kidney cancer, it may prove beneficial in some cases, typically when doctors consider immunotherapy and targeted drug therapy.   

To Sum Up

According to studies, the lifetime risk for developing kidney cancer in men is about 1 in 46 (2.02%), and for women, it is about 1 in 80 (1.03%). Like many other types of cancer, kidney cancer is curable when identified in its initial stages before it penetrates the outer layer of the kidney. Therefore, it is crucial to recognize the symptoms and report to a healthcare provider for accurate diagnosis and immediate medical attention.   

For any queries or concerns about kidney cancer and its treatment, contact ACTC, one of the best cancer centers in Florida. We are one of the leading cancer treatment centers in America that offers advanced cancer treatment and personalized care plans. Schedule an appointment with the Florida cancer specialists in Brooksville now!