Kidney Cancer

Although a singular cause of RCC is unknown, research indicates several contributing factors, including:

• Cigarette smoking
• Obesity
• Misuse of certain pain medicines
• Genetic conditions

Although most patients have no symptoms, patients should call a doctor if they experience:

• A lump in the abdomen
• Pain in the flank or side
• Decreased appetite
• Low blood count (anemia)
• Weight loss
• Blood in the urine (hematuria)

Testing usually includes blood work, urinalysis, a CT scan or an MRI, and a biopsy. A CT scan can identify a growth in the kidney. Once the diagnosis is confirmed, further tests (blood test to check the health of the liver, chest X-ray, bone scan) help determine if the cancer has spread beyond the kidney.

Knowing the stage of the disease helps inform the treatment plan:

• Stage I: Growth or tumor no larger than 7 cm found in kidney.
• Stage II: Tumor is larger than 7 cm found only in kidney.
• Stage III: Cancer found in kidney and extending locally into major veins or perinephric tissues.
• Stage IV: Cancer has spread beyond the kidney.

We base our kidney cancer treatment approach on each patient’s situation.

Treatments for local growth (stages I and II) include:

• Active surveillance: Small renal tumors (less than 3cm) and elderly patients with multiple medical issues may elect to take an active surveillance approach, with follow-up to monitor symptoms and physical examination. Repeat imaging will observe the mass for growth and other changes.
• Surgery: Depending on the tumor’s size, the stage of the disease and the overall condition of the patient, the surgeon removes all or part of the kidney surrounding the tumor. This surgery is by far the most common treatment. Minimally invasive techniques using laparoscopy or robotics can often replace larger-incision approaches, reducing pain, hospitalization and recovery time.
• Percutaneous therapy: Small tumors are treated with cryoablation (freezing) or radiofrequency ablation.
• Systemic therapy: Many new and promising immunologic therapies and targeted molecular approaches are available to treat renal cancer that has spread outside the kidney.
• Radiation: CyberKnife® SBRT (stereotactic body radiation therapy) delivers high doses of radiation in a small number of treatment sessions. Kidney cancer typically requires 4 outpatient sessions every other day (excluding weekends) for approximately two weeks.

Metastatic growths (stages III and IV):

• Surgery: While not curative, surgical removal of the kidney prior to starting chemotherapy may enhance the effectiveness of the treatment.
• Chemotherapy and immunotherapy: New treatments are available for RCC, with encouraging results in initial studies.