Kidney Cancer: Symptoms, Causes, Treatments & More!

Introduction

Kidney cancer is becoming more common worldwide, with about 400,000 new cases each year and nearly 175,000 deaths¹. 

The kidneys are two bean-shaped organs located on either side of the vertebral column, in the back side of abdominal wall, with the right kidney placed slightly lower than the left due to the presence of the liver. Each kidney is partly protected by the lower ribs and surrounded by fat covering. 

The kidneys filter waste products and extra water from the blood to produce urine, help regulate blood pressure, and signal the bone marrow to make red blood cells². 

Kidney cancer develops when cells in the kidney begin to grow uncontrollably³. This article focuses on the symptoms, possible kidney cancer causes/risk factors, and treatment options for kidney cancer, aiming to educate readers and support informed decision-making. 

What is Kidney Cancer?

Kidney cancer is a disease that develops when abnormal cells in the kidneys begin to grow out of control. It usually appears as a solid tumour (lump) in one kidney, though in some cases, tumours can develop in both kidneys⁴. These tumours often start small but can grow larger and spread to other parts of the body, causing severe complications⁵. 

Types of Kidney Cancer

The most common types of kidney cancer include⁴: 

• Clear Cell Renal Cell Carcinoma (CCRCC): This is the most common type, making up 70 to 80% of cases. It usually appears as a single tumour in one kidney and is yellow in colour due to fat in the cells (may have areas of bleeding or dead tissue). Under the microscope, the cells look clear or sometimes pink.  
• Papillary Renal Cell Carcinoma (PRCC): This type accounts for 10 to 15% of kidney cancers. It can occur in one or both kidneys and may involve multiple tumours. Type 1 has small cells arranged in finger-like patterns and tends to grow more slowly, while Type 2 has larger, more abnormal cells and often grows more aggressively.  
• Chromophobe Renal Cell Carcinoma (ChRCC): This type makes up about 5% of cases. It develops from cells in the kidney’s collecting ducts, and the tumours may look orange with large cells and clear halos around the nucleus. 
• Collecting Duct (Bellini Duct) Carcinoma: This is very rare, making up 1% or fewer of kidney cancers. It starts in the inner part of the kidney (medulla) and has irregular gland-like structures surrounded by fibrous tissue. It is usually aggressive. 

Kidney Cancer Symptoms

People with kidney cancer may have no symptoms or several symptoms. Some commonly observed kidney cancer symptoms are²: 

• You feel unusually tired much of the time. 
• You do not feel like eating. 
• You lose weight without trying. 
• You have a general feeling of being unwell. 
• You have fevers that keep coming back without a clear reason. 
• You have ongoing constipation or signs of a bowel blockage. 
• You notice blood in your urine. 
• You feel a lump or swelling in your side, lower back, or abdomen. 
• You have persistent pain in your lower back or side that does not go away. 

Note: These signs can also be caused by many other conditions. Therefore, it is important to see a doctor if these symptoms appear. 

Kidney Cancer Causes and Risk Factors

Kidney cancer develops due to DNA damage, leading to uncontrolled cell growth, forming a tumour. While many factors do not directly cause kidney cancer, they can increase the likelihood of DNA damage in kidney cells, which may eventually lead to cancer⁶. 

Key risk factors include: 

• Increasing age (especially over 60 years)⁷ 
• Smoking tobacco⁶ 
• Being overweight or obese⁶ 
• Consuming alcohol⁷ 
• Exposure to chemicals like trichloroethylene (used in metal degreasing)² 
• Long-term use of certain pain medications^2,6 
• High blood pressure or its treatments²
• Diabetes⁷ 
• Chronic hepatitis C infection²
• Kidney stones² 
• Family history of kidney cancer⁶ 
• Inherited genetic conditions such as von Hippel-Lindau disease or sickle cell trait^2,6 

Stages of Kidney Cancer

There are four kidney cancer stages based on tumour size and its spread to other nearby areas⁵: 

• Stage I: Tumour is 7 cm or smaller and confined to the kidney. 
• Stage II: Tumour is larger than 7 cm but still only in the kidney. 
• Stage III: Tumour may be smaller or larger, but cancer has spread to nearby lymph nodes or extends into major veins or surrounding fat (but not beyond the kidney’s protective layer). 
• Stage IV: Tumour extends beyond the kidney to nearby organs, the adrenal gland, or the large veins, or cancer has spread to distant organs. 

