Health Encyclopedia

Renal cell carcinoma

Definition

Renal cell carcinoma is a type of kidney cancer in which the cancerous cells are found in the lining of very small tubes (tubules) in the kidney.

Alternative Names

Renal cancer; Kidney cancer; Hypernephroma; Adenocarcinoma of renal cells; Cancer - kidney

Causes, incidence, and risk factors

Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in people 50 - 70 years old, and typically affects men.

The exact cause is unknown.

Risk factors include:

Dialysis treatment
Family history of the disease
Genetics
Smoking
Von Hippel-Lindau disease (a hereditary disease that affects the capillaries of the brain)

Symptoms

Abdominal pain
Abnormal urine color (dark, rusty, or brown)
Back pain
Blood in the urine
Emaciated, thin, malnourished appearance
Enlargement of one testicle
Flank pain
Swelling or enlargement of the abdomen
Unintentional weight loss of more than 5% of body weight

Other symptoms that can occur with this disease:

Sometimes both kidneys are involved. The cancer spreads easily, most often to the lungs and other organs. About one-third of patients have spreading (metastasis) at the time of diagnosis.

Signs and tests

Palpation of the abdomen may show a mass or organ enlargement, particularly of the kidney or liver. Men may have a varicocele in the testicles. (A varicocele that is only on the ride side is especially suspicious.)

Tests include:

Complete blood count (CBC)
IVP
Kidney x-ray
Liver function tests
Renal arteriography
Serum calcium
SGPT (also called ALT) and alkaline phosphatase
Ultrasound of the abdomen and kidney
Urine cytology
Urine test

The following tests may be performed to see if the cancer has spread:

Treatment

Surgical removal of all or part of the kidney (nephrectomy) is recommended. This may include removing the bladder or surrounding tissues or lymph nodes.

Radiation therapy does not usually work for renal cell carcinoma and, therefore, is not often used. Hormone treatments may reduce the growth of the tumor in some cases.

Chemotherapy is generally not effective for treating renal cell carcinoma. The drug interleukin-2 is effective, but toxic to patients. Other chemotherapy drugs have been used, but survival rates are short.

Current therapies include sorafenib (Nexavar), sunitinib (Sutent), and temsirolimus (Torisel). The biologic drug bevacizumab (Avastin) has also been used.

A cure is unlikely unless all of the cancer is removed with surgery.

Support Groups

You can ease the stress of illness by joining a support group whose members share common experiences and problems. See cancer - support group and kidney disease - support group.

Expectations (prognosis)

The outcome depends on the degree of cancer spread. The survival rate is highest if the tumor is in the early stages and has not spread outside the kidney. If it has spread to the lymph nodes or to other organs, the survival rate is much lower.

Complications

Hypertension
Spread of the cancer

Calling your health care provider

Call your health care provider any time you see blood in the urine. Also call if you have any other symptoms of this disorder.

Prevention

Stop smoking. Follow your health care provider's recommendations in the treatment of kidney disorders, especially those that may require dialysis.

References

US Food and Drug Administration. FDA Approves New Treatment for Advanced Kidney Cancer. Rockville, MD: National Press Office; December 20, 2005. Press Release P05-107.

Kidney Cancer. NCCN Clinical Practice Guidelines in Oncology. National Comprehensive Cancer Network. 2008. Accessed June 10, 2008.

Review Date:6/10/2008
Reviewed By:David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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