On the list of medical terms we’d rather never hear, cancer is at the top. But when it comes to combating it, knowledge is incredibly powerful. Here, top doctors share the risk factors and symptoms of kidney cancer, plus reveal cutting-edge treatments proven to help fight and even potentially cure this “silent” disease.
What is kidney cancer?
It is more common in men than women, with men accounting for about 60% of cases and women about 40%.
About 90 percent of kidney cancers are renal cell carcinoma, making it by far the most common type, says Thomas E. Hutson, DO, Pharm.D, chief of the Division of Hematology Oncology in the Department of Internal Medicine at Texas Tech University Health Sciences Center (TTUHSC) School of Medicine.
“The second most common is renal pelvis carcinoma, which is a type of urothelial cancer [that starts in the kidney]. Other types of cancer can also occur in the kidney, including lymphoma and neuroendocrine tumors, and the kidney can be a place where cancers from other parts of the body, such as breast cancer, spread.
While anyone can develop kidney cancer, awareness is key, whether you’re tracking your own risk factors or following real-life stories like the soap and Great American Family star Cameron Mathison’s recent diagnosis and recovery journey.
Kidney cancer is on the rise
In the United States, about 75,000 cases of renal cell carcinoma are diagnosed each year, and that number is increasing annually, Dr. Hutson notes. “There are also geographic differences in incidence. For example, renal cell carcinoma appears to be more common in people of Northern European descent, although it can occur in other populations.”
Kidney cancer symptoms are ‘silent’
The most common way kidney cancer is found is actually not by symptoms like blood in the urine, a mass, or pain, reveals Steven Campbell, MD, PhD, chair and professor of urology at West Virginia Medical University. “Most cases are discovered incidentally, either during imaging for unrelated medical problems or when patients have very nonspecific complaints that lead to evaluation.”
A patient with a history of lung cancer, for example, might come in for a follow-up CT scan to monitor their lungs, he continues. “Sometimes part of the kidney is captured in the scan and a mass is detected completely by accident, without any symptoms.”
There are no routine tests for this disease
One of the challenges with kidney cancer is that, unlike other common cancers, we don’t have a reliable screening test or biomarker, adds Eric A. Singer, MD, MA, MS, FACS, FASCO, urologic oncologist and professor of urology and bioethics at The Ohio State University College of Medicine.
“For example, women have mammograms to detect breast cancer, and both men and women undergo colonoscopy to detect colon cancer. But there is no routine screening test or blood test for kidney cancer.”
However, kidney tumors are detected earlier
It’s important to note that not all kidney tumors or masses are cancerous, he points out. “But usually anyone with a solid, ‘growing’ kidney mass should be evaluated. Enhancement means that during imaging, such as a CT or MRI scan, a contrast agent is injected through an IV to help the radiologist see structures inside the body more clearly.
Kidney tumors that enhance or become brighter after contrast is given are the ones we are most concerned about, as this may indicate kidney cancer.”
Indeed, imaging technology has come so far that what was once called the “terrible triad” of more advanced kidney cancer symptoms — blood in the urine, flank pain and an abdominal mass — is largely a thing of the past, Dr. Singer adds.
“Most people don’t present that way anymore because we’re able to detect kidney tumors much earlier. For many reasons, it’s less common for patients to have very large kidney masses, but it still happens.”
3 risk factors for kidney cancer
Here, Dr. Campbell notes three big risk factors that can increase your chances of developing kidney cancer. Fortunately, these can be managed through healthy lifestyle changes, such as eating a balanced diet and keeping active:
That said, the exact cause of kidney cancer remains unknown in most cases, notes Dr. Hutson, who points out some additional factors that increase the risk of the disease:
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Exposure to petroleum products and insecticides such as Agent Orange
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Renal cysts acquired in patients with end-stage renal disease
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Certain occupational links (The International Association of Fire Fighters recognizes kidney cancer as an occupationally associated cancer due to their routine and unavoidable exposure to dangerous carcinogens in their work.)
4 treatment options for kidney cancer
A biopsy may be performed to determine if a mass is cancerous. “For small masses, there’s about a 70 to 80 percent chance it’s malignant,” Dr. Singer reveals, adding that this means there’s a 20 to 30 percent chance it’s malignant. not cancer, which is a pretty good chance. “If I had a 20% chance of winning the lottery, I’d probably play a lot more often.”
If it turns out to be malignant, the main treatment for localized kidney cancer is surgery, Dr. Campbell says. “This is either what we call a radical nephrectomy, where we remove the entire kidney, or a partial nephrectomy, where we operate and remove the tumor and a small margin of normal kidney around it and save as much of the remaining kidney as possible.”
Other treatments for kidney cancer include:
Active surveillance
“When it comes to a small kidney mass, we have options like surveillance—just watching to see if it’s going to change or grow over time,” says Dr. Singer, noting that most kidney tumors grow very slowly.
Ablation
Sometimes, for patients with small tumors (under 4 cm), an interventional radiologist may do a percutaneous — through the skin — procedure called ablation, in which he freezes or heats the tumor to destroy it, Dr. Singer reveals. High-dose radiation can also be used in selected cases, he adds.
Histotripsy
“We have a new technology called histotripsy, which uses sound waves to create microbubbles in tumor cells, destroying them by causing them to pop,” says Dr. Singer, explaining that this technology has only recently been tested in kidney cancers and is currently awaiting FDA approval.
Immunotherapy
For about 20 percent of kidney cancers that are metastatic—or have spread to other parts of the body—immunotherapy is the main treatment. These drugs are usually given every three weeks and work by activating the immune system, helping the body recognize and fight cancer cells, Dr. Campbell explains.
The other main treatment for metastatic kidney cancer is targeted therapy. “Kidney cancer is interesting because the most common type secretes substances that stimulate the growth of blood vessels, a process called angiogenesis.
Essentially, the cancer tricks the body into growing more blood vessels, increasing blood flow to the tumor. These drugs, called angiogenesis inhibitors, block those substances that activate blood vessels,” essentially cutting off their food supply.
Kidney cancer outcomes are improving
“While most patients with advanced kidney cancer are still incurable, when we first entered the field, they would only live an average of one year,” says Dr. Campbell. “Now, quite often they’ll live three to four years. And many of them will live much longer than that — about eight to 10 years, and a small percentage will essentially be cured by these drugs.”
More stories about kidney health:
Feel More Energized and Less Bloated: 9 Natural Ways to Support Your Hard-Working Kidneys
If you notice your nails changing this color, it could be an early warning sign of kidney disease
The 7 best ways to prevent kidney stones, according to doctors
This content is not a substitute for professional medical advice or diagnosis. Always consult your doctor before following any treatment plan.