Kidney Cancer

There are a few different types of renal cancer:

• clear cell
• papillary (types 1 and 2)
• chromophobe
• oncocytic
• collecting duct.

Less common types of kidney cancer include:

• transitional cell cancer, which develops in the kidney’s lining
• Wilm’s tumour, which is a rare kidney cancer that affects children. 

The exact cause of kidney cancer isn’t completely understood, but there are a number of factors that can put you at risk, including:⁵

• if you’re very overweight or obese (a BMI above 25)
• smoking
• having kidney disease
• faulty genes or inherited conditions
• your family history
• high blood pressure
• drinking alcohol
• if you’ve had thyroid cancer
• having had radiotherapy for another type of cancer
• having had a hysterectomy
• some mild painkillers.

⁵ Cancer Research UK, Risks and causes of kidney cancer. http://www.nhs.uk/conditions/cancer-of-the-kidney/Pages/Introduction.aspx

Symptoms of kidney cancer include:

• blood in your urine
• feeling a lump in your kidney area
• feeling tired
• losing your appetite
• losing weight
• a high temperature and sweating
• pain in your side below the ribs.⁶

The two main symptoms are finding blood in your urine, or feeling a lump or swelling around your kidneys.

Most people who notice these symptoms do not have kidney cancer. But you should get them looked into by a doctor or kidney consultant so you can treat any problems early.

Diagnosing kidney cancer
Because kidney cancer doesn’t always have obvious symptoms, the condition’s often first picked up during a routine check-up.

If you or your GP notices any symptoms of kidney cancer, you’ll need to have a few tests including a blood test and urine sample. Following these tests, you might need a few further tests at a hospital.

• An ultrasound scan lets the consultant see inside your kidneys
• Computerised tomography (CT) scans and intravenous pyelograms (IVP) take detailed images inside your body. You’ll need to drink a special dye or have an injection to make the CT scan clearer
• A cystoscopy uses a tube called a cystoscope to look inside your bladder, which is part of the same body system as your kidneys
• A magnetic resonance imaging (MRI) scan can show if you have a tumour and what size it is.

Stages of kidney cancer
After your tests, your consultant will tell you what stage your kidney cancer is at by looking at a sample of your cancer cells under a microscope. This describes how big your tumour is and how far it’s spread. This will influence the type of treatment you’re offered.

• Stage 1: The cancer is smaller than 7cm and is only inside your kidney
• Stage 2: The cancer is bigger than 7cm, but still only in your kidney
• Stage 3: The cancer has grown into one of the major veins near your kidney called the adrenal gland. But there’s no more than one lymph node with cancer cells in it
• Stage 4: The cancer has grown into the tissue that surrounds the kidney and more than one lymph node has cancer cells in it. Stage 4 might also mean the cancer has spread to another part of your body like the lungs, bones, brain, liver or another kidney. This is classed as advanced kidney cancer, sometimes called secondary cancer or a metastasis.

⁶ Cancer Research UK, Symptoms of kidney cancer http://www.cancerresearchuk.org/cancer-help/type/kidney-cancer/about/symptoms-of-kidney-cancer

The type of treatment you’re offered depends on the type of kidney cancer you have, what stage it’s at and whether the cancer has spread.

Surgery
Surgery is the main kidney cancer treatment that’s contained to the kidney. In stage 1 and 2 kidney cancers, surgery can often remove the cancer. Sometimes, stage 3 kidney cancer can be treated by surgery too.

During surgery, surgeons will try to remove the tumour and leave as much of your kidney as possible.

But if the cancer is too large – bigger than 7cm – your surgeon may remove the whole kidney.

Radiofrequency ablation (RFA)
If you are not fit for surgery and you have an early-stage cancer, your consultant might recommend that you have radiofrequency ablation. This treatment uses heat made by radio waves to remove cancer cells from your body. This type of kidney cancer treatment means no incision is needed.

Freezing therapy
Also called cryotherapy, this is when a surgeon freezes the cancer cells in your kidney by using a cryotherapy probe to get rid of them. It’s an option for people who can’t have surgery because of other medical problems.

For some people, kidney cancer comes back after surgery. If this happens, your consultant might recommend you have the cancer removed with surgery. Or you might be recommended certain medicine to try and lower the chance of the cancer returning.

Systemic therapy
Systemic therapy uses anti-cancer medication to treat cancer cells in the body. It’s often given as a tablet, but may also be delivered into the bloodstream via a drip. If the kidney cancer is at an advanced stage (metastatic), this therapy may be suggested by a consultant, but this does depend upon the type of kidney cancer.

After treatment
You’ll have regular check-ups following your treatment. How often and for how long depends on the kind of treatment that you had.

At follow-up appointments, your doctor will ask how you’re feeling and examine you. You might also need a blood test, chest X-ray, CT scan, ultrasound or a combination.

If you’re worried or spot any new symptoms between appointments, you should tell your consultant as soon as you can.

Paying for your treatment 
You have two options to pay for your treatment – your costs may be covered by your private medical insurance, or you can pay for yourself. Check with your private medical insurer to see if your diagnostic costs are covered under your medical insurance policy. If you are paying for your own treatment the cost of the procedure will be explained and confirmed in writing when you book the operation.

Ask the hospital for a quote beforehand, and ensure that this includes the consultants’ fees and hospital charges for your diagnostics and procedure.

Want to know more?
If you’d like to read more about kidney cancer, treatment or living with kidney cancer, please visit cancerresearchuk.org.uk.