This booklet has been prepared to help you understand more about kidney cancer. It is mainly about the two most common types of kidney cancer in adults, renal cell carcinoma and urothelial carcinoma.
Understanding Kidney Cancer - A guide for people with cancer, their families and friends.
What is kidney cancer?
Kidney cancer is cancer that starts in the cells of the kidney. The most common type of kidney cancer is renal cell carcinoma, accounting for about 90% of all cases.
There were 3185 new cases of kidney cancer diagnosed in Australia in 2014. Kidney cancer is more common in men - the risk of being diagnosed by age 85 is 1 in 50 for men compared to 1 in 98 for women.
In 2015, there were 961 deaths resulting from kidney cancer in Australia.
Kidney cancer symptoms
In its early stages, kidney cancer often does not produce any symptoms. Many kidney cancers are found ‘incidentally’ when imaging is performed for other symptoms. Symptoms may include: • blood in the urine (haematuria) • pain or a dull ache in the side or lower back that is not due to an injury • a lump in the abdomen • constant tiredness • rapid, unexplained weight loss • fever not caused by a cold or flu.
Causes of kidney cancer
The causes of kidney cancer are not known, but factors that put some people at higher risk are: • smoking • overuse of pain relievers containing phenacetin (this chemical is now banned) • workplace exposure to asbestos or cadmium (construction workers, dock workers, painters and printers) • a family history of kidney cancer • being overweight or obese • high blood pressure • having advanced kidney disease • being male: men are more likely to develop kidney cancer than women.
Diagnosis for kidney cancer
Tests to diagnose kidney cancer include:
A urine test will look for traces of blood or other abnormalities in your urine.
A blood sample may be taken to check for changes that could be caused by kidney cancer. It will also identify the number of different types of blood cells present.
Kidney cancer is frequently diagnosed on an ultrasound or CT scan that is done for a completely different reason. If kidney cancer is detected, you may have scans to see if the cancer has spread to other parts of your body, such as an ultrasound, chest X-ray, CT scan, MRI, or radioisotope bone scan.
A core needle biopsy may be used to check for kidney cancer. This will provide a tissue sample which will be examined under a microscope to check for any changes in your cells.
Treatment for kidney cancer
The main treatment for kidney cancer is surgery.
If small tumours are found in your kidney your doctor may recommend active surveillance or observation as it is likely that the tumours will not be aggressive and may not grow in your lifetime. You will have regular ultrasounds or CT scans to monitor the tumours.
Surgery is the most common treatment for kidney cancer.
A partial nephrectomy (removal of part of the kidney) is the preferred option when possible.
A radical nephrectomy (removal of the affected kidney) can be performed also for renal cell carcinoma.
Radiofrequency ablation heats the tumour with high-energy waves in order to kill the cancer cells. Your doctor will insert a needle into the tumour under imaging guidance and an electrical current is passed into the tumour.
Immunotherapy works to enhance your body’s own immune system. Immunotherapy is an option for people with advanced kidney cancer. Cytokines (proteins that activate the immune system) can be given intravenously or orally, and may shrink the cancer.
Your doctor may recommend a targeted therapy if you have advanced kidney cancer or your cancer is growing quickly. Targeted therapies target specific molecules in cells to block cell growth. Targeted therapy drugs are usually given in the form of tablets or intravenously.
Tyrosine kinase inhibitors (TKIs) have been trialled in people with advanced kidney cancer and found to cause fewer side effects than chemotherapy drugs.
Standard radiotherapy is not effective in treating primary kidney cancer but it may be used in advanced kidney cancer to shrink tumours and relieve symptoms.
In some cases of kidney cancer, your medical team may talk to you about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer. As well as slowing the spread of kidney cancer, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiotherapy, chemotherapy or other drug therapies.
Depending on your treatment, your treatment team may consist of a number of different specialist staff, such as: • GP who works with your specialists and can help with treatment decisions • urologist • nephrologist • a medical oncologist • a radiation oncologist • a radiation therapist • nurses • cancer care coordinator • dietician • other allied health professionals, such as counsellor and physiotherapists.
Screening for kidney cancer
There is currently no screening for kidney cancer available in Australia.
Prognosis for kidney cancer
It is not possible for a doctor to predict the exact course of a disease, as it will depend on each person’s individual circumstances. However, your doctor may give you a prognosis, the likely outcome of the disease, based on the type of kidney cancer you have, the test results, the rate of tumour growth, as well as your age, fitness and medical history. In most cases, the earlier that kidney cancer is diagnosed, the better the prognosis.
Preventing kidney cancer
Not smoking or quitting smoking. Up to one third of kidney cancers are thought to be due to smoking.
Understanding Kidney Cancer, Cancer Council Australia, ©2016. Last medical review of this booklet: August 2016.
Australian Institute of Health and Welfare 2015. ACIM (Australian Cancer Incidence and Mortality) Books. Canberra: AIHW.
Australian Institute of Health and Welfare (AIHW) 2017. Cancer in Australia 2017. Cancer