Diagnosis of Kidney Cancer

When kidney cancer is suspected, doctors use a combination of laboratory tests, imaging, and sometimes biopsy to confirm the diagnosis and plan treatment⁵.

• Laboratory Tests: 
  • Urinalysis and urine cytology: Check for blood in the urine and help rule out other urothelial tumours. 
  • Blood tests: Complete blood count (CBC) and erythrocyte sedimentation rate (ESR) assess anaemia and platelet levels. 
  • Kidney function and electrolytes: Evaluate kidney health and guide the safe use of contrast for imaging. 

Note: Liver function tests, serum calcium, and other tests may be done based on symptoms. 

• Imaging Tests: 
  • Ultrasound: Often the first test to visualise the kidney. 
  • CT scan/PET-CT: Assesses tumour size, stage, and spread to other areas. 
  • MRI: Useful for detecting tumour invasion into veins or when contrast dye cannot be used. 
  • Chest X-ray or CT: Checks for lung metastasis. 
  • Bone scan and alkaline phosphatase: Detect bone involvement. 
  • CT or MRI of the head: Done if brain metastasis is suspected. 
• Other Tests: 
  • Renal arteriography/venography: Done if the tumour involves large veins like the inferior vena cava. 
  • Genetic testing: Recommended for younger patients or those with a family history of kidney cancer. 
  • Biopsy: Ultrasound- or CT-guided needle biopsy may be used for suspicious or cystic lesions but not routinely required. 

Complications if Left Untreated

Kidney cancer and its treatment can lead to several complications affecting different organs and body functions⁵: 

• Direct effects of the tumour: High blood pressure, constipation, abdominal bloating, or discomfort. 
• Paraneoplastic syndromes: Conditions caused by the tumour, such as high red blood cell counts (erythrocytosis), high calcium levels, liver changes, high platelet counts, and enlarged liver or spleen. 
• Metastasis (spread of cancer): 
• Lungs: breathing problems 
• Bones: pain, fractures, or spinal cord compression 
• Brain: seizures 
• Liver: jaundice or elevated liver enzymes 
• Veins: varicocele 
• Treatment-related complications: Surgery or targeted therapies may cause kidney function problems, high blood pressure, protein in urine, poor wound healing, bleeding, blood clots, heart issues, hormonal problems like hypothyroidism, or neurological symptoms. 

Treatment Options for Kidney Cancer

There are several treatment approaches for kidney cancer. Your doctor and care team will work with you to create a personalised plan, considering factors such as the stage of cancer, overall health, and personal preferences. This may include more than one type of kidney cancer treatment. Available treatment options include⁶: 

• Radiation Therapy: Radiation uses rays (high-energy) that kill cancer cells or slow their growth. External beam radiation targets the tumour from outside the body and may be used for treatment or symptom relief.  
• Immunotherapy: Immunotherapy helps the body’s immune system fight cancer. Common immunotherapy drugs for kidney cancer include: 
  • Avelumab 
  • Ipilimumab 
  • Interferon 
  • Interleukin-2 
  • Nivolumab 
  • Pembrolizumab 

• Targeted Therapy: Targeted therapy uses certain drugs that attack and destroy specific cancer cells. Drugs commonly used include: 
  • Axitinib 
  • Bevacizumab 
  • Sorafenib 
  • Everolimus 
  • Temsirolimus 
  • Cabozantinib 
  • Lenvatinib 
  • Pazopanib 
  • Sunitinib
  • Tivozanib 

• Surgery: Surgery is the most common treatment and may involve removing part or all of the kidney: 
  • Partial nephrectomy: Removes the tumour and some surrounding tissue, preserving as much kidney function as possible. 
  • Simple nephrectomy: Removes the entire kidney. 
  • Radical nephrectomy: Removes the kidney along with the adrenal gland, nearby tissue, and often lymph nodes. 

If both kidneys are removed or are non-functional, dialysis or a kidney transplant may be required. Sometimes, radiation therapy is given after surgery (adjuvant therapy) to destroy any remaining cancer cells. 

When surgery is not possible, other procedures such as the following can be used: 

• Arterial embolisation: Blocks blood flow to the tumour to shrink it. 
• Cryosurgery (cryotherapy): Freezes and destroys cancerous tissue. 
• Thermal ablation: Uses heat to destroy abnormal tissue. 

