Description
Kidney cancer is a malignant tumour that develops in kidney tissue. The kidneys are located toward the back of the abdomen and filter the blood, remove waste and regulate fluid and electrolyte balance. Renal cell carcinoma is the most common kidney cancer in adults, and many small kidney tumours are found incidentally during ultrasound, CT or MRI for another reason.
Early kidney cancer may cause no symptoms. As a tumour grows, a person may develop painless blood in the urine, persistent pain in one side of the back or flank, an abdominal mass or unexplained weight loss. Blood in the urine may also be caused by stones, infection or other urinary disease, but visible blood in the urine always requires prompt medical assessment.
Types
Clear Cell Renal Cell Carcinoma: The most common subtype of renal cell carcinoma.
Papillary Renal Cell Carcinoma: Includes different molecular and pathological subtypes, some of which are associated with inherited syndromes.
Chromophobe Renal Cell Carcinoma: A less common subtype with biological behaviour that differs from other renal cancers.
Urothelial Cancer of the Renal Pelvis: Begins in the lining of the renal pelvis and is classified as urothelial cancer, with a different assessment and treatment approach.
Wilms Tumour: Occurs mainly in children and is different from adult renal cell carcinoma.
Stages
Renal cell carcinoma is usually staged from I to IV using the TNM system, based on tumour size, invasion of surrounding tissue, lymph nodes and distant spread.
Risk Factors
The following factors may increase the risk, but having one or more risk factors does not mean that a person will develop cancer:
Smoking
Overweight or obesity
High blood pressure
Increasing age
Long-term kidney disease or long-term dialysis
Family history of kidney cancer
Inherited syndromes such as von Hippel-Lindau disease or hereditary papillary renal cancer
Long-term exposure to certain workplace chemicals
Symptoms
Early disease may not cause obvious symptoms. Medical evaluation is recommended when any of the following symptoms persist, recur, or gradually worsen:
Painless blood in the urine, which may appear pink, red or tea-coloured
Persistent pain on one side of the back or flank
A lump in the abdomen or flank
Unexplained weight loss
Persistent fatigue or anaemia
Unexplained fever
Loss of appetite
Sudden development of a varicocele in men
Diagnosis
Diagnosis usually combines medical history, physical examination, imaging, laboratory tests, and pathology. The exact tests are selected by the doctor according to the individual case.
Urine and Blood Tests
Urinalysis to confirm blood and help exclude infection
Full blood count, kidney and liver function tests, and blood calcium
Imaging
Kidney ultrasound
Contrast-enhanced CT as a commonly used assessment tool
MRI for selected patients or to assess blood-vessel involvement
Tissue Diagnosis
Some kidney masses can proceed directly to surgery based on imaging
Needle biopsy when confirmation is required or before ablation or systemic treatment
Staging Assessment
Chest imaging and, when indicated, bone scan, brain MRI or other tests
Genetic counselling and testing when hereditary risk is significant
Facts (FAQ)
Q: Does blood in the urine always mean kidney cancer?
A: No. Stones, infection, prostate disease and bladder conditions can also cause blood in the urine, but visible blood should always be assessed promptly.
Q: Are all kidney masses malignant?
A: No. Kidney cysts and some solid tumours are benign. Assessment depends on imaging features, size and biopsy when required.
Q: Can a person live normally after one kidney is removed?
A: Many people can live normally when the remaining kidney functions well, although long-term blood pressure and kidney function monitoring are important.
Q: Does every small kidney tumour need immediate surgery?
A: Not necessarily. Depending on age, other health conditions, tumour size and growth rate, active surveillance, ablation or surgery may be considered.
Q: Can kidney cancer be cured?
A: Kidney cancer confined to the kidney has a good chance of long-term control after surgery or other local treatment. Metastatic kidney cancer usually requires systemic therapy.
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*Disclaimer: The effect of treatment varies from person to person. The information on the website of Modern Cancer Hospital Guangzhou is for reference only, and cannot be used as the basis for medical diagnosis and treatment, nor can it replace the doctor's diagnosis and treatment. For more details, please review the Liability Clause.
