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Kidney anatomy
Kidney anatomy


Kidney tumor - CT scan
Kidney tumor - CT scan


Kidney metastases, CT scan
Kidney metastases, CT scan


Kidney - blood and urine flow
Kidney - blood and urine flow


Definition:

Renal cell carcinoma is a type of kidney cancer in which the cancerous cells are found in the lining of very small tubes (tubules) in the kidney.



Alternative Names:

Renal cancer; Kidney cancer; Hypernephroma; Adenocarcinoma of renal cells; Cancer - kidney



Causes, incidence, and risk factors:

Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in men ages 50-70.

The exact cause is unknown.

Risk factors include:

  • Dialysis treatment
  • Family history of the disease
  • Genetics
  • Smoking
  • Von Hippel-Lindau disease (a hereditary disease that affects the capillaries of the brain, eyes, and other body parts)


Symptoms:

Other symptoms that can occur with this disease:

Sometimes both kidneys are involved. The cancer spreads easily, most often to the lungs and other organs. In about one-third of patients, the cancer has already spread (metastasized) at the time of diagnosis.



Signs and tests:

Pressing with the fingers (palpation ) on the abdomen may show a mass or organ enlargement, particularly of the kidney or liver. Men may have a varicocele in the scrotum (a varicocele that is only on the right side is especially suspicious.)

Tests include:

The following tests may be performed to see if the cancer has spread:



Treatment:

Surgical removal of all or part of the kidney (nephrectomy ) is recommended. This may include removing the bladder or surrounding tissues or lymph nodes.

Radiation therapy does not usually work for renal cell carcinoma so it is not often used. Hormone treatments may reduce the growth of the tumor in some cases.

Chemotherapy is generally not effective for treating renal cell carcinoma. The drug interleukin-2 (IL-2) is effective in a small percentage of patients, but it is very toxic. Other chemotherapy drugs have been used, but patients generally do not live long once the disease has spead outside the kidney.

Newer therapies include sorafenib (Nexavar), sunitinib (Sutent), and temsirolimus (Torisel). The biologic drug bevacizumab (Avastin) has also been used.

A cure is unlikely unless all of the cancer is removed with surgery.



Support Groups:

You can ease the stress of illness by joining a support group whose members share common experiences and problems. See cancer - support group and kidney disease - support group .



Expectations (prognosis):

The outcome depends on how much the cancer has spread and how well it responds to treatment. The survival rate is highest if the tumor is in the early stages and has not spread outside the kidney. If it has spread to the lymph nodes or to other organs, the survival rate is much lower.



Complications:
  • High blood pressure ( hypertension )
  • High calcium level
  • High red blood cell count
  • Liver function abnormalities
  • Spread of the cancer


Calling your health care provider:

Call your health care provider any time you see blood in the urine. Also call if you have any other symptoms of this disorder.



Prevention:

Stop smoking. Follow your health care provider's recommendations in the treatment of kidney disorders, especially those that may require dialysis.



References:

Barjorin D. Tumors of the kidney, bladder, ureters, and renal pelvis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 2007.

National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Kidney Cancer. National Comprehensive Cancer Network; 2009. Version 1.2009.




Review Date: 2/12/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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