Note: Your kidney cancer treatment plan will outline the goals, options, possible side effects, and expected duration of therapy. 

Prevention Tips for Kidney Cancer

You can reduce your kidney cancer risk by making healthy lifestyle choices^2,8: 

• Keep a healthy weight by eating a balanced diet and staying physically active. 
• Eat a nutritious diet rich in fruits, vegetables, and fibre, while limiting processed meats. 
• Avoid smoking, or quit if you currently smoke. 
• Limit exposure to harmful chemicals, especially trichloroethylene, which is used in some industrial jobs. 
• Consume alcohol in moderation. 
• Use certain pain medications carefully, as long-term use may increase risk. 
• Manage health conditions that increase your risk, such as high blood pressure and diabetes. 
• Attend regular health check-ups to monitor kidney function and overall health. 

When to See a Doctor?

See your doctor promptly if you notice any of the following^5,6: 

• Blood in your urine.  
• A lump or persistent pain on your side, lower back, or abdomen. 
• Any new or unusual symptoms that concern you, especially if you have risk factors for kidney cancer. 
• Symptoms suggesting tumor spread, such as bone pain, breathing problems, seizures, or jaundice. 

Remember, early evaluation can help detect kidney problems or cancer sooner, when treatment is more effective. 

Conclusion

Kidney cancer is a serious condition, but early detection can significantly improve treatment outcomes.  

Being aware of common kidney cancer symptoms and understanding personal risk factors can help in noticing problems sooner and taking preventive steps. Additionally, maintaining a healthy lifestyle by including a balanced diet, regular exercise, avoiding smoking, and attending routine health check-ups can significantly lower your risk.  

Frequently Asked Questions (FAQs)

References

1. Cirillo L, Innocenti S, Becherucci F. Global epidemiology of kidney cancer. Nephrol Dial Transplant. 2024 May 31;39(6):920-928. Available from: https://pubmed.ncbi.nlm.nih.gov/38341277/ 
2. Centers for Disease Control and Prevention. Kidney Cancer Basics. [Internet]. CDC; [cited 2025 Aug 13]. Available from: https://www.cdc.gov/kidney-cancer/about/index.html 
3. National Cancer Institute. Kidney (Renal Cell) Cancer—Patient Version. [Internet]. NCI; [cited 2025 Aug 13]. Available from: https://www.cancer.gov/types/kidney 
4. Skelton WP, Leslie SW, Guzman N. Renal Mass. StatPearls [Internet]. StatPearls Publishing; Available from: https://www.ncbi.nlm.nih.gov/books/NBK567761/ 
5. Pandey J, Syed W. Renal Cancer. StatPearls [Internet]. StatPearls Publishing; Available from: https://www.ncbi.nlm.nih.gov/books/NBK558975/ 
6. National Cancer Institute. Kidney Cancer Treatment (PDQ®)–Patient Version [Internet]. NCI; [cited 2025 Aug 13]. Available from: https://www.cancer.gov/types/kidney/patient/kidney-treatment-pdq 
7. Scelo G, Larose TL. Epidemiology and Risk Factors for Kidney Cancer. J Clin Oncol. 2018 Oct 29;36(36):JCO2018791905. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6299342/ 
8. Tahbaz R, Schmid M, Merseburger AS. Prevention of kidney cancer incidence and recurrence: lifestyle, medication and nutrition. Curr Opin Urol. 2018 Jan;28(1):62-79. Available from: https://pubmed.ncbi.nlm.nih.gov/29059103/ 
9. PDQ® Pediatric Treatment Editorial Board. Wilms Tumor and Other Childhood Kidney Tumors Treatment. [Internet]. NCI; [cited 2025 Aug 13]. Available from: https://www.cancer.gov/types/kidney/patient/wilms-treatment-pdq 
10. National Cancer Institute. Kidney Cancer Research [Internet]. NCI; [cited 2025 Aug 13]. Available from: https://www.cancer.gov/types/kidney/research 
11. Chandwani KD, Ryan JL, Peppone LJ, Janelsins MM, Sprod LK, Devine K, Trevino L, Gewandter J, Morrow GR, Mustian KM. Cancer-related stress and complementary and alternative medicine: a review. Evid Based Complement Alternat Med. 2012;2012:979213. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3403456/ 

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