Kidney Cancer

Kidney cancer is cancer that originates in the kidneys. The kidneys are bean-shaped organs, each about the size of your fist, that are located behind your abdominal organs; one kidney sits on each side of your spine and they are protected by your lower rib cage. The tubes inside the kidneys filter and clean your blood, taking out waste products and making urine. Kidney cancer forms in the lining of tiny tubes inside your kidneys.

Kidney cancer is among the 10 most common cancers in both men and women. Overall, the lifetime risk for developing kidney cancer is about 1 in 63. This risk is higher in men than in women.

Kidney cancer becomes more likely as you age. The average age of people when they are diagnosed is 64. Kidney cancer is very uncommon in people younger than age 45.

Other risk factors for kidney cancer include smoking, having certain genetic conditions, and misusing pain medicines for a long time.

Treatment for kidney cancer depends on your age, your overall health, and how advanced the cancer is. Treatment might include combinations of surgery, chemotherapy, radiation therapy, biologic therapy, or targeted therapies.

Kidney cancer does not usually cause signs or symptoms until later in the course of the disease, but sometimes symptoms can appear sooner and lead to an early diagnosis. If the cancer is found at an earlier stage, treatment might be more effective.

See your health care provider if you notice any of the following symptoms:

• blood in your urine
• a lump in your abdomen
• weight loss for no reason
• back pain in your side that does not go away
• loss of appetite
• intermittent fever

It is not clear exactly what causes kidney cancer. In general, cancer occurs when cells in your kidney develop errors (mutations) in their DNA. The errors make cells grow and divide out of control. The accumulating abnormal cells form a tumor in the kidney that can grow to invade nearby structures and spread to other parts of the body.

Factors that increase your risk of kidney cancer include:

• older age
• smoking
• obesity
• high blood pressure (hypertension)
• treatment for kidney failure such as long-term dialysis
• certain inherited syndromes such as von Hippel-Lindau disease, Birt-Hogg-Dube syndrome, tuberous sclerosis. and familial papillary renal cell carcinoma

Tests and procedures used to diagnose kidney cancer include:

• blood and urine tests to evaluate your organ functions
• biopsy to remove a piece of the kidney and examine it to looks for signs of cancer
• procedures to create images of the kidney such as ultrasound, computerized tomography (CT) and magnetic resonance imaging (MRI)

Once your doctor diagnoses kidney cancer, he or she works to find the extent (stage) of your cancer. Your kidney cancer's stage helps determine your prognosis and your treatment options.

The stages of kidney cancer are:

• Stage I. At this stage, the tumor can be up to 2 3/4 inches (7 centimeters) in diameter. The tumor is confined to the kidney.
• Stage II. A stage II kidney cancer is larger than a stage I tumor, but it's still confined to the kidney.
• Stage III. At this stage, the tumor extends beyond the kidney to the surrounding tissue and may also have spread to a nearby lymph node.
• Stage IV. Cancer spreads outside the kidney, to multiple lymph nodes or to distant parts of the body, such as the bones, liver or lungs.

If you have or have had kidney cancer, you can take steps to manage the stress that accompanies the diagnosis.

• Learn about kidney cancer so you can make informed decisions about your care.
• Have a schedule of follow-up tests and go to each appointment.
• Take care of yourself so that you are ready to fight cancer. This includes eating a healthy that includes plenty of fruits, vegetables and whole grains, exercising for at least 30 minutes most days of the week, and getting enough sleep so that you wake feeling rested.
• Accept help and support from family and friends and talk with a counselor, social worker, or clergy member.

After kidney cancer is found and staged, your physician will discuss treatment options with you. The treatments will be based on your overall health and the extent and location of the cancer.

Treatment options may include:

• Surgery. Surgery is the standard of care for most kidney cancers. Surgical procedures used to treat kidney cancer include removal of the affected kidney or removal of the tumor from the kidney.
• Ablation and other local therapies. Ablation uses gas or electrical current to destroy the cancer calls. This type of procedure is typically reserved for people who cannot undergo other surgical procedures and those who have small kidney tumors.
• Targeted therapy or immunotherapy. Targeted treatments block specific abnormal signals present in kidney cancer cells that allow them to grow. Immunotherapy or biologic therapy helps the body’s immune system destroy the cancer cells. Drugs such as axitinib (Inlyta), bevacizumab (Avastin), pazopanib (Votrient), sorafenib (Nexavar) and sunitinib (Sutent) block signals that play a role in the growth of blood vessels that provide nutrients to cancer cells and allow cancer cells to spread. Temsirolimus (Torisel) and everolimus (Afinitor) are targeted drugs that block a signal that allows cancer cells to grow and survive.
• Radiation therapy. Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy: external radiation therapy uses a machine outside the body to send radiation toward the cancer; internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
• Chemotherapy. Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. Chemotherapy options for kidney cancer include:
  • 5-fluorouracil (5-FU)
  • Capecitabine (Xeloda)
  • Floxuridine (FDUR)
  • Gemcitabine (Gemzar)
  • Vinblastine (Velban)