Kidney cancer

What is kidney cancer?

Kidney cancer is a type of cancer that grows in the cells of the kidneys.

Kidney cancers usually grow as a solid tumour (lump) in one kidney, although it is possible to have one or more tumours in both kidneys. They start small but grow larger, eventually spreading to other parts of the body.

The cancer usually grows in the part of the kidney that filters blood. These tumours can be aggressive and can grow quickly. Sometimes the cancer will grow in the lining of the kidney or ureter (the tube that takes urine from the kidney to the bladder). This type of kidney cancer is unlikely to spread.

Kidney cancers that are found early can usually be cured. About 1,000 people still die from kidney cancer every year in Australia.

What are the different types of kidney cancer?

Different types of kidney cancer are named after the type of cell where the cancer develops:

• The most common type is called renal cell cancer, renal cell carcinoma or RCC. This type starts in the cells that line the tubules, which are part of the kidney’s filtering system.
• Another type is called urothelial carcinoma (or transitional cell carcinoma). This cancer grows in the part of the kidney where urine collects before it passes into the bladder via the ureters.
• Wilms tumour is a rare type of kidney cancer that mainly affects children.

What are the symptoms of kidney cancer?

Often there are no symptoms of kidney cancer in the early stages.

If you do have symptoms, they may include:

• blood in the urine
• a change in the colour of your urine to dark, rusty or brown
• a lump in your abdomen (tummy) or side
• pain in your side or lower back that does not go away
• unexplained weight loss
• persistent fatigue
• fever

All of these symptoms could be due to something other than kidney cancer. But if you are worried, see your doctor.

What causes kidney cancer?

Kidney cancer is more common in males than in females. Factors that increase your risk of kidney cancer include:

• smoking
• being overweight or obese
• having high blood pressure
• having severe kidney disease
• having a close family member who had kidney cancer
• being exposed to certain chemicals
• some genetic conditions

How is kidney cancer diagnosed?

If your doctor suspects kidney cancer, they will refer you for blood and urine tests. Imaging tests such as CT, MRI, ultrasound or x-ray may be used to examine the kidneys and to check if the cancer has spread to any other part of your body.

You might also have a biopsy, where a small sample of tissue is removed and examined in a laboratory.

If you have kidney cancer, your doctor will refer you to a specialist for treatment.

How is kidney cancer treated?

The most appropriate treatment will depend on the type of kidney cancer you have, where it is, and how far it has spread (known as its stage).

If the cancer is found early, the main treatment is surgery to remove the tumour or affected kidney. Other techniques that can also be used to kill the cancer include radiofrequency ablation (which uses high-energy radio waves to heat the tumour) and radiation therapy (which uses radiation to kill the cancer).

Sometimes, your specialist will recommend no treatment at first, but will monitor the cancer very closely, so it can be treated if it starts to grow. This is known as ‘active surveillance’.

If the cancer is more advanced and has spread, a range of treatments can be used to control the cancer and manage any symptoms. These may include medicines that target the cancer cells (targeted therapy), radiotherapy and/or medicine to stimulate your own immune system fight the cancer (immunotherapy). Chemotherapy is rarely used for kidney cancer.

Living with kidney cancer

You can live a healthy life with just one kidney. If you have had a kidney removed due to cancer, you will need to take care of your remaining kidney. It is important to reduce your risk of developing conditions that can affect your kidney such as high blood pressure, heart problems and diabetes. You can do this by:

• avoiding or quitting smoking
• maintaining a healthy diet
• keeping physically active
• limiting your alcohol intake

If you have had a lot of kidney tissue removed (usually more than one kidney), you may need to have regular kidney dialysis to clean your blood. This may mean regular visits to hospital.

After you have been treated for cancer, it is normal to feel afraid that the cancer will return. If you are struggling, it is important to seek support from your doctor, a therapist or other people who have gone through cancer.